flickr image By Shira Golding
Where do you turn when your aging mother can't be by herself
anymore or you notice your baby seems a little delayed? Imagine that your
teenager starts skipping school and staying out all night or imagine you
are suddenly diagnosed with a serious illness or disabled in an accident. Where do you go for help?
Sooner or later we all knock on the door of our community's
social service network. What greets us may be far less than we expect. And sadly, the help available to us will depend a lot on where we live
and how much money we make. The confusing patchwork of private, public
and non-profit agencies through which we must navigate is the
natural, unintended consequence of the free market model we've created to
deliver social services.
We are all only temporarily able bodied. We don't give
much thought social services. We are content knowing that free market
competition is efficiently keeping down the cost of publicly financed services
for the needy.
It isn't until we seek help ourselves that we encounter a
labyrinth of agencies with confusing components and cutesy
sounding acronyms for their names. Agencies often list the
types of services they offer (counseling, for example) without listing the
types of problems they serve (such as adolescent issues). Consumers are
expected to know which services work best for their problems.
Some agencies over promise results in their marketing or take
on people with problems that would be bettered resolved elsewhere. Access
to services are often restricted by bewildering eligibility requirements based
on age, gender, geography, diagnosis, income, insurance provider, religion,
ethnicity, funding source or hours of operation.
If your family has one or two very common problems, chances are
you will find the help you need. But if your problems are uncommon or
complex, your search will not go smoothly. And if you also happen to be poor,
live in an under served community or don't have transportation, the prospects
for getting effective help are slim.
This is the character of our social service networks today. They are not based on matching service availability and
capacity to the needs of local communities. They are loosely coordinated
networks created by artificial free market forces and competition between private or
non-profit agencies scrambling for dollars.
For over thirty years we have been privatizing public social
services in the belief that free markets are more efficient than government in
providing the best services at the lowest cost. Little attention is given
to the inescapable fact that market driven systems create uneven results
by their very nature. This is true in commerce but especially true in
public social welfare. Larger agencies are more politically connected and
better positioned to compete for public dollars. Wealthier communities
have a higher profit potential so they attract more and better competitors.
Smaller agencies and program models that incorporate innovative ideas
are less able to compete for government money.
Innovative approaches to helping people are usually funded in small
trials by private foundations. Even when these trials prove successful,
bringing them up to scale is almost impossible. Agency competition
actually works against it because social service providers are competing on an
artificial playing field.
Governments create the playing field on which agencies compete,
but the government departments responsible for developing and funding social
service contracts are often under staffed and ill equipped to monitor
service outcomes. They also lack the personnel and special expertise it
takes to design better programs. The time and effort involved in
researching literature, writing contract proposals, putting contracts out for
bid and guiding the implementation of new programs is enormous .
Politicians don't want to spend what it would cost to create real
free market competition for high quality services.
To overcome the uneven distribution of services problem, governments develop specially targeted service contracts with
extra financial incentives to serve specific areas. But these
initiatives are expensive and tax revenues are declining. Targeted
service contracts are usually limited in size and scope because of their higher
costs.
We have come to the point where the availability and quality of essential services, to treat an
abused child for example, becomes an accident of birth. How often
have I seen children getting excellent services in one county while children
with identical needs have no such services in another county.
Commercial markets are efficient in distributing products
according to demand when profits are distributed according to merit. This
method breaks down when applied to funding social services. The greatest demand for services are in areas with the lowest potential for profit. Competition discourages inter-agency coordination
and inadequate funding increases agency
competition in more profitable locations while discouraging them from entering
less profitable communities. This causes unacceptable inequalities in
meeting the basic human needs of our people.
There are many pressing issues that demand attention. How we fund social services is rarely among
them, yet the wisdom of distributing social services through artificially
created free markets cries out for public debate.
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