This week’s reading reviewed the social service aspect of nonprofit organizations. Social service in nonprofits is arguably the most broadly appealing and therein most sponsored facet of nonprofit organization. I feel that social service non-profits are the conventional image most people think of when envisioning non-profits --before taking this class I thought it represented the vast majority of non-profits. Our class this week was spent in the library where we learned about the resources that we could use to look up statistics on non-profits. It was interesting to see all of the tools at our disposal. Guidestar and Foundation Center in particular were helpful for me.
On Tuesday much of the class was spent debating health care. At one point the professor mentioned the cost of extending medicare to those on the verge of death. I find this debate very interesting yet, of course, highly contentious. As the video above explains "last year medicare paid 55 billion dollars just for doctor and hospital bills for the last 2 months of patients lives. That's more than the budget of Homeland Security or the Department of Education." I found this statistic, quite frankly alarming, particularly because much of these charges are unnecessary for the most part. By law medicare cannot reject any treatment based upon cost. Therefore, many expensive unnecessary procedures are given to patients that may or may not extend their lives. The debate is obviously touchy but I felt it was interesting and relevant to our class. I couldn't upload the full video but it is available here: (http://www.youtube.com/watch?v=F6xPBmkrn0g).
Chapter 4 of Nonprofit Nation goes into the relationship government has with social service non-profits that I had never considered. According to the book, the United States government accounts for “three-fifths of nonprofit social service revenue” (p. 89). Conversely, the government does not provide significant aid to other non-profit services. In my opinion social service non-profits can often be much more efficient than government social services, and therefore permit government assistance. Non-profits are not entangled by constant bureaucratic red-tape and hoops and hurdles that the government must go through. Moreover, the government is generally reluctant to try new ideas; often government agencies are conservative in that respect. Non-profit agencies on the other hand have the ability to act as laboratories for new creative ways of social service. However, the government-non-profit relationship can often be dicey. For instance, in the Supreme Court case Boy Scouts of America v. Dale (http://www.law.cornell.edu/supct/html/99-699.ZO.html) the Boy Scouts of America were affirmed the right to discriminate scout masters on the basis of sexual orientation, atheism, and agnosticism as protected by the First Amendment. The 5-4 decision was interesting because there is federal money channeled through the Boy Scouts, therefore, one would expect that the First Amendment would not necessarily be extended.
I usually think of non-profits as unable to compete economically with for-profit organizations. Non-profits do not have a profit maximizing mechanism that for-profits have because non-profits internalize so many of their externalities. However, the article titled Redeeming value: St. Vincent’s builds a business empire on what’s thrown away changed my perspective (http://registerguard.com/csp/cms/sites/web/business/25677985-41/mcdonald-agency-business-vincent-paul.csp). The St. Vincent de Paul “increased its revenues and grew its work force each year by more than 10 percent.” The St Vincent’s was economically competitive because of its outstanding financial manager Terry McDonald and because it relies on some of its returns instead of purely on donations. I think Terry McDonald’s socially minded entrepreneurism in an effective model for other non-profits. His operation provides for a creative and business minded frame of organization businesses have but also the altruistic function of non-profits. I feel that it will be important for like-minded people like Terry McDonald to represent non-profit organizations. Should non-profits have more business savvy approaches (in a limited sense) they would probably have larger successes.
The article Understanding the tools in the affordable housing toolkit by Malcolm Kenton (http://greatergreaterwashington.org/post/8786/understanding-the-tools-in-the-affordable-housing-toolkit/) gives some insight into providing affordable housing. One policy tool the article highlighted that I am particularly a fan of is inclusionary zoning. Many people think that zoning practices generally prohibit low and moderate income housing by making unnecessary zoning requirements which increase property value. Practices like these are exclusionary zoning and have been a barrier to affordable housing and social integration. Inclusionary zoning conversely requires developers to reserve a certain amount of new residential development as affordable, low-income households. Inclusionary zoning prompts a market driven solution to affordable housing problems by actually requiring developers to bear the burden through zoning requirements. Jonathan Levine's book Zoned Out: Regulation, Markets, and Choices in Transportation and Metropolitan Land-use is a really interesting book about the power inclusionary zoning can have on affordable housing.
(http://books.google.com/books?id=zURqiV_lGqkC&pg=PA116&lpg=PA116& dq=zoned+out:+regulation,+markets+inclusionary&source=bl&ots=iWOPcZ6wyD&sig=OgkQSOLyDks1NIvqrmlsXVAVwqI&hl=en&ei=m18_Tai3Moa2sAPw77nTBQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBMQ6AEwAA#v=onepage&q&f=false).
(http://books.google.com/books?id=zURqiV_lGqkC&pg=PA116&lpg=PA116& dq=zoned+out:+regulation,+markets+inclusionary&source=bl&ots=iWOPcZ6wyD&sig=OgkQSOLyDks1NIvqrmlsXVAVwqI&hl=en&ei=m18_Tai3Moa2sAPw77nTBQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBMQ6AEwAA#v=onepage&q&f=false).
Social service non-profits can be an effective alternative to cradle-to-the-grave government sponsored welfare programs. However, there certainly needs to be some middle ground. The government obviously must have some form of oversight for the money it is funding, yet, it cannot do so to the point where it impedes the non-profit’s independence.
Your blog this week brought up a lot of good points and I think you have a lot of great ideas! I was surprised when I read that more money goes to medicare bills than to education or homeland security. I recently learned in another one of my classes that 44.4% of the US budget goes to military, whereas about 19.7% goes to healthcare, 11.8% goes to responses to poverty, and only 2.2% goes to education and jobs (there is a graph that shows these stats on www.globalissues.org). This was very disturbing to me because if the amount of tax dollars spent is at all representative of how important the government thinks something is, then things like education are much lower on the governments list of priorities than I imagined. (These statistics are not extremely related to our discussion of social services, but when I read your post I was reminded of them.) The statistic that does relate to your discussion is that 19.7% of tax payer's dollars go towards healthcare, which is a decent chunk, yet we do not have a nationalized health care system. So, unlike the fact that potentially everyone benefits from education, very few people actually benefit from the large amounts of money that go towards medicare bills for the last 2 months of a patient's life. Things like the military budget and whether or not so much money should go into saving a potentially un-savable life are extremely touchy subjects, but if people want to get the most out of their tax dollars, I think it is important that these issues be discussed. It should not be a matter of making sacrifices, but rather one of getting the maximum benefit out of money that already exists. That may include uncomfortable conversations and a lot of compromise, but I think it would be well worth it. For example, maybe spending more money on preventative health education (as we discussed in lecture) rather than on end of life procedures.
ReplyDeleteTuesday's debate over health care was, in word, frightening. While both sides, pro and against universal health care can be reasonably argued, I was shocked by some of the made-up statistics people were spewing out in class. I think that if the public were more aware of what's actually documented in the entire "Affordable Health Care for America Act," all 1,990 pages of it, we could have more enlightening debates and comments like what we have with each other via blogging. I thought your comment on the Boys Scouts was noteworthy: "The 5-4 decision was interesting because there is federal money channeled through the Boy Scouts, therefore, one would expect that the First Amendment would not necessarily be extended." The argument could then be that the Boy Scouts do not have to receive government funding and they could just fend for themselves like other private organizations. However, are you saying that since the Boy Scouts are receiving some (not all) government funding, they are under rule of the feds and that they are not allowed to exercise a "no shoes, no service"- type policy? Since the bill's passing last spring, couldn't you then say that since everyone is entitled to health care and tax dollars are providing such entitlements, that insurance companies, doctors, and other health care professionals are now under strict government control? I liked that you posted that video because it brings us back to the provacative, slippery slope known as "death panels." One quote in the video was quite alarming: "Denial of death becomes a delusion and we start acting in ways that make no sense whatsover." It will be interesting to hear this man's point of view once he is 80 years old...
ReplyDeleteI like the video you put up about the cost of dying and how hospital are spending so much money to treat elders and the sick. I think there comes a point that no matter how much money you spend to treat or extent someone's life, people eventually die. Part of why the healthcare cost is so high is because of medicine and drug costs. People are using so much medical drugs to lower blood pressure or treat this condition. These things are essential buying life to live longer because there comes a point where its time to go and using more drugs is going to make the body worse. I agree with how non-profit agencies are not as effective because of all the bureaucratic red-tape, which cause lots of delay, such as funding. I also think Terry McDonald's ways are effective and sustainable for nonprofits because he runs them like businesses.
ReplyDeleteIn regards to providing healthcare to the elderly, at some point, it just becomes too expensive. Once the money runs out from savings, the government picks up the tab, such as through programs like medicade. The question comes at what point should we put a cap on benefits? It seems like we pay higher taxes as life expectancy has increased beyond the estimates of the government. A lot of areas need reform so that we don't in-debt ourselves further. Why should we pay higher taxes to support pensions that we the younger generation would never have a chance to receive ourselves. It is not sustainable the amount of debt being passed onto the next generation. Worse, costs surrounding healthcare are continuing to rise, in the article below it estimates the cost of healthcare could double by 2020 for the elderly.
ReplyDeletehttp://affordablehealth-care.com/elderly-health-care-cost.php
I wanted to touch on Boy Scouts V. Dale, the primary goals of this organization are not social service, so I don't have a huge problem with their discrimination against gays and atheists. But if it was a homeless shelter discriminating against the same groups, they provide a vital role to community. However, the ruling was that it went against the founding principles of the organization, therefore it seems that there are some limits to when an organization can and cannot discriminate. The government also controls grants and it seems like discriminatory organizations would have trouble getting funds.