37. The Risks of "Integrated Care"

The Space Shuttle, with over 2.5 million parts, 230 miles of wire and 1,060 plumbing valves was once described as the most complex "machine" ever made by man. For successful results it's mission requirements complex systems and a flawless degree of accountability were essential. Flaws in those complex systems resulted in the disasters of Columbia and Discovery. Our health care system, experienced from a patient perspective, appears to rival the Space Shuttle in complexity. But in the case of health care, complexity and a lack of accountability are factors that often lead to inadequate, inaccessible, unaffordable and unacceptable levels of care for our some of our most vulnerable citizens...those living with intellectual and developmental disabilities and/or mental health concerns that necessitate a lifelong array of specialized care services to live a full life and participate in their communities. As it exists today, our health care system is flawed and everyone agrees changes are needed. "Integrated Care" is the term often used to propose solutions to the complexity that haunts our health care system. However the political solutions being debated today merely "integrate" the payment side of care. These are "top down" economic solutions designed to outsource the state's responsibility to it's vulnerable citizenry to private enterprise where profitability and shareholder ROI is the #1 primary concern. Integrating care from a patient's perspective would ensure all mental and physical health care needs are adequately and appropriately met, attendant care is always available and barriers to inclusion are removed or mitigated. Integrated care should enable persons with disability to be integrated into our communities.