Organizing Consent Via Conceptual Stretching: The New Universalism, Financialization and Healthcare Provision

This paper critically evaluates the growing popularity of the so-called New (or Targeted) Universalism, associated with an ongoing restructuring of the provision and financing of healthcare systems since the mid-1990s. The financialization of contemporary capitalism, manifested in the increased involvement of financial investors in healthcare provision and financing systems, undergirds the development of both phenomena.

Drawing on field research with financial investors, healthcare professionals, policy and decision-makers, this research analyzes the common features and outcomes of the two distinct pathways of financialization in the Turkish healthcare system, namely a) share acquisitions in private hospitals and b) infrastructure loans provided to public-private partnership hospitals. We present two findings. First, the expansion in health insurance coverage in Turkey and the growth of public healthcare expenditures were essential precursors of financial investments in the Turkish healthcare system. Second, financial investments in the healthcare provision system compounded the inequities in access to standards of healthcare. Combining selective, targeted, minimum healthcare services financed through an earnings-related scheme with discursive references to universal rights and entitlements, the newly established general health insurance system has been central to reifying inequities in access to standards of healthcare and organizing consent to financialized capitalism.