The paper proposes to look at healthcare privatization as one of the major areas where struggles around the definition and distribution of common goods (citizenship) are waged over. It defines healthcare privatization in an encompassing manner, as involving a variety of processes that lead to an increased involvement of private interests and actors in the provision, funding and management of healthcare. The paper takes the case of post-socialist Romanian healthcare reforms and shows that they are intimately linked with the post-socialist rise of neoliberal citizenship. It also shows that, in the Romanian case, healthcare privatization has been imbricated at a structural and policy level with an increase in inequalities of access to services and with the continuation of informal exchanges between patients and healthcare personnel (‘petty corruption’).
After the 2008 financial crisis, resistance to the rise of neoliberal citizenship was expressed more and more at the collective level of labour and popular protests rather than simply an individual one. Romanian governments responded to social unrest by using the threat of criminalising informal exchanges and by promoting the idea that privatisation is the way to eradicate them. The specific forms informal exchanges take today in Romania’s healthcare services have developed, however, not despite, but because of privatising healthcare reforms. The paper shows that the continuation of these reforms will thus not generate ‘transparent’ market-like exchanges but a continuation of informal exchanges and a further increase in inequalities of access to healthcare services.