Gareth+-Memo+6+Delineating+a+Project


 * __ Memo 6: Delineating a Project __**

My work on medical tourism, on the expansion of overlap between practices of international travel and healthcare might be seen as encompassing three broader topics: the relation of individual and state, the bridging of difference in biomedical practice and knowledge, and the formation of transnational groups via technological mediation. While the patients appear in all three, it is centrally not the figure of the tourist who I look at. Rather I want to show that an industry with relatively few patients may have broad impact on the social setting in which it exists. As an examination of the way recent changes in global political and social order shape the relation of individual and state. Traditional notions of the responsibility of state for the welfare of the individual have been in particular flux within the shift toward ‘neoliberal’ governmentalities. Central to my conception of the change represented in this field is the way that the expansion of corporate powers and transnational groups are mobilized within and challenge ideas about responsibility for health.

While tourists mobilize the idea of medicine as universal practice, the knowledges and structures of medicine are variable. I question the way that dominant discourses of ‘choice,’ ‘transparency,’ and ‘privatization’ take on certain universal meanings despite very different local instantiations of practice and meaning. In the backlash against ‘the welfare state’ in developed nations, and the drive to ‘development’ in marginal nations the stage has been, in part, played out in a reciprocal shift in access to high tech biomedicine that has been enabled by the development of a private healthcare industry catering to medical ‘tourists.’ These shifts have also lead to new arrangements of power and status as medical centers are built and relocate the image, if not the reality, of access to medicine from Western Europe and America to previously marginal sites in India, Asia and Latin America.

A) Focus on Institutions: A political economic / discursive analysis of the relationship of individual and state, focusing on examination of the way access to healthcare and expectations of healthcare are shifting in relation to practices that involve travel.

B) Focus on Experts: A close analysis of the way that biomedical knowledge and practice are multiple and shaped by local cultures, focusing on the negotiation in liminal points, i.e. the process of influence of forms of care offered to cater to tourists in destination sites, and the process of legitimation of joint resurfacing in the US in response to its success in India.

C) Focus on the communications: Central to the formation of “Medical Tourism” and “the medical tourist” are web based agencies, online communities, blogs and the use of ICTs that allow an international negotiation for roles, prices and practice. The space online is used to build transnational networks.