Privatization and Health Care
The Case of Ontario Nursing Homes
Tarman, Vera Ingrid
Publisher: Garamond Press, Canada
Year Published: 1990
Pages: 128pp Price: $9.95 ISBN: ISBN 0-920059-53-8
Resource Type: Book
Cx Number: CX4506
Tarman identifies many problems with privatization, among them, a basic contradiction between the profit motive and quality of care, poor accountability and lack of public input, less government control of services with the balance of power decidedly in favour of the nursing home industry, and the problem of access.
Abstract: Privatization in health and social care has become a contentious issue. Vera Ingrid Tarman examines the private versus public debate in Privatization and Health Care: The Case of Ontario Nursing Homes. She points out that there is a "blurring of roles and responsibilities between the public and private sectors". The debate, therefore, focuses on "attempts to introduce market principles into public health and social services" rather than complete privatization of these services.
Privatization advocates believe that "government social spending presents a threat to the nation's productivity", removing initiative, creating dependency, and draining the economy" and that more efficient and responsible services are produced by the private sector. Tarman says that "perhaps the greatest advantage of the private sector is its ability to provide complete capital and some operating costs at little expense to government". However, Tarman identifies many problems with privatization, among them, "a basic contradiction between the profit motive and quality of care", "poor accountability and lack of public input", less government control of services with the balance of power "decidedly in favour of the nursing home industry", and the problem of access. She states: "the for-profit sector is unlikely to provide services where there is insufficient market demand".
Public sector planners "can design a system according to present and future demographic trends, population mobility and economic and geographic inequities" notes Tarman. Another public sector advantage is its accountability to the public -- its services are legislated, funded, and administered by government. Reforms such as the drive to integrate the socially segregated elderly; initiatives for homes to provide psychogeriatric care; development of alternatives to institutional care such as meals on wheels and day care have been a feature of the municipal homes for the aged programs, whereas, according to Tarman, many reforms have had to be "forced" upon the private sector.
Tracing the history of Ontario's nursing home policy, and examining privatization's impact on the nursing home system leads Tarman to conclude that providing health and social care and making a profit are contradictory functions. She urges that, with privatization on the rise, "further ventures into commercialization must be acknowledged, reviewed and assessed in light of the tensions between service provision and profit that commercialized services embody."
[Abstract by Ulli Diemer]