Navigating choice : medical tourism, travel, and care in the new global biomedicine

Abstract

This thesis is an analysis of what the discourse of choice enables in the practice of medical tourism, an industry providing for travel across national or regional boundaries by patients to receive direct medical services. It documents the way that the discourse of choice is mobilized as part of the usage of the term "medical tourism" and offers a case study of institutionalization of medical tourism in Manila, Philippines and the United States. In this case study, I offer an interpretation of the discourse and cultural concepts of choice in enabling and shaping medical tourism, and I suggest it is representative of the importance of choice in other areas of practice. Choice, as both a vital cultural component of neoliberalism and the ongoing consumerization of healthcare,can be seen as an active catalyst for the actions of participants in shaping the discourse and practices of travel by medical service seekers. Medical tourism can be described in terms of a choice between locations of hospital, comparable to a choice between two doctors located near each other, and as such the concept of choice obfuscates concerns about distance, travel, and differences in medical practices within the ability or access of choice of increasingly choice-making patients under neoliberal governmentality. I suggest that the discourse of choice in medical tourism serves as a key value legitimating cultural shifts across multiple forms of contemporary social life such that it serves as a primary regime of justification in the variety of social forms and governing mentalities interpreted as neoliberal.