Is promoting health equity through a well-being economy a Trojan horse for a post-capitalist socialist economy? Will it make it through the public policy gates?

Abstract

BackgroundAttempts to promote health equity through traditional means of public policy advocacy have proven profoundly unsuccessful in Canada. Despite decades of research, policy statements and declarations as to the importance of addressing the causes of health inequalities that prematurely sicken and kill, the quality and equitable distribution of the living and working conditions, i.e., the social determinants of health, continue to decline.PurposeIn this paper we examine the most recent attempt to promote public policy to reverse these developments - the well-being economy - that calls for "an economy designed to serve people and the planet, not the other way around" which has similarities with the coexisting concept of a post-capitalist socialist economy.AnalysisWe compare and contrast the assumptions of both approaches through a critical materialist political economy perspective lens and their likelihood of moving the health equity-promoting public policy agenda forward.FindingsWe found most of the well-being economy literature's preferred outcomes are remarkably consistent with the vision of a post-capitalist socialist economy that puts the well-being of people above profit-making. However, the means by which advocates propose these outcomes may come about are profoundly different. The omission of the terms socialist or socialism in the well-being economy literature suggests its advocates may see it as a Trojan Horse for infiltrating these concepts into public policy discourse.ConclusionWe see the well-being economy concept as another well-meaning initiative to promote health equity that is likely to be ignored by governing authorities whose interests are aligned with those for whom such an economy would conflict with their profit-making motives. Instead, we call for explicit consideration of a post-capitalist socialist economy and how it could move us towards a health equity promoting society.