Dr. Michael Carroll, Transcript Section 13

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KAREN: I know I was thinking of that, was going to ask before, which is you said the Tanana Hospital closed in the '80s?

DR. CARROLL: I think it was the early '80s, yes.

KAREN: And what the impact of that was.

DR. CARROLL: Well, health care changed a lot. You know, in the '80s. You know, airplane and mail traffic become much more common. Patients became more health care sophisticated. You know, they -- they wanted more diagnostic studies if they had a problem.

In the '80s, you know, we started having CT scans and ultrasounds and things that, you know, you just didn't ever expect that you would be able to offer a patient in Tanana.

And in addition to that, the really sick patients needed intensive care, we didn't really have an intensive care. And so you dealt with things as best you could with the nurses.

When the hospital closed, its biggest impact probably was on the village of Tanana because it had a significant number of employees that were from the community who no longer had, you know, reasonably good paying jobs. And so as some of those end up, having lived much of their life there, moving to Fairbanks to get a regular job in town.

It meant for the villages that were downriver from Tanana that they had to fly into Fairbanks for their health care rather than being able to stop. And so at that time, that added another hour or so of flying time and probably another $150 in travel expenses.

Now, but also, you know, you have to realize that as more and more Native people migrated to Fairbanks, they had more family that they could stay with and visit and the shopping was also always part of some of the health care visits, you know.

And Tanana had a pretty good store, but it didn't have anything that would compete with Safeway and Fred Meyer's and Foodland, like existed in Fairbanks.

KAREN: I don't know if the timing of your contact with health aides in the health aide program, and the change to how now it's run by -- it's not the Public Health Service anymore, it's the regional corporations and TCC and whatever, if you have any observations on that changeover?

DR. CARROLL: Well, at that time, the health aides were employed by the Public Health Service, I think.

KAREN: Right.

DR. CARROLL: The Tanana Chiefs existed, but they had mostly an advisory board and didn't have any direct administrative responsibility.

Most of -- most of the organizations around the state, healthcare-related organizations within the Native communities had wanted to assume more power and responsibility and direction for the regional areas, and so they've taken over most of the administrative responsibilities.

And so the funds goes to those regional health care consortiums to then be directly distributed to the representatives of the beneficiaries.

KAREN: Uh-hum.

DR. CARROLL: That's probably best because, you know, they are the ones that, I think, you know, have an important part to play in their health care, and perhaps when you have limited financial resources, are better suited to prioritizing how that -- those monies are spent.

KAREN: Uh-hum.

DR. CARROLL: There's never enough money, you know, for health care in that sort of a system, so there's always going to be someone or some individuals that feel like they are not getting the services that they would like. And the people responsible probably in the areas are best able to sort that out.