And my favourite OpenCare story is…
I have decided to put here my “homework”.
My favourite OpenCare story is still the first one: Greece’s shadow health care system. I see a strong similiarity with the cytostatic network story in Romania, though I know less of it.
No point discussing why these are care stories, that’s self-evident. It makes more sense to discuss why they are open.
- They are open in the trivial sense that they are not constructed on intellectual property rights.
- They are open in the sense that people can freely decide to step in and become a part of it. There is not even a real vetting process: the Helliniko clinic works by asking people to volunteer for a group, so that which individuals are paired with which group is driven by self selection. As for the cytostatic network, I guess that came down to people phoning up and saying "hey, I'm flying to Bucharest next week, do you want me to carry anything?". Implication: the people who are most likely to step in are the people who themselves need to use the system. The community serves itself.
- They are open in the sense that coordination and management processes are relatively fluid. People coordinate using minimal tech and whatever works (Google Groups in the case of Helliniko). This is in stark contrast to, for example, Airbnb or Uber, where every user and every provider interact in exactly the same ways, and these ways are encoded in the affordances of the respective platforms.
- Maybe they are also open in the sense that the range of what gets done (or doesn't) is not written in stone, but emerges as a function of opportunity, motivation of people on the ground and perceived need. For example, Helliniko does not do the same things a hospital does: it does not do surgery, and it has no beds – it does less than hospitals here, because covering this need would increase complexity by an order of magnitude. Neither does it do first aid, because Greeks have a right to first aid even if they are long-term unemployed. On the other hand, Helliniko hands out free pharmaceuticals and even non-medical stuff like baby formula or food for (poor) people with food intolerances. So they do more than hospitals here.
When all is said and done, everything in these stories is constantly renegotiated: the means, the teams, the actions. Except one thing: the people being served. In the Helliniko story, this is the local folks who have lost access to public health care. In the cytostatic network, it’s cancer patients and their families, who cannot get hold of certain pharmaceuticals. The service is built around their needs.
Finally: these two stories are exemplar also in the sense that they can use small contibutions, like Wikipedia (as argued here). You can help Helliniko even just putting word out on social media when the clinic needs a certain medicine, or the cytostatic network just by puntting a couple of boxes of medicines into your suitcase when flying to Romania. This does not make them more open, but it does make them better at taking advantage of being open.