The Health of Nations

Towards a New Political Economy

Gavin Mooney


The Health of Nations' analyses how power is exercised both in health-care systems and in society more generally. In doing so, it reveals how too many vested interests hinder efficient and equitable policies to promote healthy populations, while too little is done to address the social determinants of health.
Why, despite vast resources being expended on health and health care, is there still so much ill health and premature death? Why do massive inequalities in health, both within and between countries, remain? In this devastating critique, internationally renowned health economist Gavin Mooney places the responsibility for these problems firmly at the door of neoliberalism.

Mooney analyses how power is exercised both in health-care systems and in society more generally. In doing so, it reveals how too many vested interests hinder efficient and equitable policies to promote healthy populations, while too little is done to address the social determinants of health. Instead, Mooney argues, health services and health policy more generally should be returned to the communities they serve.

Taking in a broad range of international case studies - from the UK to the US, South Africa to Cuba - this provocative book places issues of power and politics in health care systems centre stage, making a compelling case for the need to re-evaluate how we approach health care globally.

Author Bio

Gavin Mooney worked as a health economist for 40 years and held academic positions in Scotland, Scandinavia, South Africa and Australia. In 2009 he was given an honorary doctorate by the University of Cape Town as 'one of the founding fathers of health economics'. He died in 2012.

Table of Contents

  • PART I - Introduction
    • Introduction: neoliberalism kills
  • PARTII - Why are things so bad?
    • 1. Why has the economics of health care policy gone wrong?
    • 2. Why have broader policies affecting health been inadequate ?
    • 3. The malaise of neoliberalism in health, health care and health economics
    • 4. Neoliberalism, the global institutions and health
  • PART III - Case studies
    • 5. The US: the fear of 'socialised' health care
    • 6. The UK National Health Service and the market
    • 7. South Africa, neoliberalism and HIV/AIDS
    • 8. Australia and victim blaming
    • 9. Local community versus corporation
    • 10. The pharmaceutical industry
    • 11. Neoliberalism and global warming
  • PART IV - Solutions
    • 12. The solutions in theory: communitarian claims
    • 13. The solutions in health care
    • 14. The solutions in society more generally
  • PART V - How things might get better
    • 15. Kerala: community participation
    • 16. Cuban health care and social determinants of health: just too good for the US?
    • 17. Venezuela: power to the community
  • PART VI - Conclusion
    • Conclusion: can we change?


'The reader will be absorbed from the first to the last page. ... This book is not only immediately relevant, it will become a classic'
Vicente Navarro, in the Preface

'Inequality, whether of wealth or power, undermines our best efforts to provide effective support to communities in their quest for better health. Mooney challenges neoliberal assumptions and through elegant case studies demonstrates how we can improve what we do through real community involvement in making decisions about health according to the values that matter.'
Stephen Leeder, Director, The Menzies Centre for Health Policy, Director, Research Network, Western Sydney LHD, The University of Sydney

'In this most original and highly readable book, Gavin Mooney makes a compelling case that we can do far more to improve people's health in both developed and developing countries. Rather than just posing the problem, he comes up with thought-provoking solutions, showing, for example, that local citizenry are fully capable of coming up with sophisticated organizational and distributional policy aimed at improving the health of the community. This book aims high and achieves.'
Thomas Rice, UCLA School of Public Health

'A biting and insightful book on what is wrong with the political economy of the world today that so much goes wrong with our health systems. Sharply written and informative in the best Zed tradition!'
Gita Sen, Centre for Public Policy, Indian Institute of Management

'This is Mooney at his "no-holds-barred" best, laying bare the power relationships affecting health. Unless health economists start paying attention to the political economy of health, progress in solving the health challenges facing us will be painfully slow. This book is setting us on that path.'
Di McIntyre, Health Economics Unit, University of Cape Town

'Many social scientists and activists have long felt extremely frustrated by a paradigm which links health care closely to the market - a market that is supposed to be free of corporate power. Mooney's book shows what can be achieved even under the power of big corporations that dominate the pharmaceutical industry worldwide, as well as under the neoliberal ideology adopted by many governments, some of which profess to be leftist. While exposing the misdeeds of big corporations and their clientelistic governments, Mooney's book indicates how much can be achieved by, first, promoting communitarianism in a principled and rational way and, second, listening to the concerns of the people being served by health care, not just hospital managers or those in the medical profession.'
Amiya Bagchi, Institute of Development Studies Kolkata

'Gavin Mooney is that rare breed, a health economist "as if people mattered". Reading this book, it is abundantly clear how much he cares about suffering, poverty and inequality: most health economists analyse and pronounce on these issues, but leave the expression of values to other professions. Mooney's clear and accessible documentation of the economics and power dynamics of social and environmental injustice in health is a must-read for anyone studying, searching or struggling for a healthier world.'
Alex Scott-Samuel, Director, International Health Impact Assessment Consortium, University of Liverpool


Publication Date: 12 April 2012
224 pages

Product ISBNs: Paperback: 9781780320595
Hardback: 9781780320601
eBook ePub: 9781780320625
eBook PDF: 9781780320618
eBook Kindle: 9781780324166

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