Since the Brazilian Regulatory Agency for Supplementary Health’s (ANS) creation in 2000, health insurance inflation has grown at a much greater pace than general inflation. Indeed, after eighteen years the private health insurance price index was close to double the official inflation index, with its 382% (see here).
The upward course of prices can be interpreted as a response to the problems arising from the escalating costs. Baumol (2012) calls this phenomenon “cost disease”, designating that labor relates differently to production: in the case of the goods, work would be incorporated into the product; in the case of services, labor would be the product being exchanged, making difficult to substitute factors.
The covid-19 pandemic is showing how important universal health systems are. As the virus continues to devastate communities and economies, many governments have started to look at them with different lens. Investing in public health systems should be mandatory, but austerity policies in peripheral countries are still the priority. Moreover, the increasing financialisation of the health sector produces conflicts that constraint the achievement of a truly universal and comprehensive public healthcare. This is what we address in our recent paper, where we argue that lead firms in the provision of healthcare plans seem to have become platforms for the accumulation of wealth by financial investors, a process that is making shareholder value the main guiding principle of firm behaviour.
A good example of such contradictions is Brazil. A universal health system called the Unified Health System (Sistema Único de Saúde, or SUS) was established in the 1988 Constitution. However, it would be misleading to affirm it has provided universal access and comprehensive care: since its inception, SUS faced an inadequate low level of public spending that jeopardized its mission. In the 2000s, the Brazilian government eventually increased public spending in healthcare, but a kind of paradox emerged as it also set up many policies to foster private healthcare and private accumulation in that sector (e.g., health-related tax expenditures).
“Without community there is no liberation, no future, only the armisticemost vulnerable and temporary between me and my oppression.” Audre Lorde to Tony Morrison
Toni Morrison is one of the writers who wrote the most about ‘the home and racial justice’. In her emblematic novel Beloved, set in the post-Civil War South, she tells the story of a young girl murdered by her formerly-enslaved mother, Sethe. Sethe is importantly surrounded by the unheimlich (Freud), the stranger, where the foundations of our ethical judgment on slavery are found. In the United States, in the period 1882 to 1895, approximately one-third to half of the average black mortality rate corresponded to children under the age of five (Bhabha, 2002). We face the dilemma of judging these acts.
Sethe, in an act of love, kills her daughter Beloved to avoid her master’s appropriation of her daughter. Sethe was a pariah in the post-slavery society of the United States. She knew from when she was a slave what it meant for a woman to have her children taken when her breasts were full of milk; that she would have been beaten to exhaustion for others to take her milk. She was raped by her master, as was the case for many of the slaves of Sweet Home; that name itself being a mockery of a plantation that was held under a system of slave laws that collaborated on that tragic fate. If a female slave escapes, there is a double loss; the capacity for reproduction and for manual labor. The slave society must permanently produce new slaves for reproduction (Bidaseca, 2010).
Sethe insistently repeats:”It wasn’t a story to share. They forgot it like a nightmare (…) What should be forgotten before it is shared; what should be hidden and silenced as to not interrupt our present?”. I wondered in my bookPerturbando el texto colonial. Los estudios poscoloniales en América Latina (2010): “This is not an easy story to transmit” but it needs to, as says Bhabha (2002), so that it may be engraved in our subconscious.
Brazil faces boiling social unrest. An institutional crisis breeds entropy into an already stressed social system fraught with inequality, increasing poverty and an escalating number of deaths from coronavirus.
A few days ago, despite another daily mass body count, the country stopped to watch the footage of a 22nd April meeting with President Bolsonaro’s cabinet. The tape release was commanded by a Supreme Court judge in an inquiry into an alleged interference by Bolsonaro in the Brazilian federal policy to protect one of his sons, currently under investigation.
The footage is horrendous to the democratic sensitivities and bitter to any political or civic taste. But I would like to point out one single intervention in the meeting that speaks to the country’s entrapment into its own version of ‘fail-forward’ neoliberalism. It reveals a government fixated in dismantling any piece of State regulation and privatizing any available company owned by the State.
Philip Mirowski has argued in his 2013 book Never Let a Serious Crisis go to waste that cognitive dissonance boosts neoliberal thought to the point that no countervailing evidence can shake its disciples’ convictions of its ultimate truth. No matter how apocalyptical a crisis may seem, there is always reason to blame government intervention for all evils plaguing the Earth.Read More »
Brazil is in a crisis again. The COVID-19 pandemic has spread across the country and political incompetence has led to a massive health crisis. Investment outflows have been rapid and the Brazilian real has depreciated dramatically. The Brazilian economy is set to contract again after three years of weak positive growth.
Brazil’s development bank Banco Nacional de Desenvolvimento Econômico e Social (BNDES) has announced some measures to deal with the financial instability caused by the COVID-19 pandemic. However, these measures are being criticised for being insufficient. Rather than being a temporary policy mistake that can be corrected easily, BNDES’ passive response is linked to the bank’s structural retreat from the economy over the past five years.
During the 2000s, BNDESwasacclaimedas a catalyst ofthe country’s economic growth. Globally, developing countries such as Indonesiasaw the rise of BNDES as something favourableand sought to mobilise their own national development banks.
In recent years, state capitalism has become an important buzzword in the development economics discussion (again). In view of the very different ways in which this term is used, Ilias Alami and Adam Dixon recently highlighted the dangers of using the term too loosely in an article in Competition and Change. In view of its recent popularity, state capitalism could suffer a similar fate to the terms “neoliberalism” or “financialisation” by becoming a very loose rallying cry without any significant analytical value. To overcome this problematic situation, Alami and Dixon propose that future research should (1) develop a theory of the capitalist state, (2) circumscribe the time horizons of state capitalism, and (3) locate state capitalism more precisely in territorial and geographical terms.
Although I am not sure whether the genius can be put back into the bottle by developing a unified theory of the state (too many different theoretical traditions are involved by now), I am very sympathetic to the latter two demands. Our recently published book “State-permeated Capitalism in Large Emerging Economies” (Routledge) is a modest contribution to the latter goals. It deals with the economic development of Brazil, India, China and South Africa between 2000 and 2015. Departing from a “comparative capitalism” perspective, we have developed an ideal type of state-permeated capitalism – as opposed to liberal, coordinated and dependent capitalism – and examined to what extent large emerging markets are approaching this ideal type. Read More »
In April 2012, at the White House on her first visit to the United States since her election in 2010, Brazilian president Brazil Dilma Rousseff scolded advanced capitalist economies for unleashing a ‘tsunami de liquidez’,a ‘liquidity tsunami’, onto the developing world. The expression liquidity tsunami suggests that the sheer scale and volume of financial capital flows to developing and emerging markets had become an issue. It indicates that these quantities were overwhelming and could trigger devastating damages.
This in itself is puzzling. Have we not been told by development economists and practitioners that financial capital flowing into the poorer areas of the world economy is something good and desirable? That one of the main causes of underdevelopment is actually the lack of capital and domestic savings in developing countries, and that this should be compensated with foreign capital inflows? Following this line of reasoning, vast swathes of financial capital flowing into emerging markets surely should be seen as a boon.
And there was some truth to that. The capital flow bonanza from the mid-2000s to late 2013 (coupled with the primary commodity super-cycle) did deliver some benefits to emerging markets. It helped governments fund themselves at better conditions. It provided the material basis for significant redistribution via a number of social policies. It contributed to economic growth performances much higher than over the previous decade. It also made a minority of people much richer in a very short period of time. In sum, the capital flow boom temporarily helped deliver some economic and social gains, and this was instrumental in consolidating social contracts between governments and their populations.Read More »
Earlier this month the final deadline arrived for political parties in Brazil to register their candidates for the presidential election in October 2018. The official launch of candidates allows us to discuss more concretely the political forces and players that will be shaping the election. It means that coalitions, alliances, and vice-president choices have taken place. So we asked, what can be said about the first candidates leading the polls? What are the main political forces underlying this election?
The Brazilian political landscape has been extremely polarised since the impeachment of president Dilma Rousseff in 2016. If the left-right dichotomy has recently been considered blurry or outdated, in Brazil one can argue that, due to the impeachment, this dichotomy has a new face, with the coup winners on one extreme and the coup losers on the other.
The nuances between right and left on the political spectrum have largely been overshadowed due to this dichotomy, with one side leading a moral crusade for a clean and corruption-free country and the other side highlighting the ongoing attack on democracy. The political mayhem reached its peak with Lula’s trial and conviction in April, which has led to a great deal of uncertainty over this period (see recent Lula’s Op-Ed from prison in the NYT).
President Termer may have been able to “keep the markets calm in” throughout such political instability, but Brazil’s economic recovery has been weaker than expected, hardships for many families have increased (see IBGE indicators for increases in income inequality, poverty, unemployment and insecurity) and the country has just set a new record for homicides at 63,880 deaths in 2017, with violence against women also increasing. There is a lot at stake in this election.Read More »