PHYSICIAN PROLETARIANIZATION AND MEDICAL-CARE RESTRUCTURING IN ARGENTINA AND URUGUAY

Labour disenfranchisement has rarely focused on skilled labor such as physicians. In Latin America, physicians play a key role in social production and reproduction. This paper traces the loss of physician control over the conditions of their work since the turn of the century. Argentine and Uruguayan physicians manage to keep the medical industry free of government intervention that would reduce their income-earning potential. Medical care in both countries has responded to the forces of ethnicity, class, and changing medical technology. Bureaucratic complexity and numerous small medical programs allow physicians to hold down several jobs. The labor theory of value suggests that physician proletarianization is well underway in both countries. Specifically, a trend toward physician proletarianization is most evident in four key ways: the terms of criteria for entrance into the profession, autonomy regarding the terms and content of work, tools of labor, and the amount and rate of remuneration. The paper concludes that studies of physician production and reproduction in the Latin American city must go beyond "doctor bashing' if we are to understand the transformation of health care delivery. -Author