By Barry Checkoway
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Extra info for Citizens and Health Care. Participation and Planning for Social Change
Sample text
The principal focus of health planning to date has been on excess bed capacity planning, an approach that targets areas in which the number of hospital beds exceeds federal bed supply standards and determines how to eliminate these beds. Excess bed capacity planning is generally one dimensional in nature. It exposes excess provision, but not insufficient capacity or the need for additional resources. It focuses on institutional, acute care alone, instead of taking into account the fact that health care is multi-level and r e quires a range of responses in the home, agency, institution, and community.
It focuses on institutional, acute care alone, instead of taking into account the fact that health care is multi-level and r e quires a range of responses in the home, agency, institution, and community. It ignores context by defining excess in terms of hospital beds available and "appropriately" used, without consideration of whether or not more appropriate resources exist or are needed. " Of course we have to start some- 52 CITIZENS AND HEALTH CARE where, but excess bed reduction may be the wrong place.
Obviously, social characteristics are sometimes related to interests and, as the following section argues, interests are precisely what ought to be represented. Thus, religious affiliations bespeak clear interests in Northern Ireland, race affects interests in America, and poverty relates to interests everywhere. Substantive Representation The key issue in substantive representation is not what representatives look like, but who they look after, whose interests they pursue. Put simply, substantive representation means acting in the interests of constituencies.