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This chapter introduces and explores the continuing relevance of George Ritzer's McDonaldisation thesis to contemporary healthcare reforms. In general terms, Ritzer's work revisits and extends Max Weber's analysis of modernity, especially the idea that social action is increasingly "rational' or driven to determine the most efficient and practical means of achieving a desired end. For Weber, this type of "instrumental rationality' was best exemplified by the growth of bureaucracy, which institutionalised the roles, rules and regulations of achieving efficient and effective modes of social action. In revisiting these ideas, Ritzer's work offers a counter-argument to more recent social theories that describe a late- or post-modern era characterised by more diverse and fluid types of action, including post-bureaucratic modes of social organisation. At its foundations, his McDonaldisation thesis, therefore, aims to demonstrate the continuing relevance of Weberian concepts of rationality and bureaucracy to contemporary society by showing how they have evolved to reflect additional social changes, especially individualisation, consumerisation and globalisation. In particular, Ritzer's work focuses on the mode of social organisation associated with fast-food chains, such as McDonalds, as exemplifying the hyper-rationalisation of everyday life. This includes rationalising the production of goods and services, and also transforming the material and symbolic modes of consumption. Importantly, he also reveals the inherent contradictions and irrationalities of this type of social action, especially latent risk and the illusion of choice.

DOI: 10.1057/9781137355621_31

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