Bourdieu and Field: Theory and Method in the Australian Healthcare Sector

Bourdieu's concepts of habitus and capital have become popular theoretical choices for sociologists of health, while the field has been of lesser interest. In this paper, we draw on a study of the Australian healthcare system to argue for the applicability of Bourdieu's concept of the field, particularly when used in conjunction with his unique methodological approach. Bourdieu's concept enables a focus on the key discourses, practices, actors and relationships that comprise the healthcare sector, while his method, that of 'mapping the field', guide analysis of the relations of power which structure the healthcare system. Our study involved a discourse analysis of the print media, 78 qualitative in-depth interviews with citizens, and 41 with gatekeepers (including doctors, health service managers and policy-makers). Applying the method and concepts of Bourdieu, the healthcare field is shown to be dominated by media messages promoting private sector medicine and discrediting public medicine. These messages, which have been strategically constructed through the policy agendas of governments since the late 1990s, are in alignment with the hierarchical arrangement of the field, where the dominant actors are from the private sector (particularly the health insurance industry and the private hospitals). Despite the continuance of Australia's world-class health system and universal national insurance system (Medicare), these discourses have contributed to a significant change in the practices and relations of power in the field. Citizens have come to believe in the necessity of purchasing private insurance and increasingly lost confidence in public sector medicine; healthworkers (particularly specialists) have increasingly taken up opportunities in the private sector, thus lessening the capacity of the public sector to provide for public patients; and private entities (e.g., insurance agencies, diagnostic imaging companies) have extended and consolidated their influence (and profitability) within the field.