Abstract
Over the last few decades, health care has been exposed to the principles of neoliberal governance. In these circumstances, state support has weakened, health care has been increasingly decentralised, and the delivery of health care services frequently privatised and transferred to new, non-public providers and social support systems.
At the same time, more emphasis has been given to the promotion of responsible behaviour by citizens and individual choice (McGregor & McGregor, 2016). The role of patients and citizens in this context is among the most debated.
Due to the emergence of responsible, responsibilised and individualised behaviour of patients and citizens (Trnka & Trundle, 2014), neoliberal governance of health care means a partial withdrawal of the state from the provision of social and health care services, which are offered increasingly by private and market-driven entities (Coburn, 2003; Schrecker, 2016). That said, an increasing number of private health care providers, together with the assumed responsibility of patients and citizens caring for their own health, represents another pillar of neoliberal health care governance.
Against this backdrop, the capacity of patients and citizens to act against neoliberal principles has been rarely discussed. To address this gap, we aim to explore the ways in which civically engaged patients and citizens cope with a deeply ingrained neoliberal imprint, by focusing on the Czech context, as one that is not narrowly dominated by market logic but that blurs the distinction between marketisation and social protection (Bohle & Greskovits, 2007).
By focusing on the context of the Czech Republic, this chapter will add to existing accounts of neoliberalism and citizenship which draw attention primarily to Anglo-Saxon and Western contexts with highly developed neoliberal regimes.