Responsibilization of care: tensions over health, insurance and the family in Brazil

When people identify a lack of care or formulate requirements for care they also identify responsibilities. Which individuals or what institutions are seen to be responsible for care, including the failure to meet care needs? This question is particularly urgent in Brazil where it is becoming more popular. Brazilian legislation states that homecare patients must receive care from family and professional caregivers whose efforts must be paid for either by a private insurer or by the state. This means that the patient’s home becomes a contested meeting ground for the responsibilities of healthcare companies, insurance companies, the state’s public healthcare services, and the patient’s family. How can that meeting ground be analyzed? We shall argue here that a situational analysis offers a conceptual space to understand the diverse moral contestations that homecare brings about. Moreover, we show how the onus of attempting to resolve various contradictions that emerge when finance and care meet at home tends to fall on the patient’s daughters in particular.