Professional vs financial capital in the field of health care—struggles for the redistribution of power and control

Abstract

The field of health care, like all fields of social life, is a site of continuous games for power and control. This paper applies the conceptual tools of the French sociologist Pierre Bourdieu—in particular the notions of field and capital—to analyse the diverse roles, and partially divergent objectives of the various institutions and individuals involved in the functions of financing, production, and consumption of health services. Participants in these struggles are seen to have different chances of winning or losing, depending on their relative power, which is determined by the distribution of differently valued capitals in this specific field. The expectations associated with the transition to market based control mechanisms in the field of Finnish health care, and the experiences of those directly involved in this transition are analysed. The nature and implications of the process of transition from a planning allocation system to a competition based resource allocation system are studied on the basis of extensive interviews and observations conducted in one university hospital and two central hospitals in Finland.