The Indian Corporate Hospitals: Touching Middle Class Lives

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[EN] The main argument of this paper is that today these hospitals are one the most efficient vehicles that promote consumerism in healthcare. If we consider consumerism as an ideology, then the corporate hospital, as a place, is like the manifesto in the field of healthcare, which through place marketing, are promoting newer perspectives of health service delivery and health. These places are creating confusion among the patients by mixing different symbols and signs from the consumption society. The mythical dimension attached to the corporate hospitals is interesting as it echoes some of the values attached to consumerism and the Indian middle class. The promotion of the personal history of the founders, the location strategy or the marketing strategy can offer interesting elements to understand how healthcare has gradually being commodified in India. The final outcome of such nexus between healthcare and consumerism can be seen in the “medicity” or “health city” projects that are mushrooming in the suburbs of Delhi, Hyderabad, and Kolkata. We previously described some elements of disneyization (Bryman, 2004), like hybrid consumption, performative labour or merchandising that Bryman found to be originated from Disney theme park. The main objective is to nurture more profits for hospitals through increased synergies and theming.

Reference

Lefebvre, Bertrand (2008) « The Indian Corporate Hospitals: Touching Middle Class Lives »,in Jaffrelot, C., Van der Veer, P. (éds) Patterns of Middle Class Consumption in India and China, Sage, New Delhi, pp. 88-109

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The Rebirth of the Hospital: Heterotopia and Medical Tourism in Asia

[EN] Medical tourism is giving birth to new places of care e.g., new international patient wards. Hospitals designed for foreign patients have been planned in India, Middle East and Southeast Asia. In fact, hospital architecture, design and organization are being rethought through this prism of medical tourism. These hospitals face a dilemma of trying to meet local healthcare needs as well as the expectations of a tourism industry standard. Hence we find it relevant to investigate the services such hospitals provide and precisely how the ‘new’ patients’ demands are being met. Foucault’s (1967) theoretical concept of heterotopia will be employed for analyzing the ‘distinctive experience’ of healthcare proffered in medical tourism. The whole experience emulates ‘a realized utopia’.

Reference

Bochaton, Audrey, Lefebvre, Bertrand (2008) « The Rebirth of the Hospital: Heterotopia and Medical Tourism in Asia », in Winter, T., Teo, P., Chang, T.C. (éds) Asia on Tour. Exploring the rise of Asian tourism, Routledge, New York, pp. 97-108

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”Bringing World-class Healthcare to India”. The Rise of Corporate Hospitals

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[EN] Corporate hospitals can be defined as private for-profit hospitals (as opposed to charitable hospitals) offering general or specialist tertiary level care (e.g. cardiac care). They are different from others hospitals because of their private corporate limited status.  Following the liberalization and economic reforms of 1991, we may suppose that corporate hospitals mushroomed all over India. Such hospitals are expanding rapidly in number especially in the metropolises such as Delhi, Kolkata, Bangalore and Hyderabad.

But more than ten years after economic reforms, they hardly tap 7 per cent of the total spendings in private healthcare (CII-McKinsey, 2002). Because of their for-profit orientation and certain misuses of public subsidies, their expansion has become controversial in a country where public hospitals and primary care facilities are in such a bad shape. With the best medical teams and the wealthiest patients fleeing from the public hospitals to these institutions reserved for elite, the gap in the delivery of quality care has surely increased. But who is responsible for this situation? The World Bank and the International Monetary Fund and their Structural Adjustment Policy? The national and local political elites who followed the prescriptions of the international agencies? The corporate hospitals and the economic powers behind these hospitals? The NRIs who came back to India with new concepts of care?

If globalization has a lot to explain on the emergence of corporate hospitals, we would like to remind of and analyse the complexity that prevailed during the birth and the development of this innovation. The interactions between local and global forces were numerous and took different channels. The birth and expansion of corporate hospitals are embedded in those channels.

Reference

Lefebvre, Bertrand (2009) « ”Bringing World-class Healthcare to India”. The Rise of Corporate Hospitals », in Vaguet, A. (éd) Indian Health Landscapes under Globalization, Manohar, New Delhi, pp. 83-99

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Interviewing elites. Perspectives from medical tourism sector in India and in Thailand

[EN] This paper aims to contribute to the methodological debates on elites interview. While researching medical tourism in India and Thailand, many interviews were conducted with medical professionals, marketing and operation managers of corporate hospitals, and key members of different ministers or professional organisations in India and Thailand. Given the potential negative impacts on the local healthcare, this elite is building a discursive reality to embed medical tourism in each country. We analysed the methodological challenges faced interviewing this elite promoting medical tourism. Though not exclusive, « interviewing up » raises various methodological issues like the access to the informers, the unbalanced power relations during the interview, the reliability of information. Medical tourism being a new trend, the deconstruction of public discourses from the various medical tourism promoters was fundamental in order to extract maximum information during the interviews. The manipulation of our positionality was of great help to gain access to our informers. While not insisting on our academic and disciplinary affiliation, the diplomatic status of one of the team’s members was on the contrary very effective in giving more credibility to our requests for interview. Our positionality was again reworked through the interview’s process. During the interview, the reciprocity of information, the exchange of opinion, was of great help to build confidence among the interviewees and to gain more sensitive information.

Reference

Bochaton, Audrey, Lefebvre, Bertrand (2010) « Interviewing elites. Perspectives from medical tourism sector in India and in Thailand », in Hall, M. (éd) Fieldwork in Tourism. Methods, Issues and Reflections, Routledge, New York, pp. 85-95

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