“Les catholiques sont l’élite!”: représentations de l’espace politique par une minorité religieuse au Burkina Faso

Abstract

The Catholic Church occupies a privileged position in the religious arena in Burkina Faso. Having invested very early in the public arena of the country, it constitutes a vital actor in the socio-political landscape of the country as attested to by its involvement in the domains of education and health and its positioning as mediator in times of crisis. Based on a field survey conducted among members of the Catholic community (members of the clergy, religious and lay), this article studies the manner in which Catholics in Burkina Faso portray themselves as a religious community in the country’s political arena. It reveals that in Burkina Faso the Catholics portray themselves as a dominant religious minority in terms of politics due to their disproportionate engagement in the apparatus of the state. The article also shows that the Catholics in Burkina Faso see their dominant position as under threat, on the one hand, from competition by the Protestants and, on the other, by the rise of Islamism.     

Physician-management relationships at HCA: a case study

The questions of whether Hospital Corporation of America (HCA), a for-profit hospital company, fostered an environment detrimental to the physician-patient relationship during the period of implementation of the Medicare Prospective Payment System (PPS) was explored. The transition to PPS provided an opportunity to evaluate whether hospital ownership differences affected responses to a payment system which encouraged institutional intervention in the practice of medicine. A case study approach was used to observe the influence of the then largest for-profit hospital corporation upon physicians' medical practice in four owned hospitals. Findings indicated that HCA hospital managers were most directly influenced by the local competitive environment and their own personal agendas in responding to PPS incentives. Corporate influence actually softened payment system incentives to intervene in medical practice by providing a generous supply of capital, and by fostering a corporate culture conducive to cooperative relationships with physicians. Better public understanding of the determinants of hospital behavior is needed to preserve or enhance important social goals such as the physician-patient relationship; easily measurable characteristics such as ownership or bed size explain little about hospital behavior or motivation.