Health Financing Systems,Health Equity and Universal Health Coverage in Arab Countries

This article provides an overview of health financing structures in Arab countries in the context of their preparedness for universal health coverage. Current arrangements have left large swathes of the population shouldering high financial burdens and facing hardships when using healthcare, with significant impoverishing and deterrent effects. Health protection schemes are most comprehensive for those who can afford healthcare; they are mainly based on contributions and formal employment and thus fail to cater for the poor and the rural and informal sectors. Financing systems also lack the operational bases and institutional prerequisites for effective resource pooling and risk sharing, with segmentation and fragmentation worsening horizontal and vertical inequities. The neglect of public health systems has reinforced inequities by widening the gap between needs and provision, and by emphasizing the ability to pay as a basis for accessing quality care. In a context of informality and poverty, focusing reforms on health insurance is not a panacea. Rather, moving towards universal health coverage and reducing health inequities will require changes in the level of political tolerance for social injustice, and a paradigm shift to a more equity‐based political economy which views health as an investment and an entitlement.     

Taming Foreign Exchange Derivatives Markets? Speculative Finance and Class Relations in Brazil

This article provides a critical interrogation of the Brazilian tax on foreign exchange derivatives deployed between 2011 and 2013. It analyses the drivers of the policy‐making process that led to implementation of the measure, locates it within the broader policy response regarding the management of cross‐border capital flows and speculative finance, and assesses its political economy significance in light of class dynamics. The author makes three arguments. First, this innovative policy tool must be interpreted in terms of the emergence of a specific form of state power allowing for the continuation of finance‐led strategies of accumulation, while mitigating some of their worst consequences. Second, this form of state power internalizes the subordinate positionality of Brazil in the global financial and monetary system. Third, while financialization processes have eroded the efficiency of a number of policy tools, this policy experiment demonstrates the possibility of regulating complex financial markets, provided that appropriate resources are dedicated to the task, and that there is the political will to do so. The article concludes by discussing theoretical implications, for how to theorize state and financialization, as well as political implications.