Working in the world of privatization, one objection I get all the time to privately operating in a here-to-for public space is that government officials are somehow more "accountable" to the public than are private companies.
This strikes me as an utter disconnect with reality. If I screw up, I make less money or even go out of business. When government agencies or officials screw up, they generally remain unchanged and unpunished forever. There are no market competitive forces just waiting to shove a government agency aside -- they have a monopoly enforced at the point of government guns. As I wrote a week ago about a conversation between myself and a government official about my operating public parks:
I understand that my margins are so narrow, if even 5% of those visitors don't come back next year -- because they had a bad time or they saw a bad review online -- I will make no money. Those 2 million people vote with their feet every year on whether they think I am adequately serving the public, and their votes directly affect how much money I make.
Government agencies have nothing like this sort of accountability for public service.
One reason government agencies seldom change is that the typical response to even overt malfeasance is 1) to give the agency more money, as the agency will blame all incompetence on lack of budget (just think "public schools" and teachers unions) and 2) the agency will fire nobody.
Take the Phoenix VA. Congress eventually rewarded the VA with more money, almost no one was fired, and the one of the worst managers in the VA system, a serial failure in multiple VA offices who would have been fired from any private company I can think of, was put in charge of the struggling Phoenix VA.
Well, it turns out that firing nobody and giving the agency more money is really a poor way to fix things.
Patients in the Phoenix VA Health Care System are still unable to get timely specialist appointments after massive reform efforts, and delayed care may be to blame for at least one more veteran's death, according to a new Office of the Inspector General probe.
The VA watchdog's latest report, issued Tuesday, says more than two years after Phoenix became the hub of a nationwide VA scandal, inspectors identified 215 deceased patients who were awaiting specialist consultations on the date of death. That included one veteran who "never received an appointment for a cardiology exam that could have prompted further definitive testing and interventions that could have forestalled his death."
The report portrays Phoenix VA clerks, clinicians and administrators as confused and in conflict about scheduling policies despite more than two years of reform and retraining.
"Unexpectedly" as a famous blogger would say.