Rescue First or Money First? Commercialised Institutions, Calculating Professionals, and Neoliberal Governance

Abstract

The health system in the market era presents hospitals and doctors with ambivalence and dilemmas. The hybrid market and planned system place dual and frequent conflicting requirements on the public hospitals -- both to uphold their public service nature and be self-sufficient. Hospitals then place market demands on ordinary health professionals who are measured according to their performance with regard to work efficiency and profit generation. The market-oriented health system encourages `rational' profit-driving activities and frequently acts to discourage altruistic behaviour that fails to generate profits. The commercialised health system threatens medical professionalism and objectifies both patients and health professionals.