The evidence from all OECD countries shows that the private sector is far more bureaucratic and much less efficient than the public sector when it comes to providing health care.
Ten Health Care Myths
Gentlemen from Hooker - and many other places - are quite literally pouring these and many other poisons into your coffee and your kids' juice. They just do it in a more indirect, anonymous, and apparently socially acceptable way.
150 Years of Dirty Water
It's a pitiful spectacle. Community groups across Ward 7 (and elsewhere) desperately scrambling for enough funds to stay alive. Group after group faced with the prospect of laying off staff, cutting back services, or closing down entirely. And these aren't generally organizations with marginal support or of limited value either. They're by and large the groups providing the best services, staffed by good people, serving large number of residents. Organizations like the Community Secretariat, the Neighbourhood Information Post, Seven News.
Many of these groups had their start in the early 1970's when the various movements for "community control" were at their peak in Ward 7. The ideal then was to create new kinds of groups and services, close to and controlled by the people, groups that could be springboards for social change, for taking power away from the large bureaucracies of the established power structure.
They had good ideals, and big plans. But things haven't quite worked out according to plan, and now much energy, far too much, has to be spent trying find money to pay next month's rent and salaries. In the process, the real goals easily can, and often do, get pushed into the background.
What happened? Government money, that's what. Groups that started out being entirely run by volunteers, by local people, began thinking about how much more they could do if only they had one or two paid people, or three, or four, or ... And why not apply for government grants? It's our own tax money, after all.
Maybe it was a good idea to take government's money, when it was in the giving mood, as it was in the early 1970's, to get more things done than we could have with just our own volunteered efforts. But government funding can also be a very dangerous thing, and too many of us weren't aware of the dangers.
Government money creates dependency
The main problem is that it creates dependency. You start counting on getting another grant after this one runs out. You don't do anything to build up your own independent resources for the day when the funding will end, because you always think it won't end. You start relying more and more on paid staff, who also start, despite the best of intentions, to make more and more of the decisions. Volunteers - your base in the community, in other words - slowly start drifting away. They feel shut out of things, and anyway the movement they joined has turned into an organization, a community bureaucracy. The paid people worry about the shrinking base of the group, but they figure that it just goes to show that you can't count on people freely giving their own time to carry the load, so we just have to apply for more money to hire more people to do all the work there is to do, especially now that people don't want to volunteer anymore...
The result is an organization that has lost its base of support, that instead of being a way of increasing people's power has become a tool for increasing the state's power over community activities. The group itself is at the mercy of its governmental benefactor. If it does anything the government doesn't like, funding can always be cut off. (In practice, it doesn't usually come to that, because we tend to not even think about acting boldly, about doing things that might offend.)
And then it comes to a time like the present, when the state is short of money, and suddenly the grants start being cut back drastically anyway. The state, after all, has little to fear from groups that can no longer effectively mobilize the support of their communities.
We've gotten ourselves into a mess, and the only way out is to learn to stand on our own feet again. That means not counting on the government money, and using any grants we happen to get to tide us over while we work to become self-sufficient. Most of all, it means building everything on the only secure base there is: the people.
Seven News July 1977