Medicine and Markets: Power, Choice and the Consumption of Private Medical Care

Abstract

The recent sociological attention to consumption is undoubtedly a reflection of the continuing power and pervasiveness of the Tory ideology of the market and the emphasis given to the ‘consumer society’. It is in the context of this political concern with consumption that writers like Peter Saunders (1986; see also Dunleavy, 1979; Dunleavy and Husbands, 1985), who is himself critical of what he sees as the biases of other sociologists, have developed the argument that divisions associated with consumption have replaced divisions generated by production as the key dimensions of stratification within present-day society. A more detailed examination shows that, in this country at least, the consumption of medical care does not fit this analysis at all well. This is because, put simply, most people consume — or more neutrally use — both private and public medical care (Busfield, 1990).¹ Consequently, it is not possible to identify any clear sectoral divide between public and private consumers, even though there is a marked division between the private and public sectors in the production of medical care — a division that is the usual basis of the distinction between private and state medicine (however, the interpenetration of these two sectors is now greater than formerly (Busfield, 1990: 82–3)).