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Accepted Paper:
Moralities of care, accumulation by dispossession and the re-definition of informal exchange in Romanian healthcare
Sabina Stan
(Dublin City University)
Paper short abstract:
The paper looks at widespread wrongdoing in Romanian healthcare in the form of informal exchanges between patients and doctors. It proposes to see these practices as instantiating both diverse moralities of care and processes of accumulation by dispossession following healthcare privatisation.
Paper long abstract:
The paper looks at widespread wrongdoing in Romanian healthcare in the form of informal exchanges between patients and healthcare personnel. It argues for the need to understand these practices in the larger context of Romania's turn to a neo-liberal pathway of development after 2000. In doing so, the paper proposes to see informal exchanges in healthcare as instantiating both diverse moralities of care (Kleinman 2012) and multi-layered processes of accumulation by dispossession (Harvey 2004) following healthcare privatisation.
Many patients traditionally framed their recourse to informal exchanges in terms of a redistributive 'moral economy' (Thomson 1971) of care provided in public units. This moral economy came to be challenged by healthcare privatisation. Thus, richer patients increasingly 'lifted-off' from public healthcare and instead promoted a neoliberal morality of care based on the use of private means for private care. In parallel, continued depressed wages for healthcare personnel led a few of them to engage in predatory forms of exchange that further exacerbated poorer patients' dispossession of public care. Finally, Romanian governments used the austerity following the 2008 financial crisis as an opportunity to speed up healthcare privatisation. In doing this, they aimed both to give the final blow to redistributive moralities of care and to channel the flows of accumulation by dispossession away from the pockets of healthcare personnel and into those of private healthcare insurers. While popular protests gave voice also to redistributive moralities of care, they managed merely to slow down but not stop or reverse healthcare privatisation.
Not rotten apples: disciplinary approaches to economic wrong-doing
Session 1