Toward a care ethical approach to access to health care in neoliberal times

Abstract

In December 2017, the Republican-controlled US Congress closed its session by pushing through a comprehensive tax overhaul bill, HR 1. Additional provisions of the ‘must pass’ bill included a last-ditch effort to quash the Affordable Care Act (ACA), otherwise known as Obamacare. In this article, I unpack some of the immediate and long-term net-positive impacts that the ACA has had on access to health care for women, infants, and children in the US while also acknowledging the continued unevenness of health outcomes along race, gender, and income differences. I argue that if we take seriously the potential of a care ethical analysis to respond to neoliberal ethics, then there is a need for a more robust engagement with intersectional analysis in order to address interlocking oppressions that exacerbate ongoing inequalities. By extension, I show how HR 1 clearly highlights the racist, classist, and gendered neoliberal logics that permeate contemporary US political and legislative debates related to health care access, underscoring the uncaring nature of US democracy and making plain a need to ‘care with’ others. I end by posing a set of speculative possibilities, asking what might be possible if we take seriously care and caring relations as fundamental to imagining worlds-otherwise.