Wolffers I
Department of Social Medicine, VU-University, Amsterdam, The Netherlands.
Soc Sci Med. 1995 Nov;41(9):1325-32. doi: 10.1016/0277-9536(94)00415-p.
The socialist republic of Vietnam had a centrally planned economy and a well-distributed health-care system that was free to all. Since 1989 the government implemented a free market policy (Doi Moi). Authorities tried to shift part of the cost to users of health care and to improve aspects of the health-care system that appeared to be ineffective. Private practice of physicians and pharmacists was introduced in Vietnam. The introduction of privatization had consequences for the public health services at provincial, district, village and hamlet level. This has changed the character of the health-care system. Pharmaceuticals play an important role in the transactions between practitioners and patients, because they are the tangible goods that are exchanged in the transactions between users and providers of health care. Medical anthropologists interprete use and ideas on pharmaceuticals in terms of local cultural categories or as metonymic signs of technologically advanced societies from whence they come. Use of pharmaceuticals can also be understood in a historical and political context. This article describes pharmaceuticals in the process of privatization in Vietnam and the way they are seen by the Vietnamese in the context of political change. Their use carries meanings of medicines about transformations in political economy and as such this can be seen as a metaphor for the changing Vietnamese health-care system.
越南社会主义共和国曾实行中央计划经济，拥有一个全民免费且分布广泛的医疗保健系统。自1989年起，政府实施了自由市场政策（革新开放）。当局试图将部分成本转嫁给医疗保健使用者，并改善医疗保健系统中似乎效率低下的方面。越南引入了医生和药剂师的私人执业制度。私有化的引入给省、区、村和小村层面的公共卫生服务带来了影响。这改变了医疗保健系统的性质。药品在从业者与患者的交易中发挥着重要作用，因为它们是医疗保健使用者与提供者交易中交换的有形商品。医学人类学家从当地文化范畴或作为其来源的技术先进社会的转喻标志来解读药品的使用和相关观念。药品的使用也可以在历史和政治背景中得到理解。本文描述了越南私有化进程中的药品以及越南人在政治变革背景下对它们的看法。药品的使用承载着有关政治经济变革的药物意义，因此这可以被视为越南不断变化的医疗保健系统的一个隐喻。
