Since the post-War period, social protection systems have experienced continuous reforms, either extending or, more often, reducing the scope and the scale of public provision. This paper seeks to present how healthcare systems have evolved both in France and in Brazil recently, in order to comprehend mechanisms through which financialization has been reshaping public care provision. This comparative analysis unveils distinct financialization dynamics of healthcare systems, built upon universalism principles. After featuring both systems, underlying their private dimension - either complementary or supplementary - the article points out how the financial sector is broadening its share in the supply of healthcare services. In what follows, the sector's process of internationalization/centralization is analyzed and lastly the regulatory role of the State in strengthening private provision is defined. Despite radically different institutional paths, the findings corroborate that in both cases finance is a driving force in reshaping the healthcare sector.
Public Health Systems (PHS) are under continuous transformation in line with economic, political, and ideological changes in capitalist economies. The current stage of capitalism is underpinned by the process of financialization, meaning an increasing dominance of financial actors, markets, practices, measurements, and narratives over other agents, including the State. This article examines how financialization has been reshaping PHS, with an in-depth study of the French case. First, we suggest how to incorporate the concept of financialization into the research on PHS transformation. We then apply this concept to reassess the trajectory of the French system from the 1990s onwards. We show the increasing participation of financial capital for long-term, short-term, and infrastructure financing, occupying roles previously fulfilled by the public sector. We then discuss how the adoption of financialized strategies led to shifts in how public actors behave, and the potentially adverse effects for solidarity, stability, and democratic participation.
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