Thursday, 29 January 2015

Private vs Public Services

Let me start by saying that I'm a big believer in public services.  I think it borders on criminal to privatize things like health care, schools, police, the military or other services which are necessary but not profitable if done correctly.

This is my basic argument: if a society has a two-tier system with a publicly-funded option and a private-for-pay option, those who can afford to will invariably take the private-for-pay option.  Those people tend to be the ones with the time and income to protest or influence changes in the public system.  Because they are receiving services, they will not see the need to improve the public system.  Invariably, the public system gets worse and worse as resources dry up and the society is left with a distinct class gap of who gets help and who doesn't.

However, I also cannot fault anyone for taking advantage of private services when they are available and needed.

I put both of my children into private therapy to deal with their autism.  I signed up for the public services but I quickly realized the challenges: the intensive program had a two year plus wait time and the other program offered 10 weekly sessions followed by a 3 to 4 month break.  It was too long to wait for the intensive program and the breaks made the other ineffective.

I even understand the limitations.  The publicly funded programs have very limited resources.  They can't add an extra "class" of intensive treatment when demand goes up, so all they can do is extend the waitlist.  (Leading to children who are more entrenched in their behavioural challenges and who take longer to go through, creating a vicious circle of longer and longer waittimes.)  The other program decided not to increase waittimes, but had to stagger serving the children so that it could treat twice as many children with the same number of therapists.  I can't fault them for making the decisions they have.

However, I can fault government policies which have not included autism as a medical condition covered under provincial health plans.  I can fault an attitude which says that it is fine to place families in the position of deciding whether to help their child or keep their home.

I am certain that the public would be outraged if they realized the extent of the problem.  The vast majority of people I've spoken to are under the impression that autism treatment is readily available and covered by the government.  When they discover it is not (and the annual costs), they are horrified.

Personal income should not stand as the deciding factor in whether or not someone receives the help they need.  We don't accept it in a court of law, in schooling, in being protected or even in garbage pickup.  Surely autism is as worthy of aid as any of those issues.

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