Paying for what ails you: Sociocultural issues influencing the ways and means of therapy payment in South India

The dynamics of payment for therapy to traditional healers and cosmopolitan pratitioners in rural South India is focused upon as a means of better understanding health care seeking behavior, patient-practitioner relationships and interactions, treatment decisions and referral. Payment to traditional practitioners involves the ideal of moral bonding while payment to cosmopolitan practitioners remains largely non-moral. Charging for therapeutic consultations through medicine costs and the layperson's means of estimating the cost of therapeutic services and regimes are investigated as factors influencing practitioner shopping, the practice of medicine, and the dynamics of prescription writing. The meaning and process of payment are identified as issues influencing both micro and macro, moral and pragmatic aspects of health care and health economy.