Health Inequalities and Neoliberalism: Corrupting the Gift and Breaking the Social Contract.
Irelandís health care system is a deeply inequitable two-tiered arrangement in which the privately insured receive swifter access to care than those without insurance. Health forms a core part of any welfare state and is key to what is known as the social contract. This paper presents original research that offers a unique perspective on the Irish health care system using a historical genealogical approach. Through a number of key case studies the origins of the current status of Irish health care are traced; a method that is informed by the work of Michel Foucault. This novel approach enables an interrogation of surrounding discourse and contributes to an understanding of contemporary neoliberal circumstances. While this research paper presents Irish case studies, there is a universal application of the approach taken to many other social systems and countries.
The core concepts of the social contract, the gift relationship, and solidarity are used to construct a unique theoretical framework upon which the case studies are positioned. An examination of the cases through the lenses of this significant body of literature opens up new ground in terms of health policy analysis. The case studies examined are effective as they serve as exemplary demonstrations of the subtle, yet significant, impact on society when the social contract is broken and when solidarity is eroded.