新自由主义全球化对“医疗化”的形构

Neo-liberalist Globalization on the Formation of“Medicalization”

"医疗化"与新自由主义全球化之间有怎样的关联?国内外社会学界对此尚缺乏系统的分析。本文以物质力量、制度、观念为分析框架,探讨新自由主义如何加剧并转变全球的"医疗化"状况。在物质上,产、官、学复合体网络的多方利益形成有力的市场力量,从而促成医疗化;在制度上,则是由于药品之国际专利权的制定与各国导致医疗化的政策;在观念上,某些压力团体因为要强化"竞争力"而推动某种服药的观念、个人自主健康管理的盛行、风险恐慌的论述普遍化及另类医疗的兴起等氛围都加剧了"医疗化"。即便有反新自由主义的力量,但医疗的供给面与需求面均被牵涉到因商品化可获利的普遍利益中,因而新自由主义的结构性力量仍难以撼动,从而使医疗化加剧。

There has been a lack of systematic analysis of the relation between ＂medicalization＂ and the neo-liberal globalization. Drawing upon Cox＇s hegemony theory, this paper intends to fill parts of this gap and suggests that Neo-liberalism intensifies ＂medicalization＂ through the aspects of material power, institutions, and conception. The paper recounts on the mechanisms within these three domains respectively. In terms of material power, a complex network formed among industry, government, and academic circle can maneuver a strong market power to intensify ＂medicalization＂. Affecting institutions include the construction of an international patent system and the policies about medicalization made by governments. As for the aspect of conception, this paper examines the promotion strategies of certain medicine by some groups having recourse to a ＂competitive discourse＂, the popularity of self-health-control management, the spread of risk discourse and the emergence of alternative medication. However, this operation has also developed other possibilities. First of all, this operation cannot be easily achieved as the anti-neoliberalist forces are resisting medicalization. Secondly, new forms of medicalization have emerged which shift from the control of the health care system to a situation in which people are more willing to seek medical treatment, as a result of the popularity of health risk discourse. Also, the development of new medical technology on the one hand stops certain aspects of medicalization, but increasingly monitors human body on the other. However, despite the existence of anti- neoliberalist forces, the medical supply side and the demand side are both involved in a common interest of commercialization. The structural power of neo- liberalism is still difficult to shake, which ends up in the further intensification of medicalization.