Portal de Periódicos da CAPES

Who speaks for whom?

1992; BMJ; Volume: 304; Issue: 6819 Linguagem: Inglês

10.1136/bmj.304.6819.103

0959-8138

Timothy J. Richards,

Language, Discourse, Communication Strategies

the arrangements envisaged by the draft law could effectively force "moonlighting" (more accurately "daylighting") into a separately identifiable and independent subsystem. Vote in favourWith the need to enact the draft law becoming more urgent as each day passed, its sponsors showed that they had learnt how to succeed in the rough and tumble of parliamentary democracy.In a heated debate they not only argued the case but also, apparently, showed flexibility by accepting several amendments.They were rewarded by an overwhelming vote.For the record, the main opponents spoke for the Federation ofIndependent Trade Unions ofRussia; their criticisms turned on considerations of social justice.As Meditsinskaya Gazeta saw the matter, the vote was a victory for the committee chaired by Dr Askalonov, and consequently it devoted some column inches to his comments.These are remarkable for the absence of what is often identified as a failing of the Russian intelligentsia-namely, the tendency to assume that a theoretically consistent scheme can be made to work well in practice.By contrast, Dr Askalonov did not claim that insurance medicine will provide the cure for all ills.He recognised that its introduction, by 1993, must be preceded not only by the creation of the appropriate infrastructure but also by a public information programme, mention of which may be evidence of far more than concern with practical details: it may be held to flow from his acceptance that the scheme can only work well if it gains "social acceptability."7Fairly self evidently, the general public are more likely to have positive attitudes towards "insurance medicine" if they experience a clear improvement in the quality of care provided by the rank and file of Russian doctors.And in this connection it is reasonable to conclude that under the new scheme consumer choice and the forces of the market place should turn out to be powerful incentives for professional self improvement. 1Bliev Yu.