Between Biomedicines – Negotiating Expectations and Cultural Beliefs on Healthcare among German, Japanese and Indian Expatriates in the USA
Highly skilled migrants do not commonly find themselves in the medical anthropological gaze. They have arguably remained invisible in much of the literature and policy, because host countries view them as politically, socially and economically ‘acceptable’ and ‘culturally neutral’. The assumption that highly skilled migrants adapt easily to their host society also holds particularly true for the health care setting: a culturally caused inability to utilize health care successfully is usually only assigned to patients with cultural backgrounds that strongly differ from the expected norm, and this expectation is mirrored in the type of cultural training offered to health care practitioners.
This project aims to challenge this assumption by analyzing the experiences and expectations of foreign-born skilled professionals with the US health care and health insurance systems, focusing on structural and functional discrepancies within health care and health insurance. In the framework of an ethnographic study, three groups of migrants and their assimilation into US American health care and insurance are compared and contrasted: German nationals, who are migrating from one Western industrial country to another; Japanese nationals, who represent migrants from a non-Western but industrial country; and Indian nationals, who come from the so-called ‘developing world’.
Drawing on both medical anthropological theory on biomedicine and research on transnationalism, I evaluate the experiences of these individuals in terms of differences in cultural understandings of medical competence and practices as well as bioethical issues surrounding physician-patient encounters and health care delivery, progression and outcomes. The transnational framework is also applied to investigate the cultural determinants of satisfaction with and expectations towards health insurance and the extent of its coverage.
The results of this ethnographic study set out to show that the experiences of these groups should not be viewed in opposition to those of other immigrant groups, but rather act as indicators of remaining barriers to all immigrant groups and other newcomers to the US health care and health insurance systems.
PhD supervisor: Prof. Dr. Hansjörg Dilger