Trading Futures

In this article, we explore what happens when idea(l)s of Islamic charity (sadaqah) and social enterprise converge within a low-cost public health clinic in Colombo, Sri Lanka. For both the clinic’s wealthy sponsors and the urban poor who use it, interpreting the intervention as a pious expression of care toward the poor or as a for-profit humanitarian venture meant extending different futures to the poor. The ambiguous temporalities of gifts and commodities anticipated by benefactors and beneficiaries involved in this challenges anthropological assumptions concerning the marketizing effects of neoliberal development interventions. Our ethnography revealed a hesitancy among the clinic’s sponsors, managers, and users to endow the intervention with a final interpretation, undermining its stated goal of promoting health care privatization and “responsibilization” of the poor.

La Covid-19 en Perú. Una Mirada Bioética a la pandemia

A bioethical view of the pandemic in Peru implies reviewing the history of crises and similar disasters. This article leads us to understand both Government’s and Citizens’ ethical behavior, from a public health perspective. The introduction presents the influenza pandemic in the context of the WWI. Then we review the possible causes of the current situation and the ethical principles that are violated. Additionally, the health care privatization is analyzed as well as the way it is related to the “alternative medicine”, - due to the increase in prices of the medicine during the pandemic – as an ethical scandal that should not go unnoticed. Finally, some conclusions, which have a nuance of proposal before what will come after passing the high peak of infections. Keywords: Ethical Principles, Beneficence, Non-Maleficence, Autonomy and Justice.

The Consequences of Health Care Privatization: Evidence from Medicare Advantage Exits

There is considerable controversy over the use of private insurers to deliver public health insurance benefits. We investigate the consequences of patients enrolling in Medicare Advantage (MA), privately managed care organizations that compete with the traditional fee-for-service Medicare program. We use exogenous shocks to MA enrollment arising from plan exits from New York counties in the early 2000s and utilize unique data that links hospital inpatient utilization to Medicare enrollment records. We find that individuals who were forced out of MA plans due to plan exit saw very large increases in hospital utilization. These increases appear to arise through plans both limiting access to nearby hospitals and reducing elective admissions, yet they are not associated with any measurable reduction in hospital quality or patient mortality. (JEL G22, I11, I12, I13, I18)