Back in 2011, New York City's Metropolitan Transit Authority removed trash cans from a few dozen subway stations as part of a pilot program. They thought this would be a great way to save money, since you don't need to empty trash cans that don't exist.
Predictably, making it harder for riders to get rid of trash responsibly doesn't eliminate the need to get rid of trash. Debris on the tracks causes fires, which causes delays and increased repairs. These trash fires were happening despite an uptick in trash collection costs for businesses and residences near the subway stations. So, in the end they put the trash cans back and have resigned themselves to emptying them.
This line of reasoning seems to be behind the rationing of home care and preventative health services. Home care, respite care, physical therapy, occupational therapy, and other services are impossible to automate, annoying to manage, and expensive. So, they just make them increasingly difficult to access. And then, predictably, more people end up getting emergency care for things that could have been prevented. This behavior on the part of the UK’s National Health Service keep coming across my desk lately although they’re hardly alone in this sort of behavior. When you have a national health serivce it’s much easier to track.
Since the government wants home care to be provided by families with the costs being born by the familes (effectively free, if not literally free, since the UK gives approved caregivers £69.70 a week, before tax, in a country where a cup of coffee costs £3.40) they limit access to alternatives. Then patients get stuck in hospitals because of the lack of available rehab centers, nursing homes, and home care services.
The government is increasing hospital visits and reducing hospital discharges because they’re hoping a lack of post-hospitalization services and supportive care will force families to provide this care for free. After so much fuss was made about flattening the curve and delaying non-essential care to keep beds open for the most seriously ill patients. While the pandemic continues.
Sometimes an agency can successfully avoid an issue by making it someone else's problem. Other times, their attempts to shirk responsibility result in creating problems for everyone else and worse problems for themselves.
On being pulled in so many directions
Giving your future self what you want doesn't require planning or sacrifice
“If you could just step up a bit to bridge the gap...” said at least once a day by different care providers. I’m getting a lot of practice stating my boundaries: “No, there is no more, I’m already operating beyond my energy envelope.” Ironic that dealing with the guilt also takes a lot of energy, but not as much as being a perpetual bridge provider.