tag:theconversation.com,2011:/id/topics/human-services-12744/articlesHuman services – The Conversation2018-05-18T10:41:35Ztag:theconversation.com,2011:article/960922018-05-18T10:41:35Z2018-05-18T10:41:35ZPrivatizing essential human services like the VA can come at a high social cost<figure><img src="https://images.theconversation.com/files/219498/original/file-20180517-26295-1rk05l0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">For-profit service providers may use discrimination as a way to make more money.</span> <span class="attribution"><span class="source">wavebreakmedia/Shutterstock.com</span></span></figcaption></figure><p>Over the years, countries have <a href="https://www.downsizinggovernment.org/privatization">privatized dozens of services and activities</a> once the sole domain of governments, such as the provision of electricity and water, road operations, prisons and even health care, with the ostensible aim of making them more efficient. </p>
<p>In the U.S., the Trump administration <a href="http://theweek.com/speedreads/754859/trump-proposes-privatizing-federal-assets-including-airports-freeways-international-space-station">has said it wants</a> to add airports and the International Space Station to that list. Some even <a href="https://www.nytimes.com/2018/03/28/opinion/shulkin-veterans-affairs-privatization.html">suggested</a> – though <a href="https://www.politico.com/story/2018/03/29/david-shulkin-veterans-affairs-secretary-privatizing-491590">vehemently denied</a> – that there was a plan to privatize health care services for veterans. </p>
<p>Before going down that road, the question needs to be asked whether privatizing essential human services serves the public interest. New research we <a href="https://academic.oup.com/jpart/advance-article/doi/10.1093/jopart/muy009/4938536">recently published</a> suggests that privatization may come at a social cost. </p>
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<img alt="" src="https://images.theconversation.com/files/219502/original/file-20180517-26300-1k7ihgt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/219502/original/file-20180517-26300-1k7ihgt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/219502/original/file-20180517-26300-1k7ihgt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/219502/original/file-20180517-26300-1k7ihgt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/219502/original/file-20180517-26300-1k7ihgt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/219502/original/file-20180517-26300-1k7ihgt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/219502/original/file-20180517-26300-1k7ihgt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Cornell Brooks, national president of the NAACP, and others spoke out in 2017 against a plan to privatize Atlantic City’s water supply.</span>
<span class="attribution"><span class="source">AP Photo/Wayne Parry</span></span>
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<h2>Economic incentives of privatization</h2>
<p>Privatization theory assumes that organizations, including those that <a href="https://academic.oup.com/jpart/article/17/3/501/943117?searchresult=1">deliver social services</a>, thrive on competition and monetary gain. </p>
<p><a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1540-6210.00157">Supporters of privatization</a> argue that companies can perform government functions more efficiently. More competition and more choice for clients are expected to put pressure on providers to be more innovative and aware of financial costs. </p>
<p>In the public sector, however, competition is almost by definition absent, either because users of services cannot be excluded from the service – breathing clean air, for example – or because there is little monetary gain to be made – such as with services to the homeless. </p>
<p>So in situations where there is no real market, governments have attempted to mimic their conditions, such as by giving citizens the freedom to choose a public service provider or negotiating contracts that include certain performance incentives. </p>
<p>But this reliance on performance contracts can lead business providers to focus on short-term financial targets – such as the number of people processed per dollar spent – oftentimes at the expense of long-term outcomes for the people served. That’s the conclusion of a <a href="https://academic.oup.com/jpart/article/17/2/189/894972?searchresult=1#15497641">study</a> of a for-profit, welfare-to-work training program in the United States. </p>
<p>This gives business providers a strong incentive to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/pam.21695">concentrate their efforts</a> on serving people that are most likely to help them achieve these goals by either focusing on those clients who are most likely to succeed or disregarding the ones that are harder to serve. Examples may include supporting primarily motivated job seekers to apply for employment or trying to avoid chronically sick patients. By focusing on easier-to-serve clients and shunning the ones who are costly, service providers are more likely to make a profit.</p>
<p>However, it’s often difficult to know in advance who’s going to cost more than someone else. As a result, many service providers end up relying on imperfect, discriminatory cues to help them weed out potential cost burdens. <a href="https://academic.oup.com/qje/article/133/1/191/4060073">Companies do something similar</a> when they use stereotypes about race or ethnicity as discriminatory proxies for unobserved characteristics in job applicants.</p>
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<span class="caption">Former Veterans Affairs Secretary David Shulkin believes he was ousted as part of plan to privatize the agency.</span>
<span class="attribution"><span class="source">AP Photo/Andrew Harnik</span></span>
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<h2>Makrini and Maes</h2>
<p>To learn more about whether for-profit service providers treat people of marginalized ethnic backgrounds differently, <a href="https://academic.oup.com/jpart/advance-article/doi/10.1093/jopart/muy009/4938536">we ran a field experiment</a> in the Belgian elderly care sector. We chose Belgium because the industry includes both public and private homes, and one of us is based there. </p>
<p>We sent basic information requests to all public and for-profit nursing homes in Flanders, the Dutch-speaking part of Belgium. Half of the requests, randomly assigned, appeared to come from a Belgian citizen (Kenny Maes), while the rest bore the signature of someone with a North African name (Mohammed El Makrini). The names were chosen based on the results of a separate survey we sent out to 2,000 Belgians asking them to rate several names on their perceived ethnicity, age, level of education and wealth. </p>
<p>In the requests, we asked nursing homes for advice on how to subscribe for a place in their facility. Withholding such information would make it harder for a prospective client to apply for a spot.</p>
<p>Of the 223 nursing homes we contacted, 71 percent responded, with public facilities being a little more likely than for-profit ones to get back to us. In general, each type of home responded to our two senders at similar rates. For example, 76 percent of public facilities replied to “Kenny,” compared with 79 percent for “Mohammed.” The response rate of for-profit homes was a bit more lopsided, but it was not what we’d consider a significant difference given the sample size: 66 percent for Kenny and 57 percent for Mohammed. </p>
<p>The really interesting finding was when we analyzed the actual responses. Upon closer inspection, we found that for-profit nursing homes were significantly less likely to provide information to Mohammed on how to enroll. Only about 43 percent of the for-profit homes that responded offered him the info, compared with 63 percent for Kenny. There was basically no difference among public facilities.</p>
<p>This is direct proof of for-profit providers discriminating against prospective clients based on their perceived ethnicity. But they’re not doing it simply out of ethnic animus. If it was, we’d have seen the same discrimination at the public facilities as well.</p>
<p>Rather, the motivation seems to be primarily economic. This is what economists call “<a href="http://www.nber.org/papers/w15860">statistical discrimination</a>.” In other words, average characteristics of the minority group – such as language barriers and having different cultural needs and habits that make them more difficult to serve – are used to stereotype individuals who belong to that particular group.</p>
<h2>Unintended consequences</h2>
<p>The <a href="http://www.governing.com/topics/mgmt/pros-cons-privatizing-government-functions.html">public debate about privatization</a> tends to almost exclusively focus on its supposed financial and managerial advantages – which are <a href="http://www.pogo.org/our-work/reports/2011/co-gp-20110913.html#Executive%20Summary">hardly clear cut</a>. Meanwhile, the potential social costs of privatization are commonly neglected. </p>
<p><a href="https://scholar.google.com/citations?user=PA7TqeEAAAAJ&hl=en&oi=ao">Our</a> <a href="https://scholar.google.com/citations?user=mniink4AAAAJ&hl=en&oi=ao">research</a> suggests that privatizing human services such as health care can result in less access for groups perceived as harder to serve because of language barriers and cultural differences. </p>
<p>Unfortunately, they also happen to be the groups that need such services the most.</p><img src="https://counter.theconversation.com/content/96092/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Trump administration wants to privatize more of the federal bureaucracy. New research suggests this can lead to discrimination in essential government services.Sebastian Jilke, Assistant Professor, Rutgers University - NewarkWouter Van Dooren, Professor of Public Administration, University of AntwerpLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/699162017-01-05T17:59:13Z2017-01-05T17:59:13ZIncubating ideas on how southern Africa can manage the Anthropocene<figure><img src="https://images.theconversation.com/files/150705/original/image-20161219-24307-sb8nmy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A market in Zambia. The Anthropocene in this case looks at the world positively and how to overcome challenges.</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p><a href="http://www.anthropocene.info/">The Anthropocene</a>, or the “Age of Man”, is the name given to the current geological epoch. This is an acknowledgement that humanity has become a dominant global force reshaping the geological, biological and atmospheric dynamics of the earth.</p>
<p>Previous epochs have included the Cretaceous period, which was following by the <a href="http://www.ucmp.berkeley.edu/help/timeform.php">Cenozoic era</a>. The <a href="http://science.nationalgeographic.com/science/prehistoric-world/dinosaur-extinction/">extinction</a> of the dinosaurs marked the transition that ended the Cretaceous period and marking the beginning of the Cenozoic era.</p>
<p>The earth is 4.5 billion years old. But modern humans have only been around for approximately 200,000 years. Human civilisations have really only thrived during the epoch known as the <a href="http://grist.org/article/2009-09-22-scientists-identify-safe-operating-space-for-humanity-nature/">Holocene</a> that started 12,000 years ago and continues to the present. During this comparatively short time, agriculture was invented, large cities were built, and humans started using energy from fossil fuels. </p>
<p>There is an ongoing <a href="http://www.smithsonianmag.com/science-nature/what-is-the-anthropocene-and-are-we-in-it-164801414/">debate</a> among scientists about when the transition from the Holocene into the Anthropocene occurred. Some scientists argue the <a href="https://theconversation.com/an-official-welcome-to-the-anthropocene-epoch-but-who-gets-to-decide-its-here-57113">transition</a> happened in <a href="http://www.igbp.net/globalchange/greatacceleration.4.1b8ae20512db692f2a680001630.html">the 1950s</a>. </p>
<p>Whatever the actual date of the transition, the Anthropocene brings with it new and diverse challenges related to biodiversity loss, increased inequality as resources become more scarce, and climate change. Considering these negative trends, scary views of the future dominate. This makes it difficult to conceptualise a more sustainable and just future society.</p>
<p>We have been involved in a project to develop possible scenarios for southern Africa that start with existing positive things happening in the region. The idea was to start thinking about possibilities that broke with a business-as-usual approach and employed more creativity in thinking about how to overcome the challenges facing the region and the world.</p>
<h2>Seeds of good Anthropocenes</h2>
<p>Many equate the concept of the Anthropocene with a group of people called eco-<a href="http://www.ecomodernism.org/authors/">modernists</a> who advocate that technology should be improved to help manage the planet meet human needs.</p>
<p>But this view is countered in a new global project called <a href="https://goodanthropocenes.net/">Seeds of Good Anthropocenes</a>. The aim of the project is to explore positive futures that are socially and ecologically desirable, just and sustainable. It is done by exploring and developing a suite of alternative visions for good Anthropocenes. </p>
<p>The project starts with the idea of <a href="https://goodanthropocenes.net/">“seeds”</a>. These are initiatives that represent alternative ways of thinking, doing, technologies or institutions that exist in experimental form, but are not dominant features of today’s world. </p>
<p>We have collected these seeds – 500 so far – from all over the world through a <a href="https://docs.google.com/forms/d/e/1FAIpQLSdbFVMmIG8iyUV8IxZn3ACbacyDyr2g83XwCU2-j34CWuJnjw/viewform">questionnaire</a> available on our website. The next step is to see whether more positive future visions can be built from them. </p>
<h2>A radically different southern Africa</h2>
<p>To explore this idea in practice we convened a diverse set of people from across southern Africa. They included artists, social entrepreneurs, researchers and policymakers who were taken through a three day visioning process that was more science fiction than science. </p>
<p>To build a scenario we adapted the <a href="http://www.infinitefutures.com/tools/sbmanoa.shtml">Manoa</a> approach, which is designed to maximise difference. Each group started with three “seeds” to build their future world. </p>
<p>Initiatives were chosen based actual representatives being present. They either had strong knowledge of the seed, or were directly involved in its development. To be as diverse as possible, we brought together seeds that were more technological alongside those that emphasised the environment through social entrepreneurship of civil society. </p>
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<a href="https://images.theconversation.com/files/150119/original/image-20161214-5882-1owfj4r.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/150119/original/image-20161214-5882-1owfj4r.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/150119/original/image-20161214-5882-1owfj4r.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=424&fit=crop&dpr=1 600w, https://images.theconversation.com/files/150119/original/image-20161214-5882-1owfj4r.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=424&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/150119/original/image-20161214-5882-1owfj4r.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=424&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/150119/original/image-20161214-5882-1owfj4r.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=533&fit=crop&dpr=1 754w, https://images.theconversation.com/files/150119/original/image-20161214-5882-1owfj4r.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=533&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/150119/original/image-20161214-5882-1owfj4r.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=533&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Seeds of Good Anthropocenes in southern Africa visioning workshop.</span>
<span class="attribution"><span class="source">Centre for Complex Systems in Transition</span>, <span class="license">Author provided</span></span>
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<p>Each group had three seed initiatives to begin with and were asked to describe what the world would look like if these ideas were the dominant way of doing things. The next step was to find creative similarities between the ideas. For example, if artificial intelligence (AI) was a widespread technology, how would it interact with a seed that emphasised the importance of reconnecting people to their food? </p>
<p>One of the groups decided that it would be possible to download knowledge of food from the AI for a day and use it to create a <a href="http://foodtravel.about.com/od/Restaurant-Reviews/fl/What-Are-the-Michelin-Stars.htm">Michelin-quality meal</a> from local ingredients.</p>
<p>From these connections, the groups went on to create stories describing what their world looked like. These were extremely interesting.</p>
<p>In the scenario entitled “Post Exodus”, for instance, the foundation was laid by initiatives representing three very different “seeds”: <a href="mailto:www.openstreets.org.za/">Open Streets Cape Town</a>, <a href="mailto:www.knowledgepele.com/">Knowledge Pele</a> and <a href="https://www.dailymaverick.co.za/article/2015-08-04-science-gene-editing-tool-takes-laboratories-by-storm-but-there-are-ethical-concerns/">gene editing</a>. This scenario described a world where humans live long, healthy lives in millions of small village ecosystems, connected through a global virtual knowledge collective. </p>
<p>The scenario that we called ‘Rhiz(h)ome’ was developed from seeds of <a href="https://www.cryptocoinsnews.com/cryptocurrency/">cryptocurrency</a>, <a href="https://www.facebook.com/tyisanabanye/">Tyisa Nabanye</a> an urban agriculture organisation, and <a href="http://www.massivesmall.com">Massive Small</a>. This led to a decentralised world characterised by empathy where work, leisure and community service are much less distinguishable. </p>
<p>The stories that emerged exceeded the research team’s expectations and were as diverse as the people who were gathered for the process. But there were some underlying commonalities that may be useful for decision-makers in the region to start thinking about southern African futures.</p>
<h2>Southern African futures</h2>
<p>All the visions contained aspects of a decentralised governance structure that emphasised the need to reconnect societies to their local environment and to embrace diversity. But this emphasis on local connections with humans and the environment was balanced by technological advances that made it possible for everyone to communicate and interact globally.</p>
<p>Focusing on southern Africa allowed for the potential to inspire new interventions in planning for the future of the region. What emerged was less emphasis on the individual and more of a focus on the common good, collaboration and empathy. This resonates with spirit of the collective or <a href="http://www.ubuntu.thiyagaraaj.com/Home/about-ubuntu/ubuntu-philosophy-meaning">“Ubuntu”</a> that is imbued within the indigenous cultures of the region.</p>
<p>These elements force a re-evaluation of how current policies in the region are helping to create a more desirable future or whether they are stifling it. The <a href="http://www.gov.za/sites/www.gov.za/files/Executive%20Summary-NDP%202030%20-%20Our%20future%20-%20make%20it%20work.pdf">South African National Development Plan</a> is a good example of an agenda setting policy that could be evaluated against these visions to see whether it is guiding us toward a more positive future or whether it is more business-as-usual.</p>
<p>As the project progresses, we aim to analyse longer-term planning documents based on the content of these scenarios. Participants will also be using the scenarios in their own work in the region and to run similar scenario processes with other groups. We will track the uptake of these scenarios to see how influential they will be in helping southern Africa to move towards a more positive future.</p><img src="https://counter.theconversation.com/content/69916/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laura Pereira receives funding from the SIDA funded GRAID project. </span></em></p><p class="fine-print"><em><span>Deon Cloete receives funding from the Guidance for Resilience in the Anthropocene: Investments for development Grant, hosted by the Stockholm Resilience Centre, Sweden</span></em></p><p class="fine-print"><em><span>Maike Hamann works for the University of Stellenbosch and receives funding from the National Research Foundation. </span></em></p><p class="fine-print"><em><span>Reinette (Oonsie) Biggs receives funding from the ETH Society in Science Fellowship, Swedish Research Council (VR), the GRAID project hosted by the Stockholm Resilience Centre, and a DST/NRF South African National Research Chair (SARChI) in Social-Ecological Systems and Resilience at Stellenbosch University.</span></em></p><p class="fine-print"><em><span>Rika Preiser receives funding from the Guidance for Resilience in the Anthropocene: Investments for development Grant, hosted by the Stockholm Resilience Centre, Sweden. </span></em></p><p class="fine-print"><em><span>Tanja Hichert is a board member of the Association of Professional Futurists.</span></em></p>The Anthropocene is often associated with problems such as climate change and inequality. But there is also hope that it can come with positive change for the benefit of people.Laura Pereira, Researcher/Lecturer at the Centre for Complex Systems in Transition, Stellenbosch UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/330902014-10-22T19:20:06Z2014-10-22T19:20:06ZInfographic: a snapshot of Australia’s child protection services<figure><img src="https://images.theconversation.com/files/64434/original/nrcpvdsb-1415838684.png?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Click for full graphic. </span> </figcaption></figure><figure class="align-center ">
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Emil Jeyaratnam, Data + Interactives Editor, The ConversationLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/322822014-10-08T03:43:37Z2014-10-08T03:43:37ZHarper review would reduce us from citizens to mere consumers<figure><img src="https://images.theconversation.com/files/60383/original/nrfcn3sj-1412053609.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The draft report of the Competition Policy Review elevates consumer choice above all other considerations</span> <span class="attribution"><span class="source">www.shutterstock.com</span></span></figcaption></figure><p>Are we consumers or are we citizens? Clearly most of us are both. In a capitalist economy people get much of what they need through competitive markets. Yet we also live within a society and have reasonable expectations that governments will provide a range of services and regulations. </p>
<p>Yet upon reading the recently released draft report of the <a href="http://competitionpolicyreview.gov.au/files/2014/09/Competition-policy-review-draft-report.pdf">Competition Policy Review</a> one could be forgiven for thinking that governments should treat their citizens solely as individual consumers, and that all services should be provided through markets.</p>
<p>The review elevates consumer choice above all other public policy considerations. In doing so, it has potentially far-reaching implications for the way Australian governments provide services. These services include health care, education, child care and a range of others that most people take to be the basic rights of citizenship.</p>
<h2>Competition principles</h2>
<p>Guiding the review are the principles of the <a href="http://www.google.com.au/search?client=safari&rls=en&q=1995+National+Competition+Policy&ie=UTF-8&oe=UTF-8&gfe_rd=cr&ei=OUIqVJbQIMeN8QeB_oHoAw">1995 National Competition Policy</a>. This policy essentially mandates that government activity should be benchmarked against the principles of competitive neutrality and third-party access. </p>
<p>The argument is the public sector should not enjoy an advantage over the private sector in providing services simply because they are run by the government. They also advocate for the privatisation of public services. </p>
<p>To put it bluntly, competition policy codified neoliberalism as a central logic of government. It also institutionalised a government preference for deregulation, marketisation and corporatisation. Since 1995, around 2000 government regulations have been scrutinised for compliance with the principles of competition policy. </p>
<p>It is therefore little wonder that neoliberal theories, such as the inherent virtues of consumer choice and the desirability of profit-oriented corporations providing basic public services, are at the core of the review’s report. </p>
<p>The report is wide-ranging and covers topics from government procurement to anti-competitive conduct and parallel imports. Perhaps most concerning is its recommendations regarding “human services”. </p>
<h2>How the review promotes inequality</h2>
<p>The review recommends that:</p>
<blockquote>
<p>user choice should be placed at the heart of service delivery.</p>
</blockquote>
<p>This sounds good until one realises what this means - a fully marketised system of education, health care, child care, aged care and many other social services.</p>
<p>The problem here is equity. The review does not view access to high-quality public services as a right of citizenship. Rather, it wants to ration social services through the market, where access is determined by an individual’s ability to pay. </p>
<p>Of course, in the utopian vision of the review panel, marketising social services will force private providers to reflect consumer preferences better than government can. Yet markets depend upon inequality. </p>
<p>The reality of marketised service provision is that high-income earners enjoy the luxury of being able to pay for high-quality services. However, the majority of people must make do with lower-quality and cheaper or free services.</p>
<h2>The costs of privatisation</h2>
<p>There are also other costs associated with moving government services to the private sector. For example, choosing the appropriate provider involves significant search costs.</p>
<p>This is especially so in the area of child care where many parents are struggling to find places for their children. The privatisation of this service has also meant that many parents are forced to use centres that have vacancies rather than those closer to home.</p>
<p>Asymmetric information is another problem. For example, in the now-marketised electricity sector, it’s in the interest of the big corporations to make it very difficult for consumers to accurately compare the price of electricity between different companies.</p>
<p>To its credit, the review recognises some of these problems. Yet it largely dismisses them as “transitional”. </p>
<p>One is left wondering when the transition period will end. In Australia we have had three decades of deregulation, marketisation and privatisation. The problems inherent in devolving responsibility for services to the individual consumer haven’t gone away.</p>
<p>Nor does the review do a good job defending its utopian vision of competition and choice. The draft report states that competition “could have” or “may have” benefits. Indeed, the word “may” is used on no less than 302 occasions in the document. Principles so central to its recommendations should have much firmer foundations.</p>
<p>Unfortunately, the idea of “the public” is almost completely absent from the draft report. In its place is the ideology of individual choice. Public provision is relegated to a residual category - a safety net available for those who fall out of the market system.</p>
<p>Decent standards of health care, education, aged care and child care are fundamental to our society. There is <a href="https://theconversation.com/we-can-learn-a-lot-about-public-policy-from-the-nordic-nations-32204">a proven alternative approach</a>: fund these services to make them available to everyone, free of charge as a right of citizenship. Those who don’t want to use public services should also then be free to choose a private alternative.</p><img src="https://counter.theconversation.com/content/32282/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Damien Cahill does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Are we consumers or are we citizens? Clearly most of us are both. In a capitalist economy people get much of what they need through competitive markets. Yet we also live within a society and have reasonable…Damien Cahill, Senior Lecturer, Department of Political Economy, University of SydneyLicensed as Creative Commons – attribution, no derivatives.