This article approaches informal relations in post‐socialist settings from a political economy perspective. Taking as a case study informal exchanges in the Romanian healthcare system, the article addresses the question of their continuity in the face of both divergent claims and increased monetarization of exchanges. It contends that informal exchanges are individual responses to the increased inequalities that followed the post‐socialist redesign of the state. However, by further heightening social inequalities and competition, contemporary neoliberal reforms exacerbate the predatory side of informal exchanges, thus threatening to disrupt their fragile accommodation with post‐socialist transformations.
Résumé
L’auteure de cet article examine du point de vue de l’économie politique les relations informelles en contexte postsocialiste. À partir d’une étude de cas du système de santé roumain, elle interroge la pérennité des échanges informels face à des revendications divergentes et à une monétarisation croissante des échanges. Elle présente les échanges informels comme une réponse individuelle aux inégalités accrues ayant accompagné le remaniement postsocialiste de l’État. Les réformes néolibérales actuelles, accentuant encore les inégalités sociales et la compétition, exacerbent cependant l’aspect prédateur de ces échanges informels et menacent ainsi leurs fragiles accommodements avec les mutations de l’ère postsocialiste.
Industrial relations scholars have argued that east-west labour migration may benefit trade unions in Central and Eastern Europe. By focusing on the distributional aspect of wage policies adopted by two competing Romanian trade unions in the health care sector, this article challenges the assumption of a virtuous link between migration, labour shortages and collective wage increases. We show that migration may also displace collective and egalitarian wage policies in favour of individual and marketized ones that put workers in competition with one another. Thus, the question is not so much whether migration leads to wage increases in sending countries, but whether trade unions' wage demands in response to outward migration consolidate collective solidarity and coordination in wage policy-making, or support its individualization and commodification.
Although the European Health Insurance Card (EHIC) was meant to bring Europeans together, this study shows that it is amplifying social inequalities across regions and classes. First, we evaluate the effects of east–west EHIC mobility, and of Eastern Europeans’ participation in it, on the practice of EU social citizenship rights to access cross-border care along spatial (east–west) and social class divides. We then assess the impact of these mobilities on healthcare resources in Western and Eastern Europe. Our findings show that the EHIC reinforces rather than reduces the spatially and socially uneven access to social citizenship rights to cross-border care. Moreover, EHIC patient outflows from Eastern to Western Europe result in a much higher relative financial burden for the budgets of Eastern European states than outflows from Western to Eastern Europe do for Western European countries. As a result, east–west EHIC mobility is reproducing rather than reversing healthcare inequalities between the two regions. Hence, the EHIC does not fulfil its promise of European social integration – not, however, because it creates a burden on Western European welfare states as often argued in Eurosceptic tabloids, but because it increases social inequalities both inside and between richer and poorer EU member states.
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