Neoliberalism, markets, fantasy: The case of health and social care

In this paper I explore one psychoanalytically inspired reason why we might worry about policies that aim to maximise market competition and user choice in some areas of social life. Using the case of health and social care, I suggest that the spread of neoliberalised practices would amplify splitting tendencies in subjects that subscribe to particular fantasies, for example, independence fantasies of 'Individual Self-Sufficiency' or dependence fantasies of the 'Caring Other'. One of psychoanalysis's strongest critical contributions resides in its effort to show what such fantasies have in common: the potential to secure allegiance through the promise of a subjective suture that results in fantasmatic over-investment. Such a perspective points to the rather urgent need to identify and promote those wider cultural and structural conditions that militate against fantasmatic over-investment and toward forms of interdependence that acknowledge contingency and ambivalence.