SEMANTIC AMBIGUITIES AND CLASSIFICATION STRUGGLES IN THE POST-SOCIALIST INFORMAL MEDICAL ECONOMY
DOI:
https://doi.org/10.2478/subbs-2021-0008Keywords:
informal payments, gift vs. commodity, medical systems, power relations, formalising common-sense on informality, symbolic power, strategic narrativesAbstract
In this paper I will engage in a process of highlighting the way in which liberal and, later, neoliberal political agendas regulate and establish formal semantic registers in the field of medical informal economy within the Romanian public healthcare system. How accurate is the legalistic approach, which classifies any extra-payment as a bribe? Despite the questionable legal status, the voluntary informal economy acquires the role of establishing bridges at human level between doctor and patient. Far from pleading to accept the conditioning of the medical act by an additional payment from patients or their family members, facts that obviously fall within the scope of illegality, I claim that the labels of “corruption”, “bribe”, “informal payment” cannot be correctly applied to the whole phenomenon of informal exchanges. Moreover, the gifts offered as a form of gratitude or to tame the “medical gaze” even have a role of social link between doctor and patient, helping to bind an unwritten human contract between the two who, in fact, are victims of the same system and its political decision-makers.References
Adloff, F. (2006). Beyond Interests and Norms: Gift-giving and Reciprocity in Modern Societies. In Constellations: An International Journal of Critical and Democratic Theory, 13(2):407–442.
Appadurai, A. (1986). The Social Life of Things: Commodities in Cultural Perspective. Cambridge: Cambridge University Press, pp. 3–61 (On-line: http://assets.cambridge.org, last access: 07.03.2021).
Bell, D. (1991). Modes of Exchange: Gift and Commodity. In The Journal of Socio-Economics, 20(2):155–167.
Balabanova, D., McKee, M. (2002) Understanding Informal Payments for Health Care: The example of Bulgaria. In Health Policy, 62: 243–73.
Belli, P., Gotsadze, G., Shahriari, H. (2004). Out-of-Pocket and Informal Payments in Health Sector: Evidence from Georgia. In Health Policy, 70: 109–123.
Bourdieu, P. (1977). Outline of a Theory of Practice. Cambridge: Cambridge University Press.
Bourdieu, P. (1984). Distinction: A Social Critique of the Judgment of Taste. London: Routledge.
Bourdieu, P. (2012). Limbaj și putere simbolică. București: Editura Art, pp. 135–163; 175–278. Ensor, T., Savelyeva L. (1998). Informal Payments for Health Care in the Former Soviet Union: Some Evidence from Kazakstan. In Health Policy and Planning, 13(1): 41–49.
Ensor, T. (2004). Informal Payments for Health Care in Transition Economies. In Health Policy, 58 (2): 237–246.
Gaal, P., Evetovits, T., McKee, M. (2006). Informal Payment for Health Care: Evidence from Hungary. In Health Policy, 77(1):86–102.
Gregory, C. (1997). Savage Money: The Anthropology and Politics of Commodity Exchange. Amsterdam: Harwood Academic.
Gregory, C. (1982). Gifts and Commodities. London: Academic Press.
Lambertini, L., Scarpa, C. (1999). Minimum Quality Standards and Predatory Behaviour, Nota di Lavoro, No. 86.1999, Fondazione Eni Enrico Mattei (FEEM), Milano (On-line: https://www.econstor.eu/handle/10419/155039, last access: 14.06.2021).
Lewin, H., Morris, J. (1977). Marx’s Concept of Fetishism. In Science & Society, 41(2): 172–190.
Lewis, M. (2000). Who is Paying for Health Care in Eastern Europe and Central Asia? Washington: The International Bank for Reconstruction and Development, pp.12–34 (On-line: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1457795, last access on 16.03.2020).
Lewis, M. (2006). Governance and Corruption in Public Health Care Systems. In Center for Global Development – Working Paper 78 (On-line: http://www.cgdev.org).
Liaropoulos L., Siskou, O., Kaitelidou D., Theodorou M. (2008). Informal Payments in Public Hospitals in Greece. In Health Policy, 87: 72–81.
Lomnitz, L. A. (1988).Informal Exchange Networks in Formal Systems: A Theoretical Model. In American Anthropologist, 90(1), 42–55.
Mauss, M. (1990 [1925]). The Gift. The Form and Reason for Exchange in Archaic Societies. New York/London: W. W. Norton.
Marx, K. (2013 [1867]). Capital, Volume I. Capitalist Production, Part I: Commodities and Money, Chapter I: Commodities, Section IV: The Fetishism of Commodities and the Secret Thereof. Hertfordshire: Wordsworth Editions Limited, pp. 46–55.
Najar, A.V., Ebrahimipour, H., Purtaleb, A., Esmaily, H., Jafari, M., Nejatzadegan, Z., Taleghani, Y.M. (2017). At first Glance, Informal Payments Experience on Track: Why Accept or Refuse? Patients’ Perception in Cardiac Surgery Department of Public hospitals, Northeast of Iran. In BMC Health Services Research, 17(1): 205
Palaga, C. (2015).From Informal Exchanges to Dual Medical Practices. The Shadows of the Romanian Health Care Reform. In STUDIA UBB SOCIOLOGIA, LX(1): 103-122.
Parry, J., Bloch, M. (1989). Introduction: money and the morality of exchange. In Money and the morality of exchange. Cambridge: Cambridge University Press, pp. 1–32.
Rus, A. (2008). ‘Gift vs. Commodity’ Debate revisited. In Anthropological Notebooks: 14(1):81–102 (On-line: http://www.drustvo-antropologov.si, last access: 12.07.2020).
Savedoff, W. D. (2006). The causes of corruption in the health sector: a focus on healthcare systems. In Transparency International. Global Corruption Report 2006: Special focus on corruption and health. London: Pluto Press.
Sharma S., Smith S., Pine M., Winfrey W. (2005). Formal and Informal Reproductive Healthcare User Fees in Uttaranchal, India. Washington, DC: United States Agency for International Development.
Smart, A. (1993). Gifts, Bribes, and Guanxi: A Reconsideration of Bourdieu’s Social. In Cultural Anthropology, 8(3): 388–408.
Stan, S. (2012). Neither Commodities nor Gifts: Post-socialist Informal Exchanges in the Romanian Healthcare System. In Journal of the Royal Anthropological Institute, 18:65–82.
Stepurko, T., Pavlova, M., Gryga, I., Groot, W. (2010). Empirical Studies on Informal Patient Payments for Health Care Services: A Systematic and Critical Review of Research Methods and Instruments. In BMC Health Services Research, 10, 273 (On-line: https://doi.org/10.1186/1472-6963-10-273, last access 12.05.2014).
Thompson, R., Witter, S. (2000). Informal Payments in Transitional Economies: Implications for Health Sector Reform. In International Journal of Health Planning and Management, 15: 169–187.
Vlădescu, C., Scîntee, G., Olsavssyky V. (2008). Romania. Health System Review. In Health Systems in Transition, 10(3): 1–172, pp. 21–80.
Williams, C., Horodnic, I.A., Horodnic, A.V. (2016). Who is Making Informal Payments for Public Healthcare in East-Central Europe? An Evaluation of Socio-economic and Spatial Variations. In Eastern Journal of European Studies, 7(1): 49–61.
Zerilli, F.M. (2013). Corruption and Anti-corruption Local Discourses and International Practices in Post-Socialist Romania. In Human Affairs, 23:212–229.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Studia Universitatis Babeș-Bolyai Sociologia
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
