Not every operation under our sun is a fitting candidate for the competitive market – be it overtly so or in disguise.
By JPOST EDITORIALMagen David Adom ambulances 311(photo credit: Reuters)
Despite the prodigious bad reputation heaped on it recently by social protest promoters, privatization – whether full, partial or quasi – has overall proved a boon for Israeli consumers. Cutting-edge telephony is perhaps the most outstanding attestation, in terms of local experience, to the advantage of dealing with profit-based firms vying with others for a slice of the market.Yet plainly, not every operation under our sun is a fitting candidate for the competitive market – be it overtly so or in disguise.The key ingredient may be whether the outfit in question is at all suitable for profit-motive management.
Broadly speaking, the crucial consideration ought to be the service component in its raison d’être. Not to put too fine a point on it, the greater the service component, the lesser the suitability for turning a given organization into a business.Take Israel’s national ambulance service-provider, Magen David Adom, for instance. For the first time in the state’s history, the Health Ministry has officially entrusted a specially formed committee with considering the notion of “ending MDA’s exclusivity.”While this wouldn’t necessarily entail privatization, it clearly implies that MDA is a monopoly in the business sense and hence that sanctioning competition from a variety of challengers should be weighed – in essence the introduction of quasi-privatization by the back door.Prima facie it’s not a bad idea. It seems wrongheaded to discriminate among ambulance services and first-responders just because of the tags on their uniforms.Ostensibly – the more the rescuers, the better.Although MDA employees approximately 1,300 emergency medical technicians, paramedics and emergency physicians, it still relies heavily on thousands of volunteers who serve in both operational and administrative capacities. MDA is recompensed by the state for its services.It is the sole officially accredited rescue and evacuation-to-hospital service-provider. All alerts from the security forces, police and the citizenry go through MDA.
To be sure, other rescue and ambulance services exist, but they are secondary at best. They are summoned via MDA and at its discretion.Numerous allegations have accumulated about MDA essentially sidelining would-be rivals to marginalize them and hog most of the income. If so, these are patently bad business practices – even if by a non-profit organization – and they warrant inquiry, regulation and, if need be, rectification. Fairness must be an indispensable ground rule, no matter who’s playing.But does this justify throwing out the baby with the bathwater? Extreme care is paramount here.The entire matter of first-aid and emergency services lacks definition and coordination in this country. Any moves to rationalize what was handed down to us over the decades by force of inertia would be welcome.That said, the last thing we wish is for a host of private responders to rush to each emergency scene with crews whose skills and expertise might not be of the highest caliber and who might not be backed up by the same broad logistical infrastructure and technical support as MDA. Plausible as competition may sound in theory, it may be too chancy when lives are on the line.We need only conjure up the all-too-common scenario here of a mass-casualty terrorist atrocity. What happens, for example, if a private ambulance operator evaluates the situation and decides that the incident isn’t worth the time, expenditure and bother? Or what if that operator prioritizes cost-cutting and simply doesn’t dispatch his best paramedics or enough of them? What’s needed is standardized coordination and synchronization among all rescue-providers that would function according to clearly imposed and rigorously supervised guidelines.This shouldn’t mean demoting MDA to just another competitor among several – just as private security companies are no substitute for the police. We need a primary emergency service-provider because emergency services are conspicuously among those for which competition is least suited – like prisons (for which privatization was an enterprise-in-progress quashed by our Supreme Court), firefighting, mother and child clinics, school nursing, psychiatric care, etc.In all the above, as in first-aid, the risks are that not enough profit can be derived from first-rate service to the general public, wherever or whatever the need may be.
