Accountable Strategies blog

A blog about accountability issues in the public, private, and nonprofit sectors

Posts Tagged ‘Obama’

Chipping away at the government-can’t-do-anything-right myth

Posted by David Kassel on July 29, 2009

Sometime ago on this site, I wrote about a battle  going on in Massachusetts over privatizing the Fernald Developmental Center, the nation’s oldest state-operated facility for persons with mental retardation.

This is a battle that has been playing out in state after state.   The argument for closing these Intermediate Care Facilities (ICFs) is that the private sector can provide this care better and cheaper.

This same myth that government can’t do anything right or efficiently is behind the opposition to President Obama’s public option in his health care reform package.  None other than Karl Rove has sounded the alarm that allowing government to complete with private health insurers will drive them all out of business and turn us into European socialists.

But shouldn’t competition from government simply bring down the rates the private insurers pay and, in turn, force the providers to cut their costs and generally operate more efficiently?  As efficiently as, perhaps, the public sector operates?

When it comes to the delivery of human services to some of our most vulnerable citizens, it is also often overlooked that government can in fact do the job as well or better than the private sector.  ICFs, for instance, must meet higher federal staffing and treatment standards than does the community-based group home system, which is primarily operated by private human service vendors.  So, while it’s true that many states want to eliminate ICF-level care because it tends to be expensive, it’s just not logical to assert that the care provided to the mentally retarded under lower standards will be better.

And as is the case in the management of health care, the public sector is capable of managing programs just as, if not more, efficiently than private-sector providers.  As the Truthdig blog noted, Medicare has far lower administrative overhead rates than private insurers (2 to 3 percent versus rates as high as 40 percent in the private sector).

And look at the CEO salaries of nonprofit human service and health care providers.   These salaries far outstrip their counterparts in the public sector.

Also, while we’re on the subject of efficiency, consider the lease-purchase plan that the Patrick administration is pursuing to develop group homes for persons with mental retardation in Massachusetts.  It will cost $257,000 per bed over 20 years to lease these group homes from developers.   The developers themselves can obtain low-cost state mortgages for the homes and then charge the state to pay back the loans.

Unfortunately, the folks who argue that government can’t do anything right and that the private sector should be running everything have had the upper hand in recent years.  Government administrators themselves are often hired for the sole purpose of fobbing off the functions and responsibilities of their agencies to the private sector.

And it’s not only state governments that are shedding their public responsibilities.  Consider federal public advocacy organizations such as the Disability Law Centers.   Our federal tax dollars fund these organzations, many of which have taken it upon themselves to file “class action suits” to close primarily state-run ICFs, whether the guardians of the residents want those facilities closed or not.

The National Voice of the Retarded, Inc. lists 28 lawsuits filed by protection and advoacy organizations in 19 states to close institutions.  The irony is that many, if not most, of the families and guardians of those facilities are involuntarily represented in these suits.  They cannot opt out of them even if they want to. 

In the name of their civil rights, facility residents are being evicted from their long-time homes under these lawsuits.  U.S. Rep. Barney Frank has proposed legislation which would give individuals and guardians the right to opt out of the suits.

All of this isn’t to say that private companies should get out of the business of providing human services or that private insurance companies should not be providing health coverage in America.  I’m not arguing here for a government-run single-payer plan. 

What I am arguing for is including government in the choice that prople have in obtaining human serivces and health care.  As President Obama said in reference to health care, the public option will keep the insurance companies honest.  It will force them to keep their premiums down and, in turn, will put pressure on hospitals and other health care providers to keep their costs down.

Similarly, in the delivery of human services, a public option is needed to provide a full range of choice in care to those most in need.  And, contrary to the long-standing myth, that public option may well be the most cost-effective one.


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Lori Berenson’s insight from prison

Posted by David Kassel on January 25, 2008

One American who has been describing the impact of the unchecked imposition of U.S. free-trade policies in poorer countries around the world just happens to be someone who has been in prison in one of those countries for more than a decade.

In a message last month from Huacariz Prison in Cajamarca, Peru, Lori Berenson, a  native New Yorker, expressed concern in particular about the signing of a new trade treaty between the U.S. and Peru. 

By way of background, Berenson has spent more than 12 years in Peruvian prisons on a charge of having collaborated with a Peruvian terrorist group, the Tupac Amaru Revolutionary Movement or MRTA.  She is serving a 20-year sentence and will be eligible for parole in three years.  In my view, she never received anything resembling due process  in her military and civilian trials in Peru, and her convictions were based on questionable circumstantial evidence.

Interestingly, a number of writers in Peru have recently begun to re-evaluate the case against her.  Those writers include a former Peruvian prime minister, a state prosecutor and a university president.  In the U.S., the mainstream media has barely covered her case.

Berenson has long expressed concern about poverty and repressive political conditions in Peru and has not been afraid to criticize Peru’s political leaders, even though she does so from prison, certainly at some personal risk.  In her end-of-the-year message, which was distributed by her parents, Mark and Rhoda, she criticized Peruvian President Alan Garcia for taking repressive measures against teachers, unions and regional opposition leaders as the economic situation in that country has worsened.  She also took direct aim at U.S. free-trade policies, including a just-signed free-trade agreement with Peru:

I wish it (the trade agreement) could be mutually beneficial but that is not possible.  I see this trade treaty as David meeting Goliath without having a
sling shot.  Peru is not on an equal footing with the US due to size,
resources, economic stability, government support of agriculture, etc.  In
Peru local production leads to local consumption, but if, say, US potatoes
start flooding the local markets what will happen to the local farmers?

It seems somewhat strange to me that both Democratic presidential candidates Hillary Clinton and Barack Obama supported the Peru free-trade agreement, even as they have campaigned against similar NAFTA-style agreements for reasons similar to the ones Berenson cites.  

Berenson maintained that Garcia´s administration has remained afloat through the current economic crisis in Peru by “using smoke screens” such as terrorism scares.

In September 2004, Berenson wrote an article for the e-zine CounterPunch, in which she described massive protests in the town in which her prison is located over the contamination of local water sources by the Yanacocha Mining Company, an affiliate of the North American mining giant, Newmont.  She described how the mining company had brought high prices, a high crime rate, out-of-town workers and ultimately increased poverty and health problems to Cajamarca.  It was part of a pattern, she noted, of unrestrained free-market capitalism imposed on poorer countries throughout the world.  Her article stated: 

Globalized capitalism continues to divide up the world into pockets of resources, natural or human, to be used and disposed of at the whim of those who have power.  Struggling against a monster of that size is not an easy feat; however, there are many who are willing to give it a try.

Berenson’s concerns about free-trade and globalization are apparently shared in a number of other countries and by governments in Latin America, though unfortunately not by the government of the country in which she’s imprisoned.   Naomi Klein reports in her 2007 book, The Shock Doctrine, that Brazil, Nicaragua, Venezuela, and Argentina have either quit or are negotiating to quit participation in the IMF and the World Bank, two of the most visible purveyors of globalization policies and their accompanying doctrines of privatization and deregulation.

It would be good to see the presidential candidates in the U.S. take a more consistent stance against the economic damage that unrestrained free-trade policies have done both in this country and abroad.  It would also be good to see at least one of them champion the cause of Berenson’s release from prison.

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