Commodification Of Health Care Research Articles

Should Healthcare for NCDs Be Equated with Other Goods and Services? — Commodification of Health Care in NDCs

Healthcare services for Non-Communicable Diseases (NCDs) cannot be simply treated as tradable goods or services. The debate surrounding whether healthcare should be equated to commodities is complex, involving economic, ethical, and social considerations. While market-driven approaches can enhance innovation and efficiency, critics caution against the risks of inequality and the erosion of social solidarity. Commodification of NCD healthcare may worsen existing disparities, prioritize profit over patient well-being, and neglect prevention strategies. Balancing efficiency with equity and preventive measures is essential in managing NCDs effectively while addressing the shortcomings of a commodified healthcare system.

Construction of nursing knowledge in commodified contexts: Views and experiences of nurses regarding primary care.

The commodification of health care, particularly primary care, presents challenges to care and knowledge development. The purpose of this study is to examine how nurses perceive and develop their knowledge in a commodified context. A mixed-methods study was conducted that included a closed-question survey and in-depth interviews with nurses in public primary care in Catalonia. There were 104 valid responses to the questionnaire and 10 in-depth interviews. The main findings of the survey were related to workload and limited time for nursing care. Six themes emerged from the in-depth interviews: (1) limited time for nursing, (2) feelings of burnout, (3) awareness of patient and family satisfaction, (4) organizational factors that favor nurses' needs, (5) organizational factors that hinder nurses' needs, and finally (6) public administration requirements. Participants perceive excessive workload and time constraints and feel that this affects their nursing care and their physical and mental health. However, nurses purposefully use knowledge patterns to cope with the problems associated with commodification. Nurses have multidimensional, contextualized, and integrated knowledge that allows them to optimize their care based on the needs of their patients. This research examines many challenges related to nursing practice and the nursing discipline and opens the door for further research that encompasses all areas of nursing.

Promoting egg freezing to the public: The price of influence

This article investigates the ethical, social, commercial, and legal implications of social media influencers promoting healthcare services, particularly focusing on a case where an influencer publicly shared her egg-freezing journey at a fertility clinic in Victoria, Australia, under a “paid partnership” arrangement. Key issues identified include potential conflicts of interest, the commodification of healthcare, challenges to informed consent, and possible violations of healthcare advertising regulations. In promoting the clinic's services, the influencer may present biased, incomplete, or misleading information, which could lead to suboptimal healthcare decisions by followers. The commodification of healthcare may encourage impulsive decisions, misrepresent the complexity of treatments, and exacerbate disparities in healthcare access. Informed consent may be compromised when potential patients are swayed by personal narratives and emotional appeals rather than objective, comprehensive information. Additionally, the article highlights the potential legal ramifications of such promotional activities, which might contravene regulations against direct advertising of therapeutic goods and services. The article underscores the need for regulatory bodies to establish and enforce clear guidelines for third-party promotional activities in the healthcare sector, prioritizing patient and public interests, transparency, ethical practices, and informed decision-making.

Indigenous Border Migrants and (Im)Mobility Policies in Chile in Times of COVID-19.

The commodification of healthcare and the structural violence towards the migrant population in the Chilean system materialize in a series of structural barriers to accessing healthcare. In the face of this structural vulnerability, cross-border health mobility is one of the primary resources of indigenous border migrants living in the Tarapacá region (Chile). This involves crossing the border of both people (specialists/patients) and objects (such as ritual supplies or biomedicines), which play a crucial role as, in many cases, it is the only way to satisfy their healthcare needs. The security-orientated geopolitics of border closure (Plan Frontera Segura) has been reinforced by immobility policies linked to the COVID-19 pandemic. While doing so leaves people without the fundamental resource of healthcare mobility or obliges them to cross the border via unauthorized crossings, exposing them to criminalization and abuse by different agents of violence (the military, people smugglers, etc.). In this paper, we will offer a description of these processes of (im)mobility, analyzing their conformation both by the current policies of the Chilean State and by the notorious deficiency in indigenous and migrant rights, denouncing the material impact they have on the health/illness/care process of indigenous migrants.

Inequality and Exclusion in Latin America: Health Care Commodification, Gendered Norms, and Violence

Since the early 1990s, a market‐orientated policymaking in Latin American countries did nothing to secure decent and productive jobs or eliminate gender inequities. It served, rather, to limit social investments that were needed to increase wellbeing, social cohesion, and, eventually, productivity. The pioneering scholarly work of the authors in this thematic issue, using either qualitative or quantitative methodologies, deepens our interdisciplinary understanding of the causes and dynamics of inequality and exclusion in these countries. Contributions are organized in three dimensions: (a) the commodification of health care, (b) gendered social norms, and (c) fragile life and violence. Based on our authors’ findings and suggestions, an agenda for change emerges that emphasizes autonomy from external pressures, community action and representation, eradication of the patriarchy, and expansion of social protection programs.

Is Medical Tourism Really Unethical? An Alternate Perspective for Developing Countries

This article makes a case for leveraging medical tourism (MT) from the perspective of improving healthcare access in developing countries. The expansion of MT at an unprecedented rate has given rise to a number of ethical concerns in both home and destination countries. Ethical debates in this field have transcended the realm of global public health and have emerged across various disciplines including development, social justice, legal, trade and policy studies. Much of the academic literature in these domains has categorically held MT responsible for commodification of healthcare, creating a duality in healthcare systems of developing countries and making healthcare inaccessible and unaffordable for the disadvantaged sections of the population. While all these claims normatively seem justified, this article asserts that despite the several ethical concerns that have been raised, MT may not necessarily exacerbate healthcare equity issues in developing countries. In fact, MT may benefit destination countries by creating a highly specialised private sector which may provide services not only to foreign patients but also to wealthier domestic patients. Voluntary opting-out of domestic patients from public healthcare will result in decongestion of public healthcare facilities, which in turn could be accessed to a greater extent by the underprivileged population at affordable cost. In addition to contributing to the limited academic literature on this particular aspect of MT, this article presents an alternate view to promote MT in developing countries from the perspective of addressing challenges related to healthcare access.

Medical Tourism in Guatemala: Qualitatively Exploring How Existing Health System Inequities Facilitate Sector Development.

This article explores how existing health inequities in the Guatemalan health system facilitate the emergence of its medical tourism industry. We report on our thematic analysis of 50 key informant interviews conducted with 4 groups of stakeholders in the local medical tourism sector. Participants frequently discussed the interplay between the country’s longstanding health inequities and the promotion of medical tourism, characterized by 4 thematic viewpoints: the private health sector is already flourishing; the highly fragmented health system already faces multiple challenges; the underfunded public health sector has a weak regulatory capacity; and the commodification of health care has already advanced. Medical tourism and health inequities shape each other in low- and middle-income countries. In addition to the potential for medical tourism to exacerbate health inequities, previously existing health inequities create opportunities for the industry’s growth. Although regulation of the medical tourism industry is necessary, it needs to be implemented both at the domestic and supranational levels for it to be effective in preventing greater health inequities, and it needs to address the political and economic drivers that make health systems generate health disparities.

O Sistema Único de Saúde e o desafio da gestão regionalizada e contratualizada

Objetivo: Analisar a regionalização da saúde, com ênfase no uso de diferentes tipos de modalidades de gestão e seus efeitos na garantia do direito à saúde. Métodos: Pesquisa qualitativa, cartográfica de ancoragem deleuzeana, recortada pela experiência do Ceará, em duas camadas investigativas, estadual, de 2013 a junho de 2015, com entrevistas de 23 gestores estaduais de saúde, abordando sua institucionalização; e na Região de Saúde Sobral, de fevereiro a setembro de 2016, discutindo os tipos de gestão adotados em unidades-referência públicas, com entrevistas de 14 gestores, 11 profissionais e 12 usuários. A análise dos discursos foi de abordagem foucaultiana e de autores da saúde coletiva. Resultados: A regionalização constituiu-se como estratégia da reforma da saúde, no Ceará, desde 90, institucionalizando diferentes modalidades de gestão, por meio de Consórcios Públicos de Saúde e Organização Social, operadas pelo mecanismo contratual de serviços de saúde. Conformou uma gestão regionalizada e contratualizada por resultados, em engate das dimensões jurídica à assistencial, com efeitos de verdade ao direito à saúde, restrito aos itens contratados e pagos, esboçando um padrão de cobertura de serviços. Considerações Finais: O acoplamento da contratualização à regionalização mostrou-se potente à modelagem do Sistema Único de Saúde pelo ideário da Cobertura Universal de Saúde, institucionalizando o deslocamento do integral e universal para o parcial e focal; do público para a privatização da gestão de seus equipamentos, mercantilização da saúde como bem de consumo e não de direito social e empresariamento dos modos de sua produção.

Public Trust in Physicians-Health Care Commodification as a Possible Deteriorating Factor: Cross-sectional Analysis of 23 Countries.

Trust in physicians has declined, and surveys of public opinion show a poor level of public trust in physicians. Commodification of health care has been speculated as a plausible driving force. We used cross-national data of 23 countries from the International Social Survey Programme 2011 to quantify health care commodification and study its role in the trust that patients generally place in physicians. A modified health care index was used to quantify health care commodification. There were 34 968 respondents. A question about the level of general trust in physicians and a 4-item “general trust in physicians” scale were used as our major and minor outcomes. The results were that compared with those in the reference countries, the respondents in the health care–commodified countries were approximately half as likely to trust physicians (odds ratio: 0.47, 95% confidence interval [CI]: 0.31-0.72) and scored 1.13 (95% CI: 1.89-0.37) less on the general trust scale. However, trust in physicians in the health care–decommodified countries did not differ from that in the reference countries. In conclusion, health care commodification may play a meaningful role in the deterioration of public trust in physicians.

Commodification of Healthcare and its Consequences

This article examines the political economy of healthcare financing and provision from a Marxist perspective. The article argues that the nature of a country's health financing system results in part as a result of the balance of class forces within a society. The commodification of healthcare is seen as not only creating barriers to access that are deleterious to society's most vulnerable members, but also distorting the dynamics of healthcare provision itself. The article closes with a typology of healthcare financing and provision and a brief analysis of essential elements of a rights-based approach to healthcare financing and delivery.

Healthcare choice: Discourses, perceptions, experiences and practices

Policy discourse shaped by neoliberal ideology, with its emphasis on marketisation and competition, has highlighted the importance of choice in the context of healthcare and health systems globally. Yet, evidence about how so-called consumers perceive and experience healthcare choice is in short supply and limited to specific healthcare systems, primarily in the Global North. This special issue aims to explore how choice is perceived and utilised in the context of different systems of healthcare throughout the world, where choice, at least in policy and organisational terms, has been embedded for some time. The articles are divided into those emphasising: embodiment and the meaning of choice; social processes associated with choice; the uncertainties, risks and trust involved in making choices; and issues of access and inequality associated with enacting choice. These sociological studies reveal complexities not always captured in policy discourse and suggest that the commodification of healthcare is particularly problematic.

Is There a Human Right to Private Health Care?

Recent years have seen an increase in the turn to rights discourse within the context of access to health and specifically health care. Developments took place at both the national and global levels, with a significant increase in right to health litigation around the world. The social economic rights regime, is expected by many to address questions of social-economic justice. In the context of the right to health, it has the potential to assist in expanding equal access to health (and health care) and redressing disadvantage. But this article considers the tension between on the one hand the ability of the right to health to reinforce privatization and commodification of health care, by rearticulating claims to private health care in terms of human rights, and on the other hand its ability to reinforce and reinstate public values, especially that of equality, against the background of privatization and commodification. The article considers claims of access to private or semi-private health programs have been made using human rights arguments with success (Canada) and with failure (Israel) and focuses on the role of rights discourse and litigation at this intersection of the public and the private, while considering the role rights play in affecting health policy and health systems at this intersection. By looking at the case law I consider how introducing human rights to the area of public health care may be used not to expand equality, but rather to re-articulate claims to private health care as human rights claims: in both Canada and Israel there have been constitutional attacks on legislation which attempted to prevent a shift from accessibility based on medical need, to accessibility based on the ability to pay.

Le marché de la santé et la reconstruction de l'interaction patient-médecin

Résumé L’orientation marchande des réformes transforme profondément l’interaction médecin-patient, qui constitue le noyau dur des systèmes de santé 1 . Les patients actifs et mieux informés ont trouvé un nouveau statut de consommateur. La prise de parole revendiquée par la démocratie sanitaire a été transformée en stratégie « exit » de la logique marchande. Dans la mesure où le consommateur souverain peut plus facilement comparer des produits standardisés, la construction du marché requiert une nouvelle conception du soin, qui tient compte de l’avancée de l’industrialisation de la médecine. Cette normativité marchande influence les règles déontologiques de la profession et active le libéralisme médical qui est source d’inégalités et d’inefficacité.

Neoliberalismo en salud: La tortura de trabajadoras y trabajadores del Instituto Materno Infantil de Bogotá

To link, from a historical point of view, the most significant transformations of the Instituto Materno Infantil (IMI) [the oldest child and maternity hospital of the country] during its process of crisis, closure and liquidation with the experiences of the hospital workers. To find experience-based and theoretical elements that can interconnect the process of health care privatization of the country with the workers' experiences of resistance and pain/suffering. Critically-oriented ethnography based on continuous collective field work, historical research (primary and secondary sources) and semi-structured interviews with 5 women who worked at the IMI for more than 15 years. A time line of 4 main periods: Los años de gloria [The golden years] (up to 1990); Llega el neoliberalismo [Neoliberalism arrives] (1990-2000); La crisis y las resistencias [Crisis and resistances] (2001-2005); and Liquidación [Liquidation (2006-20??)]. The narratives of the interviewed women unveil multiple aggressions that have intensified since 2006, have caused pain and suffering and are examples of violations of human and labour rights. We suggest to analyze the links between the different kinds of violence and pain and suffering as torture. This category is defined as the set of violent actions that cause physical and emotional pain, which are performed by actors in positions of power over other people who challenge that power and are part of modern States' ideological principles around a defined moral social order. For the IMI workers' case, the ideological principle that is being challenged is health care neoliberalism. From the analyses of bureaucracy, confinement, torturing agents, and the breaking-off of the body-mind unit we conclude that this relationship between neoliberalism and torture aims to eliminate the last health care workers of the country who had job stability and full-benefits through public labour contracts. Their elimination furthers the accumulation of capital generated by increasing over-exploitation of labour and commodification of health care.

The work of nurses in private health: Accounting for the intangibles in care delivery

With the commodification of healthcare in general and of private health in particular, it is difficult not to acknowledge the growing influence of competition and ‘the market’ in shaping the way that nurses’ work is managed by private hospitals and by nurses themselves. This paper explores the discourses shaping nurses’ work in private healthcare, drawing upon data from an ethnographic study conducted in one Australian acute care private hospital. The framework for analysis relies on an exploration of the mentalities and governance of nurses’ work in such a setting. The study shows how marketing and performance measures are believed to ensure the viability of the enterprise while simultaneously commodifying nurses’ caring work. It is this work that remains invisible to the healthcare system and the hospitals where they work.

SAÚDE E POLÍTICAS PÚBLICAS: UMA ANÁLISE A PARTIR DA AVALIAÇÃO DA GESTÃO SOCIAL

This study evaluates the management of program activities of Social Policy implemented by Governmental Organizations and Non-Governmental Organizations in the city of Joao Pessoa/PB from the analytical approach of the Health Policy. This is an Exploratory Study from secondary sources through electronic data collection using descriptive statistics. The results reveal a universe of 1,193 social organizations whose characterization points to the fragile process of decentralization of public management of health services, marked by an expanded network of primary care over a network medium and high complexity and a new process of philanthropy and commodification of health care in the management of private and public-private. These results indicate the precariousness of the Health Policy's commitment to guarantee universal rights. What leads to the conclusion that the political organization of society in the exercise of social control is necessary for the effective processes of social management of Health programs, activities and services. Accordingly, the evaluation perspective adopted here assumes the character of instrumentalization of political groups in struggles organized by the guarantee of rights. DESCRIPTORS Health Evaluation. Health Management. Public Policies. Health Facility Administration

Medical Tourism in Malaysia: International Movement of Healthcare Consumers and the Commodification of Healthcare

In Southeast Asia, medical tourism has taken off in a big way since the 1997 Asian financial crisis. Singapore, Malaysia and Thailand, in particular, have developed deliberate marketing strategies to attract foreign patients. This paper examines the development of medical tourism in Malaysia, with some references to its neighbouring competitors, Singapore and Thailand. The analysis is framed in the context of an increasing trend in the commodification of healthcare, focusing on marketing, standardization and accreditation, and turning patients into consumers as three features of the process of commodification. The advent of medical tourism in Malaysia marked a significant moment for the domestic healthcare provider industry, allowing it to survive a critical juncture. Subsequent growth of the industry has been characterised by a regional integration of hospital ownership, and an expansion of the medical tourist market. In all of this, the role of the Malaysian state is pivotal in providing a conducive policy environment, and in playing a major role in marketing Malaysian healthcare to the global medical tourist market. The process of transforming Malaysian healthcare into a global commodity is well underway, as the state institutionalises measures for tax support, accreditation, sales promotion, and marketing.

Reconstructing data: evidence-based medicine and evidence-based public health in context.

The emergence of Evidence-Based Medicine (EBM) as the gold-standard practice in biomedicine and public health practices represents a significant epistemological turn in modern medicine. The development of Evidence-Based Public Health (EBPH) followed the emergence of Evidence-Based Medicine, as an attempt to ground health policies and interventions on "sound facts". The present paper analyzes the historical and sociological roots of this turn. We evaluate the ethical and social consequences of this transformation, both within the medical profession (the polarization between a medical elite which strengthened its professional status, and a rank and file which experienced a process of "de-professionalization") and in its relationship to the welfare state (the link between the medical elite, EBM, EBPH and the commodification of health care and public health).

Can Cyprus overcome its health-care challenges?

Can Cyprus overcome its health-care challenges?

Can Cyprus overcome its health-care challenges?

The divided island of Cyprus is the only EU member state that lacks a universal health system. Public and private schemes operate in isolation, resulting in duplication and waste. Myria Antoniadou takes a look at Cyprus' unusual system and asks why it is taking so long to change.