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Citizenship, Neoliberalism and Healthcare

Health and Illness in the Neoliberal Era in Europe

ISBN: 978-1-83909-120-9, eISBN: 978-1-83909-119-3

Publication date: 26 November 2020


The aim of this chapter is to discuss the complexities and ambiguities of health-related citizenship in the neoliberal era. The scholarly discussions investigating the impact of neoliberalism on health and health care have primarily focused on the power of the neoliberal system. At the same time, the capacity of patients and citizens to act against neoliberal principles has been rarely discussed. Against this backdrop, we explore the ways in which civically engaged patients and citizens cope with neoliberal governance. To do so, we focus on the Czech context, as one that is not narrowly dominated by market-driven neoliberal logic but that blurs the distinction between marketisation and social protection. More specifically, we address the following two questions: What are the reactions of citizens and patients to the imperatives of neoliberalism? What are the implications for our understanding of health-related citizenship in the neoliberal era? Our analysis is underpinned by interviews and observations of public and patient involvement in the Czech Republic. Furthermore, the data gathered from interviews were enriched through a review of available documents, including media articles, policy briefs, political statements and websites. We conclude that the neoliberal era is not only connected with the emergence of individualised, conscious citizens whose health is governed at a distance, but also with the occurrence of collectively organised, health-care conscious citizens who problematise the nature of contemporary health-care governance. We thus explain and illustrate how neoliberal ideology is imprinted on the behaviour of patients and citizens, as well as how they resist and strategically appropriate neoliberal imperatives.




This research was supported by the Czech Science Foundation (GAČR), Standard Grant Nr 17-01116S – Civic engagement and the politics of health care. The participation of Petra A. Honová was also supported by the grant SVV (260 596). We would like to thank the book editors, Jonathan Gabe, Angela Genova and Mario Cardano for their valuable comments and suggestions on the first draft of this chapter. We also thank all collaborators who contributed to the data collection process at different stages of the project, in particular to Tereza Sedláčková, Lucie Kondrátová, Karolína Dobiášová, Anna Černá, Aneta Soukopová, Jan Fiala, David Kocelský, Filip Klicnar, Petra Králová and Tereza Navrátilová. We are also very grateful to all research participants for their time and availability.


Numerato, D., Čada, K. and Honová, P.A. (2020), "Citizenship, Neoliberalism and Healthcare", Gabe, J., Cardano, M. and Genova, A. (Ed.) Health and Illness in the Neoliberal Era in Europe, Emerald Publishing Limited, Leeds, pp. 75-89.



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