The role of municipal government has changed considerably over the years. Our local councils were originally assigned the sorts of responsibilities that required local flavour—such as ditches, roads, and drainage.
Yes, the flavour of local government is still local, close to the people and accountable to its ratepayers. But the menu, the scope of its responsibility, has expanded to the point that it’s become almost unreadable.
Even though our councils are recognizing important gaps that need to be filled for the good of the people, they’re getting involved in areas that were never intended to be their responsibility—both by choice and by necessity.
Today’s blue-plate special in Niverville is the medical clinic.
I doubt anyone disagrees that it’s important to have doctors in Niverville. The medical service provided to the town at large, and especially the seniors living at the Heritage Centre campus, is essential for the general well-being and economy of the community.
In fact, the very value of our homes depends on the availability of these services, since prospective buyers will ask about them. Yes, it can certainly be agreed upon by all that the grocery store, our great schools, and our medical clinic are important.
But for some, this is the end of our common ground. Libertarians, anarchists, and Marxists can sign off here.
For the rest of us, we may share another point of agreement: in a perfect world, our municipal government should not be running a medical centre. The Burnetts’ dream would remain in their hands and continue to build towards the vision they had when they first came to Niverville. And I’m sure the town was not in the market for another venture, another project to take up their time and energy.
But the world is an imperfect place, requiring us to change plans and make tough choices.
Is it the best option for the town to assume ownership of a medical clinic? Now, this is where we can delve into some really interesting discussion.
Medical services straddle two worlds: there is the world of business, and then there is the world of social services. Much like with agriculture, a for-profit industry that also happens to feed the world, it would be inadequate and inappropriate to say the medical field is only one or the other. The for-profit side of medicine must be protected, not for the sake of the operators of medical clinics, but rather for the continuity of their services, which they provide for the greater good.
Given the current situation, however, it became clear that someone needed to step up… and quickly. We can debate the merits of other doctors taking over, but the reality is that the business could not move to a new owner quickly enough. Without a new set of doctors ready to take over the business, it would seem that government was the logical choice.
If government decided to stay out of it, that would have meant the closure of the clinic… so governmental involvement became inevitable. But the question remained: how deep should the government have dipped its toe? What should government involvement look like? Should it be long-term? Should the government merely offer a subsidy and otherwise remain hands-off?
Personally, I would rather see the model chosen by Niverville’s council—full ownership—than a long-term commitment to a taxpayer-funded subsidy, which is the model that has been applied in other communities. Yes, there may be years when the clinic doesn’t make money and the difference must be drawn from tax revenues. But this would have happened with a subsidy anyway.
If there’s good management and a balanced board in place to operate the clinic, the operation may show a profit, allowing reinvestments in the clinic that strengthen and enhance its service offerings.
I’m not a gambler, but it seems pretty damned simple that the chance of a win is better than the guarantee of a loss.
But for how long should this go on? We just don’t know. There may come a time when prudency dictates an exit, a turnover of responsibility back to the professionals in the clinic. Or maybe not. Will our young up-and-coming doctors seek the yoke of owning a medical clinic or will they instead seek an environment in which they can do what they love with a greater degree of professional flexibility?
Despite all the unanswered (and unanswerable) questions, it’s clear that action was required and the local government, the kind of government that’s closest to us and the most capable, stepped up.
The stability and availability of Niverville’s medical clinic isn’t just about personal health, but also about the economic health of the community. As I keep the Burnetts in my thoughts and prayers, I will add the new board of this endeavour to my list as well.
