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From a utilitarian universal health coverage to an inclusive health coverageHealthcare systems vary across countries but the access to health is considered fundamental both individually and collectively. Individually, good health is one of the main contributors to well-being, and collectively it has an important effect on countries’ productivity. From a utilitarian perspective, governmental intervention in health coverage has the purpose to maximise the total ‘utility’, in this case the total welfare, of all the members of society. Health services must therefore be produced and allocated efficiently, and distributed in accordance to equity. This approach gave origin to the so-called ‘universal’ healthcare systems, in trying to provide healthcare for as many members of a community as possible. Such systems can be considered inclusive insofar to try not to leave anyone out of coverage, but their implementation is not free of criticism. One of the limitations is that they tend to provide the same level of coverage for everyone, regardless of their differing characteristics, circumstances, and needs. This also means that some health issues will not be covered by the public health system, and if patients need specialised attention they will need to use private health provision, with the subsequent exclusion of those without enough resources. It is for this reason that healthcare systems are evolving to become ‘inclusive’ in a different manner, away from the ‘one size fits all’ approach covering only basic minimum health services, and aiming to provide different services to people with different needs, including giving access to health to the poorest of society.
Relativizing Universality: Sociological Reactions to Liberal UniversalismThis paper offers an appraisal of the relationship between sociology and philosophy grounded in a critique of the former discipline’s failure to contend with the dominance of neoliberalism in the run up to the financial crisis. In the first instance, it considers the prevailing philosophical ethos after the end of the Cold War and what Francis Fukuyama (1992) called the ‘End of History’. It observes the emergence of an increasingly unchallenged political monad around the conjoined principles of liberal democracy and neoliberal economics and its ascendance to the status of socio-historical universality despite becoming increasingly problematic. The second half of the essay then carries this political-philosophical analysis into an exploration of contemporary sociology and its approach to the intellectual critique of dominant ideas and structures. It proposes that an emergent strain of philosophical relativism has inadvertently moved us away from some of the critical responsibilities of the traditional intellectual and eroded our capacity to offer practical alternatives to overwhelmingly neoliberal governance. The article ends on the hopeful note that a slight change in tack might push us toward reclaiming responsibilities and revitalising the debate on social transformation.