Friday, January 9, 2015

BC Health Care - The Problem with Regionalization

Health Care Reform 

Regionalization took healthcare out of the hands of community and put in the hands of an administrative board, people I never have spoken to – they are even hard to reach. People complain that absent government involvement in healthcare we would be subject to corporations, I would submit that at least with corporations there is a motive to speak to me and see to my needs. The degree of arrogance in health administration, generally, is appalling – regionalization only makes it more aloof. With the introduction of regionalization came more distance from health providers as opposed to less. In British Columbia we have no control over how we access healthcare, we are the treated like a herd of cattle, to take medical care like the anonymous people deliver it, and there is no other option for us. This would be ok if healthcare was coming to us in an adequate way, but it is deficient, and regionalization contributes to deficiency, rather than serving to contribute to the needs and wants of patients.

What was the motive for regionalization anyway, the government of the day would have said, efficiency of course. We can all see that healthcare costs are growing as opposed to lessening. What was saved really by regionalization - some back office expenses – maybe – some consolidation of support services – maybe. What was the cost – distancing administration from services, further bureaucratization and the dismantling of community control over our care. Any benefit that was garnered from consolidation could have been done through inter-community co-operation shepherded by government, instead, regionalization was forced on us by government – top down, we know best.
Regionalization as a solution is contrary to England’s National Health Service’s conception of solution, which, under the Tony Blair Government, privatized hospitals through societizing them. It seems to be commonsense that making an organization bigger is going to make it less responsive, and regionalization has certainly done that.

Regionalization is a part of a more general trend in society at large, which is to professionalize and institutionalize medical services. This is in part due the monolith that has emerged under a single payer system, and in part the credentialization processes and related organization. When I was a child my mother, with five children, had a cure for everything – we never went to the hospital unless, as was once was the case, my brother reported his arm was bent; now people are encouraged to call the doctor prior to engaging in exercise. The point here is that healthcare delivery, despite clear deficiencies, remains solely in the hands of institutions and professionals – worse however, is that the regulations designed to support the healthcare complex prevents us from helping ourselves. Now, with regionalization, the government sponsored institution and healthcare regulatory complex is even further removed from our control. 

There a number of ills with healthcare delivery in British Columbia, regionalization has exacerbated nearly every one. The single factor that maintains service delivery in the system today is the goodwill of caregivers; regionalization is increasingly removing institutional access to that goodwill.           
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