A Market of Distrust and Obligation: The Micropolitics of Unofficial Payments for Hospital Care in China

A Market of Distrust and Obligation: The Micropolitics of Unofficial Payments for Hospital Care in China

Cheris Shun-ching Chan - Department of Sociology, University of Hong Kong

Monday, October 14, 2013 - 4:30pm to 6:00pm
Room 203, Luce Hall See map
34 Hillhouse Ave.
New Haven, CT 06511

Based on ethnographic studies in public hospitals in four Chinese cities in 2011-2013, this project examines the institutional and cultural factors behind the practice of unofficial payments for hospital care in urban China. The corporatization of public hospitals that started in the 1980s and intensified in the 1990s-2000s resulted in earning them widespread distrust. The generalized distrust in hospitals and physicians induced patients to revive a tradition of delivering hongbao (red packets containing money) to physicians, but imbued it with new meanings and new practices. Patients offered hongbao not only to gain preferential treatment in the context of over-demand for quality services but also, equally important, to boost their confidence in physicians whom they generally distrusted. Furthermore, hongbao exchanges are found to be highly associated with the use of Chinese guanxi (interpersonal relationships). Hongbao exchanges among strangers are different from those among socially connected ties in terms of their cultural meanings and practical impacts.

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China