Neoliberal Reforms in Public Policy: Ideology and/or Governmentality
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Neoliberal Reforms in Public Policy: Ideology and/or Governmentality"

The past few decades have seen an extensive diffusion of neoliberal ideas across all types of welfare regimes and policy sectors. Not only have the core institutions of central government been reformed to incorporate market-based principles from private management, but various fields of welfare services have similarly witnessed neoliberal waves of reform. Whether in health care, education or labour-market regulation, policy reforms have aimed to create an organizational structure similar to that of the market.

In order for public policies to assume the characteristics of the market, it has been necessary to identify or in many situations create the core components of a market organization such as consumers, providers, goods, and a medium for choice and competition. While being reminiscent of the market, these neoliberal reforms are often not about simply leaving social questions to the private market, but rather about creating market-like structures within the confines of the state and public policy.

The aim of this workshop is to discuss a variety of questions related to the dispersion of neoliberal policies within the context of the welfare state including; What does it involve for the individual citizen to be given and to be subjected to the status as a consumer of welfare? And what does it mean to introduce a competition principle into the existing systems of providing social assistance to groups with special needs? Is there a new type of neoliberal welfare regime on the horizon or would it be more correct to understand it simply as a regression towards the residual model?

The workshop accepts both theoretical and empirical research on neoliberalism and neoliberal policies.

Holger Højlund: Health Promotion in Civil Society Biopolitical government of diversified cultures and communities

During the last 20-25 year, Denmark has witnessed the consolidation of a strong emphasis on preventive health programs that purports to respect local diversity and citizens’ values. This article explores this tendency at the level of national policy programs as well as at the level of local municipalities. It demonstrates two characteristics of this multi-level preventive strategy that break with the so-far dominant approach of public health provision. First, an expansive preventive rationality is supplementing, overlaying, and to some extent challenging the domain which was conventionally delineated by medicine and diagnostic treatment. By this token the knowledge privilege of medicine is supplanted by new constellations of professional disciplines and their values, including pedagogy, therapy, socio-psychology, and anthropology. Second, the national health strategy promotes an explicitly anti-authoritative and non-tutelary approach. It embraces an ethos of involvement, participation and respect for the values represented by citizens and communities. Both national health campaigns and local initiatives seek to sway agents previously unrelated to health issues to take up the goals of preventive health promotion, thereby spanning and dissolving traditional sector boundaries. Theoretically, the article aims to demonstrate the potentials of applying a reading of Foucault which sees biopolitics as  embedded within a governmentality framework in which the municipality is symbolically recoded through a fantasy of localism.

Keywords: Health promotion, biopolitics, governmentality, civil society, fantasy, localism.

Lars Thorup Larsen: Governing Health Care Through Consumer Rights

This comparative case study explores how neoliberal policy ideas play out in two radically different political settings—the Danish and American health care systems. Both countries introduced strong, neoliberal “free choice” reforms in the 1990s and early 2000s.

We use two theories about neoliberalism as our conceptual lenses. One (David Harvey) emphasizes the goal of liberating market capitalism from government regulation and strengthening the power and wealth of business elites. The other (Michel Foucault) emphasizes how market-like social arrangements can be used as governing technologies that can be applied to any area of social relations or public policy. In both countries, policymakers used consumer choice rhetoric and reforms to accomplish both kinds of objectives. In Denmark, with its universal public insurance and predominantly times for non-acute care in public hospitals by allowing private hospitals to compete with them, and thereby increase efficiency. In the U.S., consumer choice reforms were introduced into Medicare, a bastion of public insurance that resembled European social insurance, with equal coverage for all beneficiaries. These reforms were also intended to make the public health insurance system more efficient—specifically to restrain costs—by allowing private insurance plans to compete for beneficiaries. We found some ways that the reforms in both countries did accomplish their objectives— mainly, growing the private sector by giving private business access to public, taxpayer-financed revenues. We found that the goal of governing different actors (patients, doctors, hospitals and insurers) had much more varied results and sometimes was undermined by the goal of expanding the private sector.


Lars Thorup Larsen, Associate Professor, Department of Political Science, Aarhus University.

Kristoffer Stegeager, Region Midtjylland.

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Larsen, Lars Thorup & Deborah Stone: Governing Health Care Through Consumer Rights

Stegeager, Kristoffer: (New) Public management – A history of coming into being

Højlund, Holger: Health Promotion in Civil Society: Biopolitical government of diversified cultures and communities

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Revised 2012.01.15