
Contents
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Becoming Private Consumers of Publicly Financed Care Becoming Private Consumers of Publicly Financed Care
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Interviewing “Consumers” Interviewing “Consumers”
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Don Anastasio: Work as Health Don Anastasio: Work as Health
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Doña Carmen: Caring for the New Health Consumers Doña Carmen: Caring for the New Health Consumers
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Teresa Ramírez: Disability and the Precariousness of Class Mobility Teresa Ramírez: Disability and the Precariousness of Class Mobility
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Conclusions: Consumers, Citizens, and the State Conclusions: Consumers, Citizens, and the State
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3 New Consumer Citizens: Life Histories
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Published:August 2014
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Abstract
This chapter describes the life histories of particular citizen consumers who struggled to obtain care from the privatized health system under the MMA. It argues that the aspirations of neoliberal health policies never managed to transform patients into calculating, health-seeking consumers. The chapter offers four explanations for why this is so. First, compared to mainland U.S., market reforms came relatively late to Puerto Rico and the government had a larger symbolic and functional role in caring for the sick and poor. Second, the model of the decision-making consumer does not account for the moral and social criteria that people actually employ when making decisions about their health care. Third, the able-bodied, individualistic assumptions underwriting the notion of the health care consumer are out of place in describing how people react to and experience illness, disability, and dependency. Fourth, the “choices” that consumers can actually make regarding their care are quite limited.
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