The Isolation of Health Services in Society: Development and Consequences

Abstract

That there exists an isolation of health services today is a consequence of important structural changes in society, especially the structure of both the family and occupations and increased professional dominance within the health field. The crisis of the health care system is due to its demand for increased economic resources and political support, a demand which is not met by the broader society, i.e. we are dealing with a failure of legitimacy, resulting among other things from the fact that health professionals have not publicly discussed the aims and methods of their field. Due to the failure of legitimacy we see a diversity of popular movements and activities, which can be described as individuals involved in organized protest. Some of these movements result in a certain strengthening of individual resources, thereby restraining the growing inequality of resources between professionals and patients. The article deals with what could be called the crisis in the health care system. The general economic crisis of society adds to and sharpens this development, but we will here argue the existence of a separate and independent crisis in the health field, which would have developed anyway. The background of the health care crisis is the separation of health services from society in ways that will be described, and the increasing inequality of resources between the agents of the health care system and the people. We will describe an economic-political aspect of the crisis as well as an aspect of legitimacy bound up with it. Finally we point to the reactions of the population in the face of the health care crisis. The authors work with analyses of the primary health care system (authorized as well as unauthorized),1 as relates to people's illness and illness behavior. This is the basis of the article. The research data available in this area are scarce, and we would like to point out that the paper as a whole aims to present a hypothesis rather than established facts. We think this has a value in itself and hope that the readers will accept the limitations of this approach. The article confines itself to the health services of Denmark, though similar tendencies could be described as regards the social services.