2NC---Turns Case---Ineq/Efficiency

Jenny Formby, 9-2019, Jenny Formby is the general secretary of the Labour Party in London. (UNIVERSAL BASIC SERVICES: The Right to a Good Life, Labour UK, 9-2019, https://labour.org.uk/wp-content/uploads/2019/09/12730_19-Universal-Basic-Services_v5.pdf, 7-18-2023)//AAlmand

For certain goods direct provision by the state has advantages that cash payments do not. It is true that an entitlement to a “national minimum” for a particular good or service could, in principle, be guaranteed through a cash benefit (or voucher or insurance system) rather than through direct state provision. Students of neoclassical economics will have been taught the so-called Second Welfare Theorem which says, broadly speaking, that any desired allocation can be achieved by giving people a transfer and then allowing the market to take its course. Assuming that the cost of universal access was covered by the state through general taxation, why would it matter if everyone received the national minimum as a cash payment rather than in kind? One reason is that a national minimum may not be enough to cover need. How much health or social care someone needs varies widely over the course of one’s life and from person to person in ways that are unpredictable. Given this, if everyone were given an equal cash payment the outcome would be unequal as those with high needs would be unable to cover the cost of their care. Another reason is efficiency. One has only to look at the US health system to see the dangers of for-profit private provision. When healthcare is provided for profit there is a huge incentive to overtreat or to prioritise the most lucrative treatments. This creates inefficiencies and channels resources towards where the money is rather than towards need. The final reason is that inequality is more likely to emerge whenever cash is the medium. This is because the wealthy are likely to top up their guaranteed national minimum to purchase better quality services. This risks creating a stratified system of provision and undermining the solidarity and principle of equal access for all citizens that a national minimums are supposed to create. It is also important that the public sector is the provider of those services and not private companies. For the last forty years, the dominant view was that introducing private companies and market competition to public services would have a disciplining effect that would drive efficiency improvements. However, the internal market for the NHS, academisation of schools and widespread outsourcing are creating a growing body of evidence that creeping privatisation of public services has been counter-productive. Quality has been eroded due to cost cutting and fragmentation. “Efficiency” gains have mostly not materialised and, where they have, they have come at the expense of workers. Perhaps most worrying, however, is that the involvement of private providers has brought with it a cultural shift as profits and margins increasingly take precedence over social purpose.