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The Cruel Fantasies of Well-Fed People
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this post was submitted on 28 Oct 2023
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The hospital is over a hundred years old. It's a real hospital. It's not a big hospital, but it's where I went when a nail went through my hand and they had all the necessary scanners and a surgeon and stuff. I'm not sure why you'd just speculate otherwise? You consistently downplay the depth of rural communities and I find it frustrating.
Well, I don't know the exact situation there, but generally speaking it is not viable to have a typical hospital in a community of just 5000 people. It just doesn't work out economically (even under ideal assumptions), which means other people must pay for it without benefitting from it, which is not exactly fair.
It's not exactly fair in the same way that it's not exactly fair that we have to grow food for you guys in cities. We do things for each other because we're a society and being a society is cool.
I disagree, there is nothing wrong with asking rural inhabitants to come to a nearby city to get treatment in a hospital, if that means that the service of this hospital can benefit people equally instead of it being monopolized by a small number of rural inhabitants.
And no one is forcing anyone to grow food, rural inhabitants are not enslaved by city dwellers.
But a society needs a certain amount of food and other resources for a given number of people, there is just no way around that if you don't want people to starve.
So what is your proposal to this? We can't continue as is, and moving all the city inhabitants to rural areas is clearly also not feasible.
Would they not have a hospital/emergency care facility that is appropriately sized to cater to the needs of that particular community? I don't really see how it would be a significant a drain on resources for a rural community to have that, unless I'm not accounting for something. And if that smaller hospital is adequate for the community, wouldn't that reduce the burden on the larger city hospital?
I could see them still being required to go to a larger city hospital for more unique problems that require specialists, but for more standard care, on the surface it seems like a local hospital would be a good thing to have, especially since there might be doctors that would prefer to live in a rural area anyway, which would cut down the energy needed for their own commute if they instead had to work in a city hospital.
Maybe I am a bit more specific with the definition of "hospital".
Hospitals typically means 24/7 full care with a significant number of in house patients.
A larger health center might offer 24/7 emergency care and some ambulance services, but is typically not equipped and staffed to deal with anything other that short term ambulant care.
Ah, I think definitions may be at the heart of the disagreements I've seen here. From what I've read just now, a health center in Europe and other places with universal healthcare is, as you say, a place with emergency care, but with only a small amount of beds available.
In the U.S., a health center is seemingly exclusively used to refer to a facility that cares for people without medical insurance or low-incomes, and does not relate to the size or capability of the facility.
So I think some of the other users here (if they're US based) may be getting the idea that when you say there shouldn't really be hospitals in rural areas, you're advocating for having no in-patient medical facilities in rural areas of any type, and to require anyone with any sort life-threatening or serious immediate medical problem to travel to a city to resolve it, since for us, 'hospital' is pretty much a catch-all term for anywhere that can perform serious medical procedures, where as non-serious issues (colds/flus, diagnoses, getting prescriptions) are handled by Clinics.
EDIT: We do have Urgent Care Centers though, which could be an equivalent to Health Centers? I'm not entirely sure, I haven't really used the medical system that much thankfully.
Hmm, yeah I can see how that could cause some miscommunication. But AFAIK this isn't only a European thing but also how the WHO classifies various types of health infrastructure.
I think the real point of miscommunication between us is your concept of efficiency. Literally everything about our modern, western life is unsustainable, no matter where you live. Urban places are less inefficient, but they're still monstrously unsustainable. In the United States, even if you stop traveling, heating your home, and barely even eat, you still live unsustainably due to the government that operates a military on your behalf.
To actually live sustainably, we have to fundamentally reimagine society. I don't think it's at all obvious that this new society's rural communities need be unsustainable. In fact, I do think, as I said elsewhere, that any sustinable world is going to necessarily have more rural inhabitants, because the agricultural workforce will probably have to expand a lot, and probably be significantly collectivized, if we want to fix our food system.
I don't think it's a definition thing. I am US based but I've actually spent much of my life in Europe and my entire family lives there. Rural hospitals are not urgent care centers or health clinics. They're smaller but they're 100% real hospitals in the sense that both Americans and Europeans (at least in Spanish) use that word. They have 24/7 emergency care and can deal with serious health problems. However, they're not all "trauma centers." Trauma centers are a network with different nodes of various "levels," and different hospitals are certified at different levels of trauma care. There's usually only a couple of "level 1 trauma centers" in a region.