The Politics of Regionalization.

Abstract

Regardless of their policy outcomes, strategies of regionalization are prevalent because they are politically useful. They permit governments to be seen addressing serious systemic problems in the healthcare system without fundamentally upsetting the face-to-face relationship between physicians and patients. They shift the responsibility for unpopular policies, including the consolidation of services, away from provincial governments. They can be part of a larger process of decentralizing power that is undertaken for larger, non-health-related reasons. They can also serve as a strategy of disruption that destabilizes the bases of influence enjoyed by specific stakeholder groups. For epistemological reasons, it is difficult to determine with any certainty what the specific outcomes of regionalization are. Thus, to mitigate the utilization of regionalization for politically advantageous reasons, it is useful not only to catalogue the outcomes of policies of regionalization, but also to identify whose interests are furthered, and whose are hindered, within a strategy of regionalization.