Which of the following reflects a neoliberal approach to economic development?

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Environmental Policy

R. Dolzer, in International Encyclopedia of the Social & Behavioral Sciences, 2001

3.4 Neoliberalism and Environmental Policy

The paradigm of economic neoliberalism raises hopes for more prosperity, but it also raises questions concerning the protection of the environment. The call for a lean state allows for and fosters a liberal economy which has dominated national and international debates in the 1990s and has been reinforced by the globalization of the economy. Inasmuch as free markets by themselves do not price negative environmental effects, economic neoliberalism will have to be combined with governmental or intergovernmental structures equipped and authorized to gather sufficient information and to exercise sufficient authority to protect the environment as a public good. This holds true, in principle, for the national and for the international level.

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URL: https://www.sciencedirect.com/science/article/pii/B008043076704496X

University Choosers and Refusers

Erica Southgate, Anna Bennett, in Widening Higher Education Participation, 2016

Part 1: Choice and the Neoliberal University

Neoliberalism is a ubiquitous feature of western second modernity societies and has been described as: an ideology (Amable, 2011); a pervasive set of discourses (Gaffikin & Perry, 2009); and a new form of political and economic governance (Larner, 2000). Neoliberalism reflects the tenets of classical liberalism (the self-interested individual and free market, laissez-faire economics) but is characterized by intense individualism, consumer sovereignty, freedom and choice, competition, marketization, and modes of governmental and institutional regulation that rely on performativity and audit mechanisms (Olssen & Peters, 2005).

Commentators suggest that neoliberalism has remade universities as corporate entities headed up by knowledge managers who seek to guide an entrepreneurial or enterprise institution to successfully compete in ever-deregulated national and global educational markets (Marginson & Considine, 2000; Peters, 2013). Connell (2013) argues that under neoliberalism education systems “come to stand, not for the common interest and self-knowledge of the society, but for ways to extract private advantage at the expense of others” (p. 106). The human capital function of education is emphasized: individual students should make calculated investments in developing the skills, knowledge and attitudes they need to acquire positional good within local, national, and global markets and this has, according this logic, a positive economic flow effect for the nation state (Rizvi & Lingard, 2011). Choice is a driving concept. It is considered a fundamental property of the individual consumer who possesses the capacity to make unrestrained, rational decisions within the higher education marketplace. Bauman (2000) encapsulates the pervasive logic and irony of this type of individualization and choice when he writes:

“Let there be no mistake…individualization is a fate, not a choice. In the land of the individual freedom of choice the option to escape individualization and to refuse participation in the individualizing game is emphatically not on the agenda…(If people) fall ill, it is assumed that this has happened because they were not resolute and industrious enough in following their health regime; if they stay unemployed, it is because they failed to learn the skills of gaining an interview, or because they did not try hard enough to find a job or because they are, purely and simply, work-shy; if they are not sure about their career prospects and agonize over their future, it is because they are not good enough at winning friends and influencing people and failed to learn and master, as they should have done, the arts of self-expression and impressing others. This is, at any rate, what they are told these days to be the case, and what they have come to believe, so that they now behave as if this was, indeed, the truth of the matter.”

original emphasis, p. 34.

The intensity of individualization in Western societies has been examined by a number of sociologists (for an overview see Brannen & Nilsen, 2005). Beck (1994) suggests that it has led to the emergence of the “choice biography,” a reconceptualizing of biography as self-made, as requiring people to rationally take control of, shape and propel themselves towards their own life goals. This contrasts with the normal or standard biography, where people’s life course is conceived of as more linear and related to their social origin (Brannen & Nilsen, 2005). While subject to considerable debate (Brannen & Nilsen, 2002; Roberts, 2010; Woodman, 2009, 2010), the idea of choice biography does capture something of the logic inherent in the opening quotes where people are compelled to manufacture, self-design, and self-stage their own biographies (Beck & Beck-Gernsheim, 1995), with minimal acknowledgment of the broader economic, social, and cultural constraints that affect choice.

Social theory has long problematized ideas of unfettered freedom of choice. It offers a number of conceptual tools that problematize the idea of choice as a highly individualized expression of freedom and responsibility mediated through calculated action.

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URL: https://www.sciencedirect.com/science/article/pii/B9780081002131000147

Environmental Compliance by Industry

D.G. Holdsworth, in Encyclopedia of Applied Ethics (Second Edition), 2012

The Ascent of Markets

As a philosophical movement, neo-liberalism is often traced back to Friedrich Hayek, and this is both theoretically and historically important. In our context, neo-liberalism can simply be thought of as a general term that refers to the growing valorization of markets as alternatives to traditional forms of governmental regulation, and in that sense it is intimately bound up with the phenomenon of economic globalization. It is critical to recognize that globalization has other dimensions (cultural, social, technological, etc.), but economic and market factors have arguably been the drivers of the actual forms of globalization that have dominated recent events. It is certainly economic globalization and the neo-liberal agenda to promote markets that has constituted the context for regulatory reform.

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URL: https://www.sciencedirect.com/science/article/pii/B9780123739322000855

Women’s Rights

L. Walter, in Encyclopedia of Applied Ethics (Second Edition), 2012

The Right to Development

Coming to the forefront in the 1980s, ‘neoliberalism’ is an approach to the political economy that encourages economic globalization and free trade, deregulation of the private sector by the state, and limitation of state functions and taxation. Even as neoliberal globalization has generated more wealth for some people in developing countries, primarily in East Asia, it has led to economic dislocation for others along with greater concentration of wealth and power and higher levels of inequality that undermine the democratization process. As an approach to national debt and financial collapse, neoliberal policies of the International Monetary Fund (IMF) called for ‘structural adjustment programs’ that cut public spending for social security programs to allocate funds to debt repayment in support of the financial sector. In developing countries, cuts in social services mandated by IMF exacerbated the impacts of gender inequality. Women’s lower literacy rate, greater responsibilities for child care, maternal health issues, fewer employment opportunities, restricted access to land and credit, and limited political power have meant that they have benefited less than men have from globalization and suffered more from cuts in social security. Thus, women and children remain the majority of people in poverty worldwide. Another distressing effect of the increased gender and class inequality has been a rise in levels of human trafficking, mostly in the form of sex trafficking of girls and women.

The 1986 UN Declaration on the Right to Development was, in effect, an acknowledgment that economic and social rights are far from being realized, especially in the global South and among women and children. Coming at the end of the UN Decade for Women, the declaration announced the UN’s intent to make substantial progress on the fulfillment of economic and social rights by ensuring women’s participation in its development projects, both as a strategy for development and as a matter of social justice. In 2000, the UN identified ‘gender equality’ as one of eight Millennium Development Goals to be advanced by the year 2015. Strategic approaches to achieve gender equality have included the establishment of judicial procedures for enforcing economic and social rights and the incorporation of women into the development process at all levels of participation.

A significant criticism of the framing of economic and social rights as the right to development is that such a conception implies that economic and social rights are not entitlements but only aspirations, and that the failure to fulfill them is not an entitlement failure but, rather, an effect of underdevelopment. One reason for this concern is that when conceived of as aspirations, economic and social rights have been distinguished from civil and political rights by the lack of effective measures for bringing violations of economic and social rights before the courts, except as civil rights cases of discrimination against protected classes. For example, if someone did not have anything to eat, she has not been entitled to legal redress from the state, even though she had a right to food. Women’s human rights advocates Florence Butegwa and L. Muthoni Wanyeki, Executive Director of the African Women’s Development and Communication Network, are among Southern leaders who assert that failure to fulfill economic and social rights should be justiciable. That is, it should be subject to redress by the courts under national and international law. Their leadership was instrumental in the UN adoption of the Optional Protocol to ICESCR in 2008. This protocol makes judicial review of individual cases of economic and social rights violations possible under international human rights law in countries that ratify it.

Gender mainstreaming is another international strategy to promote gender equality as a right to development. As formulated in the 1995 Beijing Platform for Action, gender mainstreaming calls for an assessment of the implications for women and men of any proposed laws, policies, or projects, a mandate that the UN Economic and Social Council has applied to all of its development projects. Some women’s rights advocates have questioned whether the gender mainstreaming strategy and its roots in the conceptualization of women’s rights as human rights represent progress in the establishment of women’s rights. They fear that gender mainstreaming may instead co-opt the strong normative basis of women’s rights as entitlements and social justice into a weaker normative position of aspirations for gender equality and development. Skeptics also point out that gender mainstreaming is a strategy mostly limited to state agencies and state-funded projects in an era of declining state power, economic globalization, and privatization. Analyzing gender mainstreaming and the internationalization of women’s human rights in the European Union, Sylvia Walby argues that previous feminist concerns about the patriarchal character of the state have, to a considerable extent, been addressed by the European Union’s gender mainstreaming procedures and by the international normative framework of women’s rights as human rights. Significantly, Walby credits women’s transnational organizations with facilitating the establishment of these conceptual and structural changes and with continuing to monitor them to ensure that their progressive intent is realized.

Walby’s focus is on the European Union, whereas much of the development work to fulfill women’s economics and social rights has been initiated and promoted by women’s organizations from the global South. Although the transnational nongovernmental organizations working on women’s rights to development include representatives from the North, the dynamic center is in the South, where the need for progress on the right to development is most urgent. Many development efforts by women and men in the global South promote ‘sustainable development,’ a form of development that incorporates all types of rights within its framework.

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URL: https://www.sciencedirect.com/science/article/pii/B9780123739322004142

Neoliberalism, the Market and Performativity

M.A. Peters, in International Encyclopedia of Education (Third Edition), 2010

Introduction: The Birth of Neoliberalism

Neoliberalism is a popular label for the doctrine of political and economic liberalism and set of policies, originating in the 1970s, that wielded together classical liberal political theory as exemplified by the Mont Pelerin Society following World War II (WWII) and neoclassical economic theories that became identified with the so-called Chicago school under Milton Friedman, in the 1960s. It is not a unified and coherent doctrine and it has taken on different manifestations at different times and places – sometimes with contradictory results. For an ultimately moral doctrine based on a classical account of political and economic freedom – a marriage of the free market and the open society – paradoxically, beginning with Chile in 1973, administrations and policy regimes based on the minimal state and open global market were brutally established with force and coercion, against the rule of law, and in an antidemocratic way. This imposition became commonplace, during the 1980s, with structural adjustment policies of the International Monetary Fund (IMF) and the World Bank (WB) that forced the transitional economies of Latin America and elsewhere to liberalize trade and monetary systems, to open up their economies, and to privatize state assets and cut-back state welfare.

For analytical purposes, we can postulate several historical stages of neoliberalism:

1.

The development of the Austrian, Freiburg, and Chicago schools in neoclassical economics in the first part of the twentieth century.

2.

The first globalization of neoliberalism with the establishment of the Mount Pelerin Society, in 1947, through the intellectual conduit of Hayek.

3.

The development of the Washington consensus during the 1970s.

4.

The Central Intelligence Agency (CIA)-sponsored coup of Salvador Allende in Chile and the imposition of neoliberal market reforms by General Pinochet.

5.

The New Right ascendancy of the Thatcher–Reagan years during the 1980s.

6.

The emergence of structural adjustment loans and institutionalization of neoliberalism through a series of world policy agencies such as IMF, WB, Organization for Economic Cooperation and Development (OECD), and World Trade Organization (WTO).

7.

The transition to knowledge economy and knowledge for development in the 1990s and beyond.

This article briefly considers the role that Friedrich von Hayek played in contemporary neoliberalism prior to detailing the rise of the New Right and the emphasis on accountability and performativity in education.

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URL: https://www.sciencedirect.com/science/article/pii/B9780080448947005431

It Takes Two People to Tango (or more!)

Janet Dine, in The Changing Face of Corruption in the Asia Pacific, 2017

Abstract

This chapter argues that the prevailing definition of corruption is itself corrupt. It is used to promote neoliberalism by denigrating public institutions. The “Unholy Trinity” of the World Bank (WB), the International Monetary Fund (IMF), and the World Trade Organization (WTO) uses “corruption” as a moral deflection device to disseminate policies of privatization, a small state, the excellence of multinational enterprises, and trickle-down economics. These policies are predicated on selfishness and have led to huge inequality between states and individuals. The true definition of corruption is “decay, degeneration, disintegration and debasement,” and we have seen all of this leading to disintegration and warring factions in neoliberal societies. This is the new reality that has emerged from neoliberal economics.

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URL: https://www.sciencedirect.com/science/article/pii/B978008101109600006X

THE IMF CRISIS AND THE CRISIS OF THE KOREAN LABOUR MOVEMENT

Kevin Gray, in South Korea, 2008

5 CONCLUSION

At the beginning of the 1990s, the Korean labour movement was faced with a new challenge in the form of the double transition to democracy and neoliberalism. Under authoritarianism, the labour movement had been a central pillar of a relatively unproblematic pro-democracy movement. By the beginning of the 1990s, however, increased government repression of militant unionism combined with new opportunities for participation posed a fundamental challenge to the continued viability of militant unionism. The IMF crisis, whilst in many ways represented a heightened form of processes of neoliberalisation already underway, provoked an intense internal debate within the labour movement over what relationship between labour and the democratic political institutions should be. The debate has largely revolved around whether these new institutions provide a means through which the livelihood of workers can be shielded from the processes of profound neoliberal restructuring, or whether participation in such institutions themselves are integral to those processes. The empirical evidence over the past decade appears to suggest that the latter would be a more accurate: social corporatists institutions in the form of the Tripartite Commission have provoked serious divisions within the labour movement between militant and moderate factions, of the kind that could not have existed under the total exclusion of the authoritarian labour regime.

The failure of the Korean labour movement to devise a coherent unified strategy vis-à-vis neoliberal restructuring no doubt reflects the nature of the dilemma posed. The notion that the close study of other cases is likely to produce any easy answer is, however, questionable. In this sense, the debates which have taken over labour union strategy occupy an important place in the wider contemporary discourses that stress Korea's national modernisation, democratisation, graduation to advanced industrialised status, and the emergence of a mature capitalist economy. The question left to the labour movement is the extent to which the labour movement is able to retain an influential actor in the continued transformation of Korean economics, politics. In the past decade since the crisis, the labour movement has unfortunately been something of a passive actor in these processes. The present weakened and internally divided nature of the labour movement suggests that the outlook may not be so bright. Of course, many of the problems that have been faced by the labour movement are out of the movement's control, and are indeed global processes. However, if the labour movement is to regain its former dynamism and historical importance, a key stage in this task will be a deeper understanding of the specifiety of Korea's position within the broader uneven development of global capitalism, the sources of strength and tradition within the Korean labour movement itself, and their changes and continuities between the pre- and post- IMF crisis eras and their implications for labour strategies, and the creative means of establishing solidarity and organisations beyond the core workforce and indeed beyond national boundaries. These are the key tasks that will have to be taken up by the labour movement if it is to retain relevance in the post-IMF era.

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URL: https://www.sciencedirect.com/science/article/pii/B9781843344728500093

Medical Tourism

N. Lunt, D. Horsfall, in Encyclopedia of Health Economics, 2014

Why do People Travel?

As would be expected, globalization has played a significant role in the development of medical tourism. Developments in medical tourism mirror the expansion of markets in health care and embedding of neoliberalism on the world stage. Precipitating the rise of what is seen as a consumerist age marked by lower levels of social solidarity, globalization has advanced the commodification of health care. At the most basic level the advent of the Internet and lowering of travel costs has undoubtedly played a vital role in not only raising awareness of the opportunities for surgery abroad but also making the pursuit economically viable. The freeing of medical services from their traditional territorial boundaries reflects a more transnational and international role for health policy development, with partnerships developing between organizations in established and developing medical markets, transnational companies with an increasing stake in health care in multiple countries, and an emerging role developing for supranational bodies.

In terms of the medical tourism market, the free movement of goods and services under the auspices of the World Trade Organization and its General Agreement on Trade in Services has accelerated the liberalization of the trade in health services, as have developments with regard to the use of regional and bilateral trade agreements. As health care is predominantly a service industry, this has made health services more tradable, global commodities. But that it is easier to travel abroad for care does not fully explain why patients become medical tourists.

The most common explanatory factor cited is that of cost. Indeed it is clear that for those in the US and Western Europe who feel the need to ‘go private,’ the potential cost savings of traveling abroad are huge, with any review of prices showing a potential saving between 30% and 90% depending on the treatment sought (see Boxes 1–4). In terms of familiarity, expatriates often have medical care on their visits back to their ‘home’ country, which would also show up as medical tourism; for example, the large Indian Diaspora in the UK, and the 2nd Generation Mexicans living in the US (see Boxes 4 and 5). In addition, some treatments may not be available or may be subject to a wait in the home country, including the latest technology and techniques. Moreover, some treatments may not be legal in the country of origin. The desire for privacy and wish to combine traditional tourist attractions, hotels, climate, food, cultural visits with medical procedures are also thought to be key contributing factors to the growth in this market. Each of these factors, on their own or in combination, has shifted the direction of medical travel. In the present day not only are India and Thailand top destinations for complex elective procedures but also the very tourists visiting their hospitals, along with those in Poland, South Africa and beyond, are traveling from countries with established and often championed health care systems. Conversely, these championed health systems continue to treat medical tourists at facilities with long-standing reputations (see Box 5).

Box 1

Case study 1

Brazil
Estimated size of industry 50 000 Inward medical tourists per year
Key procedures offered Cosmetic, reproductive, and bypass
Estimated cost saving – for the consumer 45–60%
Key pull factors Cost, quality of care, and range of procedures
Role of state Limited
The Brazilian medical tourism market centers on cosmetic surgery. Indeed there are more plastic surgeons per capita in Brazil than any other country in the world. Studies suggest that the patient-centered nature of care in Brazil, the willingness to offer procedures not available elsewhere, and the reputation for quality are key pull factors in addition to cost. This perceived high level of quality is undoubtedly aided by the proportion of accredited clinics (more facilities accredited than any country other than the US) and partnerships with organizations such as the International Hospital Corporation, which is based in the US.
The Brazilian government plays only a limited role in promoting the industry. Indeed, although health tourism was recognized in the Brazilian National Tourism Plan (2007–10), it was not identified as an area of focus or potential revenue. This undoubtedly reflects the fact that most medical tourists are catered for in private clinics and that as yet, it is estimated that the financial benefits of even the long-established cosmetic industry are relatively modest.

Source: Reproduced from Edmonds, A. (2011). ‘Almost invisible scars’: Medical tourism to Brazil. Signs: Journal of Women in Culture and Society 36, 297–302; Herrick, D. M. (2007). Medical tourism: Global competition in health care. NCPA Policy Reports. Dallas: National Center for Policy Analysis; and Ramírez de Arellano, A. B. (2007). Patients without borders: The emergence of medical tourism. International Journal of Health Services 37, 193–198.

Box 2

Case study 2

Hungary
Estimated size of market Estimated 40% share of European dentistry tourism market. Has been estimated between 400 000 and 1 million medical tourists
Average potential cost saving for the consumer 45%
Major clinical areas Dentistry
Key pull factors Cost, quality, reputation, and location
Role of government Keen to promote the industry and reduce regulatory road blocks
Hungary is an exporter country within the medical tourism market. Its reputation for high quality and low costs makes it, along with countries such as Poland, a genuinely accessible and affordable option close to Western European countries such as Germany and Austria. It has been labeled the dental capital of the world, with a much higher dentist per capita ratio than can be found in neighboring Austria, Germany, or the UK. Indeed it is estimated that between one in two and one in three of all Austrians travel to Hungary to meet their dentistry needs. The Hungarian government has offered much in the way of support for the medical tourism industry, expanding domestic incentives to travel to wellness locations to the foreign tourist market, proclaiming 2003 as The Year of Medical Tourism, and even using its premiership of the EU to promote the medical tourism industry.
Recent years have seen an expansion into the cosmetic surgery market as well as the general medical surgery market. The expansion into other clinical areas is still at a relatively early stage.

Source: Reproduced from Herrick, D. M. (2007). Medical tourism: Global competition in health care. NCPA Policy Reports. Dallas: National Center for Policy Analysis; and Terry, N. P. (2007). Under-regulated health care phenomena in a flat World: Medical tourism and outsourcing. Western New England Law Review 29, 421.

Box 3

Case study 3

Thailand
Estimated size of the market Between 350 000 and 1 million visitors per year
Average potential cost savings for the consumer From 30% to 90% depending on the procedure
Main clinical areas Cosmetic, fertility, dental, gender reassignment, and cardiac
Major pull factors Cost and quality
Role of state Key role in promoting the industry. Legislative role in reducing barriers to the industry
The Thai medical tourism industry is part of the first wave of Asian medical tourism markets to open up and along with Singapore and India represents one of the biggest exporters of medical tourism services. As with most other Asian countries, cost is a key driver of medical tourism with cardiac, cosmetic, and gender reassignment procedures between 60% and 90% cheaper than US prices.
Both business and the government have played major roles in marketing Thailand as a cheap, safe, and relaxing country in which to get the highest standard of treatment. On a practical level, the Thai government has eased visa restrictions on medical tourists and provided funds to support the development of a medical hub in and around Bangkok. Thai hospitals meanwhile have sought to market themselves to the wider world by placing a heavy emphasis on high rates of Thai Joint Commission International accreditation and the reputations of established hospitals such as the Bumrungrad and Bangkok Hospitals.

Source: Reproduced from Chee, H. L. (2007). Medical tourism in Malaysia: International movement of healthcare consumers and the commodification of healthcare. ARI Working Paper (Online) 83. Available at: http://www.ari.nus.edu.sg/docs/wps/wps07_083.pdf; Fedorov, G., Tata, S., Raveslooy, B., et al. (2009). Medical travel in Asia and the Pacific: Challenges and opportunities. Bangkok: UN ESCAP; Herrick, D. M. (2007). Medical tourism: Global competition in health care. NCPA Policy Reports. Dallas: National Center for Policy Analysis; and Whittaker, A. (2008). Pleasure and pain: Medical travel in Asia. Global Public Health: An International Journal for Research, Policy and Practice 3, 271–290.

Box 4

Case study 4

India
Estimated size of the market Conservative estimates suggest an inflow of at least 200 000 medical tourists, though much higher estimates are available
Average potential cost savings for the consumer From 30% to 90% depending on the procedure
Main clinical areas Cosmetic, fertility, orthopedic, and cardiac
Major pull factors Cost and quality
Role of state Key role in promoting the industry. Legislative role in reducing barriers to the industry
The Indian medical tourism industry is a major exporter of medical tourist services. Initially built around treating medical tourists from West Asia and the Middle East, India is beginning to attract an ever-increasing number of European and American medical tourists.
As with most other lower-middle income countries provider countries, cost is a key driver of inward medical travel – cardiac, cosmetic, and even dental procedures can be found between 60% and 90% cheaper than US prices.
Central to the expansion and dominance of the Indian medical tourism market have been both private and public endeavors. The Indian government has relaxed visa laws, introducing a special visa category – an M visa – to cater for the growing number of medical tourists as well as allowing tax breaks to providers. In the private domain, the Apollo Group controls some 50 hospitals and markets these rigorously on the basis of their quality, safety, and in many cases accreditation or partnership with US hospitals. One particular advantage the Indian market has over its Thai and Singaporean counterparts is the large Indian Diaspora, which is increasingly being targeted by marketing campaigns.

Source: Reproduced from Chee, H. L. (2007). Medical tourism in Malaysia: International movement of healthcare consumers and the commodification of healthcare. ARI Working Paper (Online) 83. Available at: http://www.ari.nus.edu.sg/docs/wps/wps07_083.pdf; Ramírez de Arellano, A. B. (2007). Patients without borders: The emergence of medical tourism. International Journal of Health Services 37, 193–198; and Whittaker, A. (2008). Pleasure and pain: Medical travel in Asia. Global Public Health: An International Journal for Research, Policy and Practice 3, 271–290.

Box 5

Case study 5

USA
Estimated size of the market An estimated 43 000–103 000 foreigners travel to the US and 50 000–121 000 US residents travel out. Estimates are as high as 500 000 for outward flows
Average potential cost saving for the consumer Costs in the US are among the highest in the world
Main clinical areas Cosmetic, fertility, orthopedic, and cardiac
Major pull factors Quality
Major push factors Cost and access
The US medical tourism market is more complex than any other, owing much to the fact that it is both an importer and exporter of medical tourists. There are three main import drivers. The first is access to health care within the US. With an estimated 46 million uninsured Americans and one of the most expensive health care systems in the world, many Americans can simply not afford surgery at home. Estimates are as high as half-a-million Americans leave the US as medical tourists every year, largely to Central and South America, but also increasingly to India and the East Asia.
Second, the large number of immigrants in the US, many of whom have demonstrated a preference to return to their home country for care. In particular, the large Mexican Diaspora is an increasing source of outward medical tourists, with some US-based companies even extending their health care cover to procedures undertaken in Mexico.
Third, changing attitudes as seen with the increasing outsourcing of the US medical industry. Although the use of foreign-based radiologists to provide overnight cover for US radiologists may not be directly bound to burgeoning medical tourism market, it is indicative of the changes occurring within the US market and shifting perceptions. There is an increasing acceptance that lower costs elsewhere do not necessarily signal lower quality. A range of employers are sanctioning its employees to seek medical care abroad within the coverage of their health care policies. Many of the facilities treating American medical tourists abroad are controlled by or in partnership with US corporations, many of which are providers of domestic health care.
The motivations for non-US citizens traveling to the US vary, however the high quality of care, international reputation of flagship health care facilities, and high waiting times in neighboring Canada are thought to be key drivers.

Source: Reproduced from Herrick, D. M. (2007). Medical tourism: Global competition in health care. NCPA Policy Reports. Dallas: National Center for Policy Analysis; Keckley, P. H. and Underwood, H. R. (2008). Medical tourism: Consumers in search of value. Washington: Deloitte Center for Health Solutions; Johnson, T. J. and Garman, A. N. (2010). Impact of medical travel on imports and exports of medical services. Health Policy 98, 171–177; Terry, N. P. (2007). Under-regulated health care phenomena in a flat World: Medical tourism and outsourcing. Western New England Law Review 29, 421; and Whittaker, A. (2008). Pleasure and pain: Medical travel in Asia. Global Public Health: An International Journal for Research, Policy and Practice 3, 271–290.

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Introduction

Barney Warf, in E-Government in Asia, 2017

1.1.1 Theorizing e-government

Understanding e-government conceptually involves a journey into the immense thicket of literature concerning the changing nature of the state in late capitalism. An enormous body of work has traced the rise of neoliberalism, mounting global competitiveness, the emasculation of the welfare state, and their linkages to contemporary globalization and international trade, and needs not be recapitulated here. The influential perspective of Castells (1996, 1997)Castells, 1996Castells, 1997 distinguished earlier information societies, in which productivity was derived from access to energy and the manipulation of materials, from later informational societies that emerged in the late 20th century, in which productivity is derived primarily from knowledge and information. In his reading, the time–space compression of postmodernism was manifested in the global “space of flows,” including the three “layers” of transportation and communication infrastructure, the cities or nodes that occupy strategic locations within these, and the social spaces occupied by the global managerial class. Suffice it to say that it is no accident or coincidence that e-government arose on the heels of the microelectronics revolution of the late 20th century, and that it represents part of a broader process by which capitalism has brought the state to heel, including enormous pressures to deregulate, downsize, reduce employment, and improve efficiency.

In the developing world, international donors and actors such as the World Bank, IMF, and USAID have increasingly turned to e-government as a means to promote “good governance.” Combatting corruption is high on the list of expectations for its adoption and implementation. Jane Fountain’s (2001a) Building the Virtual State: Information Technology and Institutional Change has been widely acclaimed for its neoinstitutional analysis of the use of information technology, including virtual agencies and single portals through which citizens can access numerous public services. This last model has been widely adopted in Asia, as shall soon be seen.

The literature on e-government comes primarily from those working within public administration and political science. Many theorizations emphasize various “stages” models ranging from the primitive to sophisticated, or more condescendingly, from the immature to the mature (e.g., Fath-Allah et al., 2014). For example, Holliday and Kwok (2004) differentiate between emerging, enhanced, interactive, and seamless forms of e-government along a continuum. Layne and Lee (2001) offer a four-stage model. Davison et al. (2005) similarly identify a series of steps in the transition from government to e-government, including three models of “maturity” ranging from simple digital presence to full-scale, interactive service delivery. Often metaphors of life stages, evolution, contagion, or learning curves are deployed. Stages, steps, levels, and continuums can be important descriptors of the degree of sophistication of e-government systems, but one must avoid the implication that there is some teleological inevitability behind them, i.e., all countries must march mechanically through a predefined set of stages. Variations and jumping stages are possible and common. Again, there is no single trajectory: national context matters, and it is impossible to understand e-government within its spatiotemporal coordinates.

Perhaps the most common theorization of e-government is the technology acceptance model (TAM), introduced by Davis (1989, 1993)Davis, 1989Davis, 1993. Drawing on a tradition of technological and innovation diffusion, the TAM approach emphasizes how users accept and utilize specific technologies, particularly computer-related ones. It operates at the interface of social and personal psychological variables. Experience, education, cultural norms, and gender roles are part and parcel of this phenomenon, as are personal considerations such as self-assurance. Potential users judge an innovation based on its perceived usefulness and ease of use, including convenience and heightened job performance, all of which may be shrouded in uncertainty. Significant factors that enter into the adoption of a technology include its potential savings in terms of time and cost. Such decisions are also made in light of social pressures from peers and supervisors, and are embedded within the wider context of policies, regulations, and the legal environment. Some assert that the TAM model considers citizens to be little more than consumers, while others stress that the differences are considerable. The TAM approach has often been applied to e-government to understand its variable adoption among countries and groups (e.g., Carter and Belanger, 2005; Hung et al., 2006). This view is not so much wrong as it is self-evident and pays little attention to the roles of power, conflict, class, and inequality in shaping access to all technologies, including the Internet.

E-government is sometimes held to inevitably promote democracy by making governance more transparent (Netchaeva, 2002; Rose, 2004; Prasad, 2012), a claim that mirrors Utopian expectations of the Internet in general. Johnson and Kolko (2010, p. 17) note that “Many current models of e-Government have an unstated assumption that a desire to fulfil democratic functions motivates the creation of e-Government initiatives and that the ultimate goal of e-Government initiatives is increased transparency and accountability.” Certainly there is some merit to this line of thought. The best and most effective forms of e-government have generally been found in democratic societies, which tend to be wealthier ones. E-government may improve trust and accountability, and minimize corruption, and in some cases allow for citizen input and feedback. More efficient e-government raises citizen satisfaction. Yet the extent to which e-government enables democracy, or vice versa, is almost impossible to determine empirically. The relation may be simultaneously determinant, i.e., a two-way street. Moreover, authoritarian governments also use e-government (e.g., China), often to legitimate themselves in the eyes of the populace, without democratic inklings. There is, therefore, more than one trajectory involved here.

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URL: https://www.sciencedirect.com/science/article/pii/B9780081008737000015

Prevention of Violent Conflict by Structural Accommodation

Christian P. Scherrer, in Encyclopedia of Violence, Peace, & Conflict (Second Edition), 2008

NGOs in Conflict Situations

NGOs have become a mass phenomenon only since the mid-1980s. There are three reasons why NGOs have become key players on an international level.

1.

The first condition was set when neoliberalism became state policy in France, under Giscard d’Estaing, as well as in Britain, under the rule of Margaret Thatcher, and in the US after Ronald Reagan was elected in 1980.

2.

Civil society building in Western countries, as a result of the 1968 rebellions, increasingly created a more and more complete network and a parallel infrastructure of civil society institutions which were assuming many functions of state institutions.

3.

Governments created NGOs for intelligence purposes and used them as instruments for activities they could not carry out themselves, especially in situations of intrastate conflict and possible violations of noninterference.

During the 1980s, ‘conflict resolution’ became an issue and developed into an industry in US. Before the mid-1980s assistance in conflict situations, especially in intrastate conflicts, was bound by strict rules. Assistance in war situations was only given after the adversaries agreed to a cease-fire. In the mid-1990s, ‘conflict prevention’ became more and more important. This is a result of large-scale failures of the international system. Effective prevention would make many NGOs jobless. NGOs were increasingly operating in conflict areas under ill-defined and self-appointed multitask mandates that included virtually everything from humanitarian assistance up to conflict resolution.

The crisis in Rwanda was among the most noticeable events to require mounting assistance of NGOs worldwide. The genocide in Rwanda resulted in an unprecedented loss of lives. More than 1 million Rwandans became the victims of the genocidal state machinery which is more than double the casualties recorded for all the violent conflicts in countries such as the former Soviet Union and Yugoslavia since 1990. The genocide in Rwanda sent shock waves throughout the international community. The very role of NGOs in conflict situations came under scrutiny. Some of these organizations were said to have been actively contradicting and precipitating the government’s policy, especially the official policy concerning the internally displaced persons (IDPs). The UN created UNREO, a specialized body to coordinate the 500 INGOs in Rwanda.

Since the electronic media became more and more important for funding of NGOs, the role of the media had to be reassessed. During the period of April–May of 1994, some NGOs such as Caritas or Care International received donations of up to 1.2 million US dollars per day, from deeply concerned citizens, based on the images of refugees beamed into their living rooms by the international news media. The result of these developments is highly ambiguous: in some Third World countries humanitarian aid accounts for up to 50% of the value of the Overseas Development Assistance. The long-term perspective of development as an instrument for conflict prevention is increasingly challenged by short-term NGO activism.

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URL: https://www.sciencedirect.com/science/article/pii/B9780123739858001689

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