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Feiler, Therese (2018): Encoding truths? Diagnosis-Related Groups and the fragility of the marketisation discourse. In: Feiler, Therese; Hordern, Joshua; Papanikitas, Andrew (eds.) : Marketisation, Ethics and Healthcare. Policy, Practice and Moral Formation. 1. Auflage. London; New York: Routledge; Taylor & Francis. pp. 67-83
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This chapter critically examines an instrument at the meso-level of healthcare which was used to operationalise marketisation: Diagnosis-Related Groups (DRGs). It will contest four constitutive claims that have accompanied the introduction of DRGs: First, the claim that marketisation or quasi-marketisation is theologically and ethically neutral; second, the assumption that marketisation is a natural, impersonal and global evolution. Third, the claim that DRGs represent care transparently and therefore better, suggested by phrases such as ‘money follows the patient’. Finally, the claim that DRGs do not touch the substance of medical work will be examined. The four theologically informed counterpoints to the DRG system are theological significance, historical interpretation and consequently systemic responsibility, the representation of care and the transformative nature of vocation. These destabilise the marketisation discourse, which has attempted a transvaluation of values, fundamentally relocating and redefining healthcare whilst concealing this very move.