Jenkins Danisha, Cohen Jennifer, Walker Rae, McMurray Patrick, Dillard Wright Jess
School of Nursing, San Diego State University, San Diego, California, USA.
Department of Global and Intercultural Studies, Miami University, Oxford, Ohio, USA.
Health Equity. 2024 Jul 26;8(1):480-492. doi: 10.1089/heq.2024.0059. eCollection 2024.
This article politicizes a reimbursement model proposed by some professional nursing associations that aim to better align the price of nursing labor (nurses' pay) to the value of nursing and make nurses' contributions more visible.
Using the concept of "missing care," the critique reveals how professionalization directs attention to individual-level interactions between care seekers and practitioners while obscuring from view the harm inflicted by social institutions and structures constitutive of a capitalist political economy and the related carceral state.
Direct reimbursement models render practitioners complicit in the harms perpetrated and perpetuated by the health care industrial complex while professionalization processes are deployed to reduce cognitive dissonance (and moral injury) produced by combining harm with nursing's normative principles.
We describe and trace the complementary capitalist imperatives of extraction-based profit maximization and efficiency through the health care industrial complex to demonstrate how formative those imperatives are of the health care system, care-seekers' outcomes, nurses' experiences, nonconsensual modes of data collection, and surveillance.
The naturalization of racial capitalism and the precarity and violence it entails foreclose the creation of ethical alternatives that prioritize well-being instead of the pursuit of profit that could bring the provision of and payment for care closer to the normative principles held by practitioners.
本文将一些专业护理协会提出的报销模式政治化,这些协会旨在使护理劳动力价格(护士薪酬)更好地与护理价值相匹配,并使护士的贡献更显著。
通过“缺失护理”的概念,该批评揭示了专业化如何将注意力引向寻求护理者与从业者之间的个体层面互动,同时掩盖了资本主义政治经济及相关监禁国家的社会制度和结构所造成的伤害。
直接报销模式使从业者与医疗保健产业综合体所造成和延续的伤害同谋,而专业化过程则被用来减少因将伤害与护理的规范原则相结合而产生的认知失调(和道德伤害)。
我们描述并追溯了通过医疗保健产业综合体实现基于提取的利润最大化和效率的互补资本主义要求,以展示这些要求对医疗保健系统、寻求护理者的结果、护士的经历、非自愿数据收集模式和监督的形成作用。
种族资本主义的自然化及其带来的不稳定和暴力排除了创造优先考虑福祉而非追求利润的道德替代方案的可能性,而这种替代方案本可使护理的提供和支付更接近从业者秉持的规范原则。