Re: healthcare/development

[Greg Brown <gregb@alaskapacific.edu>]

Dan Schmidt wrote:

>         This is where I begin to feel like the martyr that G.Brown mentioned,
> because I don't think the Business of Medicine needs to be bigger. I think
> communities can be plenty healthy without lots of MRIs and Arthroscopic
> surgeries.

   I agree.  Size matters.  Competition is essential.  Small is (generally)beautiful.
Here is what Paul Hawken (The Ecology of Commerce)
has to say about "size" today:

   "Enormity, corporate or otherwise, has never been the friend of
humankind...Big corporations take care of what they know how to take
care of, and that is other big things: factories, mass markets, mass
production.  In habitats and ecosystems, we sense how important the
small things are. We humans have yet to create anything that is as
complex and well-designed as the interactions of the microorganisms
in a cubic foot of rich soil.  No ecologist would claim to fully
understand the workings of an ecosystem, but all praise the minutiae
within, the economy that governs, and the wonderously designed
interaction and diversity that marks that cubic foot of soil, that
produces the maximum amount of life with the absence of waste.
The most well-meaning of businesses, whatever its size, cannot
restore society or the environment if it neglects the small things that
need caring for.  In fact, you could almost define the restorative
economy as one that turns its attention in a big way to the small
things."
    "Instead, corporations are creating a second world, an
environment of deadening commercial strip centers leading in
and out of our towns and cities, garbage trains loaded with
trash and toxins, and Bhopals where 200,000 people are sick
or dead or dying.  It is a world where fewer and fewer people
benefit from the grosser and more swollen acts of commerce,
a world in which the small things, the seemingly inconsequential
forms of life, are extirpated with disdain, but to our ultimate peril."
(p. 103)

   Extrapolating to health care:  small, community-based health care
(not disease care) would ensure competition, diversity, and
responsiveness.

--
Greg Brown, Associate Professor
(gregb@alaskapacific.edu)
Alaska Pacific University
(907) 564-8267
Fax: (907) 562-4276