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Cash-strapped American cities are finding it harder to maintain social services that their citizens and civic leaders alike once took for granted. Population explosions, compounded by the flight of affluent taxpayers to the suburbs, have drained urban resources and forced many cities to make difficult, often painful, choices. Public hospitals, boons to the poor and still a distinguishing feature of the American medical industry, are among those institutions under threat of the budgetary ax. Hospitals are as expensive to run as medical care is costly to the consumer. The return of tuberculosis and the spread of newer epidemics among urban populations have pushed hospital resources to their limits. Many in government are looking to another American institution, the free-enterprise system, for succor. The privatization of public hospitals is becoming a popular alternative to propping up struggling taxpayer-supported hospitals.
Public hospitals are not, however, the only urban institutions under fire. Schools---long the targets of criticism and in palpable decline in most American cities---also drain as much as a billion dollars from municipal treasuries nationwide. Complete privatization of schools is probably not on the horizon, as public schools have been a part of American life since colonial times, but many different uses of government education resources are under serious consideration. The first is school autonomy, which consists of breaking the links within school systems and permitting individual schools to draw up their own budgets. Another solution is the so-called voucher system. Under a voucher system, cities would provide tuition credit to individual students, who would then attend whichever school they wished, public or private. Presumably, better schools would receive more applicants, making public schools as competitive as private schools are today.
While privatization has succeeded in the manufacturing sector, many critics point out that while privatizing a phone company may produce dramatic financial benefits, doing the same with hospitals or schools may hurt more people than it helps. They worry that the poor and uninsured will no longer have a reliable source of health care as private hospitals turn away those who cannot pay. Parents worry that their children may not gain acceptance to selective private schools and be shunted into substandard programs. Advocates respond to such criticism by pointing out that an efficient, private hospital or school would eventually have sufficient resources to accommodate even the neediest customers.
According to the passage, which of the following has contributed to the decline of public hospitals?
A.The emergence of serious, widespread disease
B.The unwillingness of governments to expand their health care budgets
C.Taxpayer objections to skyrocketing health-care costs
D.The increase in private hospitals
E.An increase in the population of affluent citizens
According to the passage, all of the following are arguments in favor of the privatization of hospitals and schools EXCEPT
A.the expense involved in transforming private institutions to public institutions
B.the belief that privatization fosters competition
C.the expense to taxpayers that public institutions present
D.the benefits that the poor would derive from efficient private institutions
E.the success of privatization in other public services such as public utilities
Select the sentence in the second paragraph in which the author cautions against an unlikely result.
