The Language of Informality: Secrecy, Allusion, and Normalization of Informal Payments for Health Services in Romania

This paper examines the role of language in normalizing informal payments for health services in Romania. Based on qualitative interviews with 27 participants diverse in terms of age, gender, ethnicity, education, and place of residence, the study explores how these informal payments, often euphemistically called “șpagă” or “atenție” (“attention”), are embedded in a coded language. Participants have acquired and mastered this language through socialization and repeated personal experience, yet they frequently struggle to articulate it explicitly. This ambiguity is a central feature of the language of informality, reflecting and reinforcing the moral uncertainty that allows contested practices to persist.

Phrases such as “să fim luați în evidență” (“to be properly attended to”) or “a băga în buzunar” (“to slip into the pocket”) obliterate the transactional nature of the interaction and contribute to making these payments appear as routine or expected. Framed in familiar, indirect, and often jocular terms, informal payments are thus transferred into the field of everyday interactions.

This paper argues that the language functions to conceal and normalize informal monetary transactions in health settings, while also exposing the gap between the ideal healthcare system patients hope for and the one they encounter in reality. The findings contribute to a deeper understanding of how disreputable exchanges become socially embedded, particularly in health systems marked by resource scarcity and inequality.