In all Andean countries, neoliberal water doctors have proposed water reforms closely following the privatization prescription, receiving powerful backing to implement their water-sector sanity programs and provide their universal medicines. These water reforms and the language used to justify them closely resemble those of colonial and post-colonial ‘civilization’ efforts. They also, like their predecessors, associate private property rights with civilization, justifying far-reaching interventions to turn ‘backward’ water management institutions into modern ones. Andean collective water management is generally categorized as ‘anomalous’, requiring curing. Anomalies are either normalized by powerful neoliberal laws, or denied legitimate existence. Modern extractive players-continuing the mythical Andean pishtaku vampires-encroach on their territories with “progress”. Under a self-fulfilling neoliberal model prophecy, these collectives themselves are blamed for their backwardness and also for weakening under neoliberalism-to be remedied by more neoliberal prescriptions. This chapter scrutinizes how neoliberal water hospitals’ treatment programs are based on ‘universal’ laws of human and natural behavior, justified ‘globally’ (not from local evidence and water tragedies). It also examines how local user collectives struggle to show the real outcomes of neoliberal policies and actively question their universalistic pretensions.