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The Competition State and the Private Control of Healthcare

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Global Health Governance

Part of the book series: International Political Economy Series ((IPES))

Abstract

Recent remarkable developments in the life sciences and in the provision and politics of healthcare are described and interpreted in writings on the bio-economy, bio-capital and the ‘politics of life itself’(OECD International Futures Programme, 2006; Rose, 2007; Sunder Rajan, 2006). Conspicuous dimensions of these changes, from a political economy perspective, include their global scale and the tendential fusion between science and technology, capital, and the state. Basic biological and medical research, largely funded by governments, is undertaken within international networks permeated by commercial interests, particularly those of the pharmaceutical industry, and economic considerations loom large in the regulation of markets. But politics is not waning — popular expectations, and pressures exercised by civil society organisations (CSOs), impose constraints on the health industries. Indeed, healthcare and pharmaceutical policy are high on political agendas everywhere as governments wrestle with the challenge of reconciling economic objectives — support for the pharmaceutical, biotechnology and related industries — with social policy and the crises of essential drugs and neglected diseases in the developing world. Taken together these contradictory pressures reflect that the state is present and active in the dynamics of the political economy of health, technological development and global health markets.

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Bibliography

  • F. M. Abbott (2005) ‘The WTO Medicines Decision: World Pharmaceutical Trade and the Protection of Public Health’, The American Journal of International Law, 99 (2), 317–358.

    Article  Google Scholar 

  • J. Abraham and H. L. Smith (eds) (2003) Regulation of the Pharmaceutical Industry (Houndsmills, Basingstoke: Palgrave Macmillan).

    Google Scholar 

  • A. Amin (ed.) (2003) Post-Fordism: A Reader (Oxford: Blackwell).

    Google Scholar 

  • Australian Government (2008) Independent Review (PBS), http://www.independentreviewpbs.gov.au/internet/independentreviewpbs/publishing.nsf/Content/home-1

    Google Scholar 

  • M. Benner and H. Löfgren (2007) ‘The Bio-Economy and the Competition State: Transcending the Dichotomy between Coordinated and Liberal Market Economies’, New Political Science, 29 (1), 77–95.

    Article  Google Scholar 

  • R. Boyer (2005) ‘How and Why Capitalisms Differ’, Economy and Society, 34 (4), 509–557.

    Article  Google Scholar 

  • R. Boyer and J.-P. Durand (1997) After Fordism (Basingstoke: Macmillan).

    Google Scholar 

  • V. Bradford Kerry and K. Lee (2007) ‘TRIPS, the Doha Declaration and Paragraph 6 Decision: What are the Remaining Steps for Protecting Access to Medicines?’, Globalization and Health, 3 (3).

    Google Scholar 

  • B. Carlsson (2007) ‘Innovation Systems: A Survey of the Literature from a Schumpeterian Perspective’ in H. Hanusch and A. Pyka (eds) (2007) Elgar Companion to Neo-Schumpeterian Economics (Cheltenham: Edward Elgar).

    Google Scholar 

  • P. G. Cerny (1990) The Changing Architecture of Politics: Structure, Agency and the Future of the State (London: SAGE).

    Google Scholar 

  • P. G. Cerny (1997) ‘Paradoxes of the Competition State: The Dynamics of Political Globalization’, Government and Opposition, 32 (2), 251–274.

    Article  Google Scholar 

  • I. M. Cockburn (2007) ‘Global Innovation in the Pharmaceutical Industry’, National Academies STEP Board Conference on Globalization of Innovation: Emerging Trends in IT, Biopharma and Financial Services.

    Google Scholar 

  • P. Cooke (2004) ‘Regional Knowledge Capabilities, Embeddedness of Firms and Industry Organisation: Bioscience Megacentres and Economic Geography’, European Planning Studies, 12 (5), 625–641.

    Article  Google Scholar 

  • P. Cooke (2007) Growth Cultures: The Global Bioeconomy and its Bioregions (London: Routledge).

    Google Scholar 

  • A. Dickins (2006) ‘Vital Issues and Theoretical Challenges: International Political Economy and the Global Bioeconomy’, GBRG Working Papers No. 7, Norwich: Global Biopolitics Research Group, University of East Anglia.

    Google Scholar 

  • E. Doran and D. A. Henry (2008) ‘Australian Pharmaceutical Policy, Price Control, Equity and Drug Innovation’, Journal of Public Health Policy, 29 (1), 106–120.

    Article  Google Scholar 

  • P. Drahos and J. Braithwaite (2002) Information Feudalism: Who Owns the Knowledge Economy (London: Earthscan).

    Google Scholar 

  • P. Drahos and J. Braithwaite (2004) Who Owns the Knowledge Economy: Political Organising Behind TRIPS (Sturminster Newton, Dorset: The Corner House).

    Google Scholar 

  • Ernst and Young (2007) Beyond Borders: Global Biotechnology Report 2007.

    Google Scholar 

  • European Union (2007) Competitiveness of the European Biotechnology Industry, European Commission, Enterprise and Industry DG, http://ec.europa.eu/enterprise/phabiocom/docs/biotech_analysis_competitiveness.pdf

  • J. Fagerberg, D. C. Mowery and R. Nelson (eds) (2005) The Oxford Handbook of Innovation (Oxford: Oxford University Press).

    Google Scholar 

  • C. Freeman (2007) ‘A Schumpeterian Renaissance?’ in H. Hanusch and A. Pyka (eds) (2007) Elgar Companion to Neo-Schumpeterian Economics (Cheltenham: Edward Elgar).

    Google Scholar 

  • D. Harvey (2005) A Brief History of Neoliberalism (Oxford: Oxford University Press).

    Google Scholar 

  • K. Harvey and M. M. Hodge (1995) ‘Australian Medicinal Drug Policy’ in H. Gardner (ed.) (1997) The Politics of Health: The Australian Experience (Melbourne: C. Livingstone).

    Google Scholar 

  • C. Hay (2004) ‘Re-Stating Politics, Re-Politicing the State: Neo-Liberalism, Economic Imperatives and the Rise of the Competition State’, Political Quarterly, 75 (1), 38–50.

    Article  Google Scholar 

  • C. Hay and M. Lister (2006) ‘Introduction: Theories of the State’ in C. Hay, M. Lister and D. Marsh (eds) (2006) The State: Theories and Issues (Houndmills, Basingstoke: Palgrave Macmillan).

    Google Scholar 

  • C. Hay, M. Lister and D. Marsh (eds) (2006) The State: Theories and Issues (Houndmills, Basingstoke: Palgrave Macmillan).

    Google Scholar 

  • R. Henderson, L. Orsenigo and G. P. Pisano (1999) ‘The Pharmaceutical Industry and the Revolution in Molecular Biology: Interactions Among Scientific, Institutional, and Organizational Change’ in D. C. Mowery and R. R. Nelson (eds) (1999) Sources of Industrial Leadership: Studies of Seven Industries (Cambridge: Cambridge University Press).

    Google Scholar 

  • D. Henry (2007) ‘Patients the Losers and Makers of the Winners in PBS Tinkering’, The Weekend Australian, 9–10 June, Health 19.

    Google Scholar 

  • J. Hill, A. Kirchner and A. Holmes (2001) Pharmaceutical Industry Action Agenda: Discussion Paper, Pharmaceuticals Section, Department of Industry, Science and Resources.

    Google Scholar 

  • T. Hubbard and J. Love (2004) ‘A New Trade Framework for Global Healthcare RandD’, PLoS Biology, 2 (2), 147–150.

    Article  Google Scholar 

  • Informa Healthcare (2007) ‘SCRIP 100’ in A Supplement to Scrip World Pharmaceutical News (Informa Healthcare).

    Google Scholar 

  • B. Jessop (1993) ‘Towards a Schumpeterian Workfare State?: Preliminary Remarks on Post-Fordist Political Economy’, Studies in Political Economy, (40), 7–39.

    Google Scholar 

  • B. Jessop (1997) ‘Twenty Years of the (Parisian) Regulation Approach: The Paradox of Success and Failure at Home and Abroad’, New Political Economy, 2 (3), 503–527.

    Article  Google Scholar 

  • B. Jessop (2002) The Future of the Capitalist State (Oxford: Polity Press).

    Google Scholar 

  • B. Jessop (2008) State Power: A Strategic-Relational Approach (Cambridge: Polity).

    Google Scholar 

  • P. Kanavos (2001) Overview of Pharmaceutical Pricing and Reimbursement Regulation in Europe (London: LSE Health).

    Google Scholar 

  • R. Loeppky (2005) ‘History, Technology, and the Capitalist State: The Comparative Political Economy of Biotechnology and Genomics’, Review of International Political Economy, 12 (2), 264–286.

    Article  Google Scholar 

  • H. Löfgren and R. de Boer (2004) ‘Pharmaceuticals in Australia: Developments in Regulation and Governance’, Social Science and Medicine, 58 (12), 2397–2407.

    Article  Google Scholar 

  • G. Lopez-Casanovas and J. Puig-Junoy (2000) ‘Review of the Literature on Reference Pricing’, Health Policy, 54, 87–123.

    Article  Google Scholar 

  • M. Mazzucato and G. Dosi (eds) (2006) Knowledge Accumulation and Industry Evolution: The Case of Pharma-Biotech (Cambridge: Cambridge University Press).

    Google Scholar 

  • M. McKelvey (2007) ‘Biotechnology Industries’ in H. Hanusch and A. Pyka (eds) (2007) Elgar Companion to Neo-Schumpeterian Economics (Cheltenham: Edward Elgar).

    Google Scholar 

  • J. Mittra (2007) ‘Life Science Innovation and the Restructuring of the Pharmaceutical Industry: Mergers, Acquisitions and Strategic Alliance Behaviour of Large Firms’, Technology Analysis and Strategic Management, 19(3), 279–301.

    Article  Google Scholar 

  • S. Morgan, M. McMahon and D. Greyson (2008) ‘Balancing Health and Industrial Policy Objectives in the Pharmaceutical Sector: Lessons from Australia’, Health Policy, 87 (2), 133–145.

    Article  Google Scholar 

  • OECD (2005) Biotechnology for Sustainable Growth and Development, http://www.oecd.org/dataoecd/60/63/23536372.pdf

  • OECD International Futures Programme (2006) Scoping Paper — The Bioeconomy to 2030: Designing a Policy Agenda, http://www.oecd.org/dataoecd/26/29/36972476.pdf

  • Office of Fair Trading (2007) ‘Annexe K’, International Survey of Pharmaceutical Pricing and Reimbursement Schemes (London: Office of Fair Trading).

    Google Scholar 

  • C. Hay and M. Lister (2006) ‘Introduction: Theories of the State’ in C. Hay, M. Lister and D. Marsh (eds) (2006) The State: Theories and Issues (Houndmills, Basingstoke: Palgrave Macmillan).

    Google Scholar 

  • C. Hay, M. Lister and D. Marsh (eds) (2006) The State: Theories and Issues (Houndmills, Basingstoke: Palgrave Macmillan).

    Google Scholar 

  • R. Henderson, L. Orsenigo and G. P. Pisano (1999) ‘The Pharmaceutical Industry and the Revolution in Molecular Biology: Interactions Among Scientific, Institutional, and Organizational Change’ in D. C. Mowery and R. R. Nelson (eds) (1999) Sources of Industrial Leadership: Studies of Seven Industries (Cambridge: Cambridge University Press).

    Google Scholar 

  • D. Henry (2007) ‘Patients the Losers and Makers of the Winners in PBS Tinkering’, The Weekend Australian, 9–10 June, Health 19.

    Google Scholar 

  • J. Hill, A. Kirchner and A. Holmes (2001) Pharmaceutical Industry Action Agenda: Discussion Paper, Pharmaceuticals Section, Department of Industry, Science and Resources.

    Google Scholar 

  • T. Hubbard and J. Love (2004) ‘A New Trade Framework for Global Healthcare RandD’, PLoS Biology, 2 (2), 147–150.

    Article  Google Scholar 

  • Informa Healthcare (2007) ‘SCRIP 100’ in A Supplement to Scrip World Pharmaceutical News (Informa Healthcare).

    Google Scholar 

  • B. Jessop (1993) ‘Towards a Schumpeterian Workfare State?: Preliminary Remarks on Post-Fordist Political Economy’, Studies in Political Economy, (40), 7–39.

    Google Scholar 

  • B. Jessop (1997) ‘Twenty Years of the (Parisian) Regulation Approach: The Paradox of Success and Failure at Home and Abroad’, New Political Economy, 2 (3), 503–527.

    Article  Google Scholar 

  • B. Jessop (2002) The Future of the Capitalist State (Oxford: Polity Press).

    Google Scholar 

  • B. Jessop (2008) State Power: A Strategic-Relational Approach (Cambridge: Polity).

    Google Scholar 

  • P. Kanavos (2001) Overview of Pharmaceutical Pricing and Reimbursement Regulation in Europe (London: LSE Health).

    Google Scholar 

  • R. Loeppky (2005) ‘History, Technology, and the Capitalist State: The Comparative Political Economy of Biotechnology and Genomics’, Review of International Political Economy, 12 (2), 264–286.

    Article  Google Scholar 

  • H. Löfgren and R. de Boer (2004) ‘Pharmaceuticals in Australia: Developments in Regulation and Governance’, Social Science and Medicine, 58 (12), 2397–2407.

    Article  Google Scholar 

  • G. Lopez-Casanovas and J. Puig-Junoy (2000) ‘Review of the Literature on Reference Pricing’, Health Policy, 54, 87–123.

    Article  Google Scholar 

  • M. Mazzucato and G. Dosi (eds) (2006) Knowledge Accumulation and Industry Evolution: The Case of Pharma-Biotech (Cambridge: Cambridge University Press).

    Google Scholar 

  • M. McKelvey (2007) ‘Biotechnology Industries’ in H. Hanusch and A. Pyka (eds) (2007) Elgar Companion to Neo-Schumpeterian Economics (Cheltenham: Edward Elgar).

    Google Scholar 

  • J. Mittra (2007) ‘Life Science Innovation and the Restructuring of the Pharmaceutical Industry: Mergers, Acquisitions and Strategic Alliance Behaviour of Large Firms’, Technology Analysis and Strategic Management, 19(3), 279–301.

    Article  Google Scholar 

  • S. Morgan, M. McMahon and D. Greyson (2008) ‘Balancing Health and Industrial Policy Objectives in the Pharmaceutical Sector: Lessons from Australia’, Health Policy, 87 (2), 133–145.

    Article  Google Scholar 

  • OECD (2005) Biotechnology for Sustainable Growth and Development, http://www.oecd.org/dataoecd/60/63/23536372.pdf

    Google Scholar 

  • OECD International Futures Programme (2006) Scoping Paper — The Bioeconomy to 2030: Designing a Policy Agenda, http://www.oecd.org/dataoecd/26/29/36972476.pdf

    Google Scholar 

  • Office of Fair Trading (2007) ‘Annexe K’, International Survey of Pharmaceutical Pricing and Reimbursement Schemes (London: Office of Fair Trading).

    Google Scholar 

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© 2009 Palgrave Macmillan, a division of Macmillan Publishers Limited

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Löfgren, H. (2009). The Competition State and the Private Control of Healthcare. In: Kay, A., Williams, O.D. (eds) Global Health Governance. International Political Economy Series. Palgrave Macmillan, London. https://doi.org/10.1057/9780230249486_12

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