Consumer Groups in the Policy Process
Edited by Hans Löfgren, Evelyne de Leeuw and Michael Leahy
Chapter 1: Introduction – Consumer Groups and the Democratization of Health Policy
Michael Leahy, Hans Löfgren and Evelyne de Leeuw This book examines the extent to which consumer groups engage in the development of policy affecting their members’ health and health care. Such engagement may be referred to as the ‘democratization of health’, but, as the contributions to this book show, there are considerable differences between national contexts as to what this means, both in theory and in practice. Before summarizing those differences, however, some account of the notion of democracy and the impetus to democratize human institutions is needed. Democracy had its origins in ancient Greece, but its modern form stems from the French Revolution. In the name of the people the French Revolution cast off the shackles of the political and ecclesiastical hierarchies and proclaimed the ‘liberty’, ‘equality’ and ‘fraternity’ of all.1 In the spirit of the Enlightenment the traditional authority of divine revelation was supplanted by the authority of scientific reason and the ideal of individual liberty, as in Immanuel Kant’s notion of personal autonomy. This legacy subsequently developed in two streams. One of these emphasized individual liberty, which in the political sphere was conceived in negative terms as freedom from government, and in the economic sphere as market freedom. The other stream was the socialist/collectivist one, which placed the emphasis on ‘fraternity’ and thus a common good to be attained by collective action. PostEnlightenment culture enjoins the exercise of the power of reason to bring both the physical world and the social world under human dominion. In...