Equity, democracy and globalization

Abstract

Pragmatic moves have been proposed to democratize deliberation about health care within states while putting aside questions of equity. Wealthy countries are being advised that they must, in the context of globalization, adopt stringent market-led disciplines, long familiar to less developed countries subject to structural adjustment programmes. Decisions affecting inequalities in health are being made by undemocratic trans-national regulatory organizations pursuing a market based project, including the World Trade Organisation (WTO). Inequalities in income and health are pronounced in the United States, where market liberalism is entrenched. Accounts of globalization differ regarding the scope attributable to individual states to carry out sustainable redistributive policy. Critics of free-market globalization argue that states can co-operate to challenge democratic deficits in trans-national regulatory bodies to counter the growth in inequality.