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Race as a Currency? Profitability and Racialization in French Healthcare Institutions

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Race in the Marketplace

Abstract

As in many other countries, French public hospitals began implementing new public management reforms in the 1980s with the aim of controlling public health expenditures and increasing the financial profitability of healthcare institutions. However, public hospital patients often have characteristics that are in contradiction with these reforms’ requirements: a weak “mobilizing value” combining the need for time-consuming care, long stays in health departments, and problems of solvency. Healthcare professionals are therefore encouraged to select patients based on their presumed profitability. Medical, paramedical and administrative staff daily use racialization to assess the patients’ “care load” and budgetary value, and to decide if they represent a risk for healthcare institutions based on profitability criteria. Patients categorized as Roma are perceived as non-profitable patients since they are said to be poor, nomadic, homeless, dirty, non-French-speaking, undocumented migrants, etc. As a consequence, some specialized departments refuse to receive them even when they are sent by the Emergency Room (ER) department of the very same hospital. And some ER departments drive them away on false pretexts, endangering these racialized patients’ health. Budgetary results trump the principle of access to health care. In this way, health care represents a market in which race is a currency.

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Correspondence to Dorothée Prud’homme .

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Prud’homme, D. (2019). Race as a Currency? Profitability and Racialization in French Healthcare Institutions. In: Johnson, G., Thomas, K., Harrison, A., Grier, S. (eds) Race in the Marketplace. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-11711-5_15

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