Ideological assumptions of Chile’s international migrant healthcare policy: A critical discourse analysis

ABSTRACT

In the current historical moment of rewriting the Chilean Constitution, there are new hopes for producing a different socio-legal, political-economic and public health order. The Chilean case holds important implications for global health practitioners, researchers and policy-makers because it clearly shows both the impacts of neoliberal processes on a worldwide scale and neoliberal policy responses. This article contributes to the field of global health policy critical analysis by offering scrutiny of Chile’s international migrant healthcare policy from the perspective of its ideological assumptions. We apply Fairclough’s analytical perspective to the Chilean migrant healthcare policy, identifying its components, argumentative premises and ideological assumptions that contribute to the reproduction of the processes of social determination. It allows us to identify bias mobilisation, exclusion, and subordinate inclusion processes that systematically lead to the omission of structural processes in the social determination of migrants’ healthcare, contributing to their reproduction. We conclude by problematising the place of academia in said reproduction to the extent that the concepts and premises they use remain in the ideological territory of exclusion of the structural defined by the policy, disconnecting reflection and action in the health field from collective demands.

KEYWORDS:

• Public policy
• critical discourse analysis
• interculturality
• neoliberalism
• social determinants of health

Acknowledgement

The authors would like to thank Mike Harvey, Joel Ferral and Kavya Nambiar for their support in proofreading this article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Throughout the text, inverted commas mark off a word or phrase that is being discussed. Given that those concepts are widely used in the Policy text it would be awkward to try to indicate all of the pages on which they appear.

2 Neoliberal multiculturalism is a governmental rationality that administrates cultural difference through its recognition and valorisation. The policies emanating from such multiculturalism have three main characteristics: they are presented as politics of recognition; they encourage the participation of civil society; and they render invisible the neoliberal production of inequality (Díaz-Polanco, 2007; Piñones-Rivera et al., 2017).

3 It is worth noting that there is also no mention of the global political determinants of health (Forman, 2019; Gore & Parker, 2019).

Additional information

Funding

This work was funded by the FONDECYT Postdoctoral Project 3180173; Agencia Nacional de Investigación y Desarrollo, Chile.