Regimes of Inequality: Politics and Health in Europe

The last thirty years have witnessed a sustained rise in inequality in
the rich democracies, even in the face of expert consensus that
inequity is harmful for both society and the economy. I examine the
political dynamics underlying inequality’s remarkable resilience since
1980 by studying largely unsuccessful attempts to reduce socioeconomic
inequalities in health in Europe. The clash between postwar welfare
regimes and specific aspects of neoliberalism prompt politicians to
attempt to reframe economic inequality in less contentious,
medicalized terms. But the institutionally-rooted logic of
appropriateness that structures policy-making in the arena of
inequality constrains policy efforts to reduce health inequalities,
just as it constrains efforts to reduce the underlying social
inequalities that cause them. It is not inaccurate to claim broadly,
as some have, that "neoliberalism kills;" but neoliberalism, as an
umbrella concept, affects different types of political economies in
ways that are different and yet also predictable given their
characteristic policy arrangements. The distinctive political
dynamics generated by different welfare regimes’ interaction with
specific instantiations of neoliberalism in the 1980s and 1990s shape
how politicians frame the issue of inequality, the tools they use (and
avoid using) in order to combat inequality, and ultimately their
success or failure in combating rising inequality into the 21st
century.