Contesting neoliberalism with human rights? Liberal exhaustion and exploitation in Colombia’s health system

The neoliberal reorganisation of social policy has provoked counterreactions worldwide. One genuinely liberal contestation of neoliberal restructuring is based on human rights mobilisation, and, in many countries, judicial guarantees of social human rights. This article investigates the interaction of neoliberalism and human rights liberalism in the domain of health policy. I focus on Colombia, where ‘health as a human right’ has become a widespread reference for resistance against neoliberalism. However, human-rights-based mobilisation has proven unable to revert disinvestment from public infrastructure. Rather, the judicialized enforcement of the right to health has reinforced a pharmaceutical bias and cost-shifting towards profitable care. Neoliberalism and the right to health co-create a politics that offloads the actual cost of care to precarious workers and vulnerable patients. I draw on feminist economics and critical public health to capture these exhausting and exploitative tendencies of (neo)liberalism. The article is based on rich qualitative material gathered in the context of ‘post-neoliberal’ reform struggles and health system crisis in Colombia.