this post was submitted on 28 Oct 2023
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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.