Reflections on the Human Condition - Api-fellowships.org

Bank itself may be subject to forces pushing for
privatization (in this case, divestment of its development
financing role to private capital markets), much in the
way that welfarist states are being urged to selectively
offload their more profitable social services to the private
sector. Not surprisingly (as an institutional compromise
and accommodation), the WB, without requiring
much of a push, seems to have re-positioned itself to be
an even more influential agent which can promote the
privatization and retrenchment of the welfarist state,
including the welfarist state in its developmentalist
incarnation. We see, for instance, an expanded role
of IFC/MIGA to promote private sector involvement
in “development”; World Bank bonds to raise funds
in private capital markets to make up for funding
shortfalls from donor countries; World Bank Institute,
recently established ideological hub to propagate more
vigorously the neo-liberal agenda through a global
network of affiliated and influential think-tanks, in
the process, disingenuously exaggerating the role of
the “free” market in fostering “development”, and
denigrating the state-led experiences of much of East &
Southeast Asia. Since the time of AW Clausen (World
Bank President, 1981-1986, former president Bank of
America, not coincidentally a time when metropolitan
banks were flush with liquidity from Eurodollars and
petrodollars), there have been persistent calls from
certain US quarters for IFIs (esp. the World Bank) to
divest more of its development financing activities to
private capital markets. The same interests presumably
are among the perennial chorus clamoring to reduce
US contributions to multilateral lending agencies.
The Meltzer Commission, in its report to the US
Congress in 2000, recommended in effect a triage of
borrower countries: debt cancellation, outright grants
and performance-based concessional loans for the most
destitute of highly-indebted countries, as opposed to the
more “credit-worthy” borrowers with access to capital
markets, who should be weaned from multilateral
lending agencies and henceforth be serviced by private
lending institutions (i.e. the financial analogue of
“targeted” programs in health services). Indeed, this
is the persuasive face and generic template for the
privatization of social services. [see also The New Public
Finance (ed. Inge Kaul & Pedro Conceicao), Oxford
University Press, 2006 for a discussion of “publicprivate
partnerships” in development financing and the
financing of global public goods; Einhorn, Jessica. 2006.
“Reforming the World Bank: Creative Destruction”. In
Foreign Affairs 85(1):17-22].
33 McCormack, G. 2002. “Breaking the Iron Triangle”.
In New Left Review, January-February 2002, pp.5-23;
see also Koizumi: Crazy like a Fox for a description of
CHANGING LIFESTYLES AND HEALTH
205
these zoku (“policy groups” or factions). Darrel Whitten.
www.atimes.com. 12 August 2005.
34 in the 1980s and 1990s, critics and skeptics of the
socialist project spoke patronizingly if not dismissively
of actually existing socialism, warts and all. By the
same token, one should also speak of actually existing
neo-liberalism (market fundamentalism), in light of
contemporary and cumulative evidence from the past
two decades (silence from the neo-liberals in the wake
of the scandals and debacles engulfing WorldCom,
Enron, Long-Term Capital Management, Halliburton,
etc) rather than dissemble on about some hypothetical,
idealized construct emanating from Chicago and
Vienna.
35 Halevi, J. and Lucarelli, B. 2002. “Japan’s Stagnationist
Crises”. In Monthly Review, February 2002; Ikeda, S. 2004.
“Japan and the Changing Regime of Accumulation:
A World-System Study of Japan’s Trajectory from
Miracle to Debacle”. In Journal of World-Systems
Research, X, 2, Summer 2004: 363-394; Patnaik,
Prabhat. 2004. The New Imperialism, paper presented at
the International Development Economics Associates
(IDEAs) international conference on ‘’The Economics
of the New Imperialism’’, Jawaharlal Nehru University,
New Delhi, January 22-24, 2004.
36 Ikegami, N. 1991. “Japanese health care: low cost
through regulated fees”. In Health Affairs 10(3):87-
109; N Ikegami & JC Campbell. 2004. “Japan’s
Health Care System: Containing Costs and Attempting
Reform”. In Health Affairs 23 (3):26-36; N Ikegami
& JC Campbell. 1999. “Health care reform in Japan:
The virtues of muddling through”. In Health Affairs
18 (3):56-75; Ikegami, N. and Campbell, JC. 1995.
“Medical care in Japan”. In New England Journal of
Medicine. 333:1295-1299.
37 the Japanese government began providing health
insurance in 1927, and in 1961 universal coverage was
achieved.
38 Thairatch Newspaper, 7 January 2001, p. 1.
39 Thailand Law Forum. Accessed on 19 October 2005.
40 Dr. Prawase Wasi, emeritus professor of medicine at
Mahidol University and a prominent public intellectual,
was a key figure in the Thai movement for constitutional
reform. He emerged from that experience with a
tactical approach “Triangle that Moves the Mountain”
which was influential among health systems reform
activists who sought to nurture and build upon the
Ref lections on the Human Condition: Change, Conflict and Modernity
The Work of the 2004/2005 API Fellows