Community Service Obligations Research Articles

Emergency Physicians’ Ethical Issues with Hospital Business Models

BackgroundThe changing hospital business model has raised ethical issues for emergency physicians (EPs) in a healthcare system that often prioritizes profits over patient welfare. For-profit hospitals, driven by profit motives, may prioritize treating patients with lucrative insurance plans and those who can afford expensive treatments. Private equity investors, who now own many for-profit hospitals, focus on short-term financial gains, leading to cost-cutting measures and pressure on EPs to prioritize financial goals over patient welfare. Nonprofit hospitals, mandated to provide charity care to the underserved, may fail to meet their community service obligations, resulting in disparities in healthcare access. ObjectiveThis review examines the ethical challenges faced by emergency physicians (EPs) in response to the evolving hospital business model, which increasingly prioritizes profits over patient welfare. DiscussionEmergency physicians face ethical dilemmas in this changing environment, including conflicts between patient care and financial interests. Upholding professional ethics and the principle of beneficence is essential. Another challenge is equitable access to healthcare, with some nonprofit hospitals reducing charity care, thus exacerbating disparities. EPs must uphold the ethical principle of justice, ensuring quality care for all patients, regardless of financial means. Conflicts of interest may arise when EPs work in hospitals owned by private equity firms or with affiliations with pharmaceutical companies or medical device manufacturers, potentially compromising patient care. ConclusionEmergency physicians must navigate these ethical issues while upholding professional ethics and advocating for patients' best interests. Collaboration with hospital administrators, policymakers, and stakeholders is vital to address these concerns and prioritize patient welfare in healthcare delivery.

DIGITAL LITERACY TRAINING FOR PRE-SCHOOL TEACHERS IN THE ERA OF INDUSTRIAL REVOLUTION 4.0

The purpose of this training is to achieve the following objectives; 1) Share information on government literacy initiatives. 2) Assist teachers in finding affordable and reliable sources for textbooks through literacycloud.org. 3) Support teachers in conducting research that can be published in journals. 4) Fulfilling the community service obligation of an institution. This training took place at TK ABA 3 Randegan in Tanggulangin Sidoarjo. It involved 18 teachers and the principal. The training used methods of lecture, question and answer, practicum, discussion using applications and online article searches. The trainees used their cell phones and leptops. The team responsible for implementing the program determined that the digital literacy training went according to plan and achieved its goal of improving participants' digital literacy skills.

The changing nature of community service obligations in the postal sector and the future of Australia Post

The changing nature of community service obligations in the postal sector and the future of Australia Post

MODEL EKONOMI BERBAGI “Mobile-SECO” (PLATFORM MULTI-SIDED MARKETS) SEBAGAI EKOSISTEM SOSIO-EKONOMI ISLAMI

The most disruptive business model innovation of 21st century global market place is sharingeconomy. The value of sharing is indispensable to unlocking ambiguity, paradox and the uncertainty ofeconomy. Sharing economy by definition has to design socio-economic ecosystem between communitieswho share features of production. Sharing economy hold three core features: (1) digital platform, (2) access ofownership and (3) deeper social interaction. Mobile SECO will comes as a platform of multi-sided marketswhich aims to developers capturing value of socio-economic ecosystem. With that value, Mobile-SECO willhelps users and developer campaign the project to be shared with all of social media, that’s what we call Mini-Campaign Platform (MCP). Hopefully, Mobile-SECO will become a platform that can attract developers toimplement of fiqh muamalah as community service obligations.

The changing role of accounting: From consumers to shareholders

From the view of accounting as a social, political and institutional practice, this study examines the processes of accounting change as a State-sponsored consumer co-operative transformed to a private sector company pursuing profitability and value creation for shareholders. Accounting policy and practice were important aspects of the institutional and regulatory logics as the organisation changed from an entity focused on community service obligations to one that was profit driven. The State was the main factor/agent enabling this change. We frame our study within institutional theory and the political economy of accounting. We use institutional theory to inform our understanding of the institutional terrain and the political economy of accounting to understand the power and coercion of the State. Accounting rules and practices were co-opted to provide legitimacy, resistance, institutional logic, coercive change, and to redistribute wealth and power in society.

Corporatized Public Land Development Bodies in Australia: Who Are the Stakeholders and Why Are They Important?

This study examines post-corporatization activities of public sector organizations, which are expected to act according to commercial principles, but, at times, are also asked to undertake projects that are not profitable: community service obligations (CSOs). Managers of government-owned corporatized entities in land development are interviewed, and a focus group at a state Treasury department conducted. We determine, when undertaking CSOs, who are the stakeholders, as perceived by management, and why they are considered important. The stakeholders are government, community, treasury (as separate from government) and the relevant private sector. Values, in addition to power, urgency and legitimacy, influence stakeholder prioritization.

Increasing Student Learning: Factors influencing hospitality students' intention to engage in community service

Service learning is a blend of academic learning, service to community, and civic responsibility. It offers the opportunity for hospitality students to develop skills, such as communication, leadership, and time management. College students majoring in hospitality management were recruited and participated. Community Service Attitudes Survey (CSAS) was used to investigate the perceptions and attitudes of college students toward community service. Regarding the intention to engage in community service, perceptions and moral obligation were significant factors of engagement intention in community service. Among the components of significant factors community connectedness and norms made significant contributions to explaining variance in the hospitality students' intention for engaging in community service.

The Proposed Privatisation of Queensland Motorways

This article evaluates the proposed sale of the tolling rights on Queensland Motorways from an economic welfare perspective. Weighing against the sale are arguments about optimal risk allocation and network externalities. In contrast, there is a productive efficiency case in favour of the sale. Privatisation also raises questions about private monopoly power and the delivery of community service obligations, although these could be handled through contract specifications. The sale price is essentially a distributional issue. The back-of-the-envelope financial analysis here suggests that the mooted sale price of $3 billion would undervalue the asset and therefore transfer net worth from Queensland taxpayers to private investors.

Labor, Government Business Enterprises and Competition Policy

Long before the introduction of federal trade practices legislation or tariff reform, governments in Australia - especially Labor governments - attempted to reduce the costs or improve the quality of goods and services by establishing government business enterprises. With the rise of neo-liberalism industry policy of this kind all but disappeared. According to the National Commission of Audit (NCA), established by the Howard Government, there were only three circumstances in which Government Business Enterprises (GBEs) could be justified: when 'the private sector was seen as incapable of delivering the required products or services'; when 'the community considered it appropriate that government should own a firm that operated as a natural monopoly'; or when 'the government wanted to fulfil a community service obligation'. This article offers a historically-grounded critique of the NCA's position. It traces the history of GBEs as a spur to competition across the states and the Commonwealth. It shows that what counts, or doesn't count, as a government's 'core activity' is as much a matter of politics as it is of economics, and it locates the politics of the NCA within the broader neo-liberal project of limiting collective choice.

Public Policy: The Competitive Framework ‐ by Ewen J. Michael

Part 1 Building a Background for Public Policy Analysis Ch 2 What is the state? Ch3 The Market System at Work Ch 4 Issues in Public Economies Ch 5 Intervention and Market Failure Ch 6 Decision making: Who influences Whom Ch 7 Interest Groups and Theory of Market Segmentation Part 2 Contemporary Issues in Policy Analysis Ch 8 Competition Ch 9 Privatisation and the Economics of Interest groups Ch 10 Community Service Obligations: A strategy to avoid collective failure Ch 11 Accountability and the Democratic Process

The Dilemma of Privatized Public Services: Philosophical Frames in Understanding Failure and Managing Partnership Terminations

This paper uses social theory to explicate the competing perspectives on the on-going and, increasing, privatization of public services in the U.K. It suggests that if business ignores these perspectives then political imperatives will come into play that will inevitably turn privatization initiatives commercially sour. Contrary to political rhetoric, public/private partnerships (PPPs) constitute a more strategic form and process of out-sourcing, demanding that wherever public funding flows, private “rent-seeking” opportunities be created for the private sector. Seen in these terms, managerial elites will need to understand and anticipate conditions under which the state would seek to terminate lucrative partnering arrangements in the public interest. Political–administrative dialogue on partnerships can involve an unresponsive discourse or a dialogue of the deaf, both constituting a threat to business through the imposition of undefined community service obligations or hostile and unprofitable terminations by the state. Performance required of PPPs goes beyond market success and requires co-optation of strategic stakeholders, raising significant issues about corporate governance directions. Business leaders will need to develop communicative rationalities that build pluralized decision structures and implementation capacities. The paper concludes by outlining design features of more effective regulatory regimes to avoid hostile and unprofitable terminations of increasingly contested PPPs. The conclusion is less sanguine about the ability, or even the wish, of governments to do so.

Economic policy for rural and regional Australia

The efficiency and equity effects of economic policies affecting the quarter of Australians who live in rural and regional Australia (RARA) are reviewed. For the most part it is argued that economy‐wide policies, rather than region or industry specific policies, are appropriate. Progressive income taxation, means‐tested social security payments and government funded education, health and other services directly and efficiently redistribute to support equity. Subsidies for particular industries in RARA, such as dairy, and input subsidies targeted at RARA, such as community service obligations, misallocate resources and are ineffective in meeting equity goals. Better property rights and procedures for allocating most natural resources, especially water, are necessary.

Performance-based quality contracts for the bus sector: delivering social and commercial value for money

Reform of the bus sector has been occurring in many countries. One matter central to these reform initiatives is the establishment of a value for money (VM) regime to ensure that operators deliver to the market the best possible service levels consistent with stakeholder needs, and especially with the objectives of government. A key underlying feature of VM is identifying the benefit to society associated with each dollar of subsidy support from government. This paper reviews the elements of a VM regime within the setting of an incentive-based performance contract, and develops a formal framework for establishing optimum subsidy based on system-wide maximisation of social surplus. The maximisation of social surplus is subject to a number of constraints, including the commercial imperative of the operator, minimum service levels under community service obligations (CSO), and a fare and subsidy budget cap. An important feature of the performance-based contract (PBC) regime is a passenger trip-based incentive payment scheme linked to user and externality benefits that incorporates a subsidy per additional passenger trip above the patronage delivered under service and fare levels compliant with CSO. In this way, rewards to operators are revealed through the fare box, through increased consumer surplus and through reductions in negative externalities such as those associated with the use of the car. PBCs can be designed to accommodate both the transition from an existing regime and post-transition growth strategies. The implementation of PBCs is illustrated using data from private operators in the Sydney Metropolitan Area.

Performance-based quality contracts in bus service provision

Institutional reform of the bus sector is a topical discussion item in a number of countries at present. A specific focus is on ensuring a value for money (VM) regime to identify the benefits to society associated with each dollar of subsidy support from government. This paper promotes the position that a performance-based contracting (PBC) regime offers the best prospects of achieving a system-wide VM outcome. It proposes a reward system for bus operators that combines payment for delivering a minimum level of service (MSL), that meets government community service obligations, plus an incentive regime that rewards operators for patronage increases (above MSL patronage levels). The patronage incentive is based on expected user and external benefits deriving from service improvements and patronage increases. Cost benchmarking at relevant best practice levels is proposed as essential to ensure remuneration is based on efficient cost levels. The paper argues that a PBC approach is consistent with maximising social surplus from public transport provision across a geographic area, for any given budget constraint and regulatory imposed minimum service levels. The main alternative, competitive tendering (CT), is argued to be less attractive than PBCs in terms of securing the maximum social surplus to the community, given the total amount of subsidy support available, although CT is an appropriate non-compliance condition. This paper is a companion to Hensher and Houghton [Hensher, D.A., Houghton, E., Performance-based contracts for the bus sector: delivering social and commercial value for money, Trans. Res. B, in press] that details the economic framework and an application of PBCs.

Contestability and social justice: The limits of competitive tendering of welfare services

Abstract This paper critically analyses competitive tendering as a model for the provision of welfare services. Competitive tendering, driven by National Competition Policy and other imperatives for greater efficiency and a smaller public sector, is now used extensively by governments to fund welfare services. However, the suitability of this funding model to welfare services generally, and specifically welfare services in non-metropolitan areas, can be criticised on both theoretical and empirical grounds. Competitive tendering is grounded in economic rationalist, urbo-centric assumptions that are largely inappropriate for welfare provision, and have limited validity in rural areas. There is little rigorous empirical evidence of improved efficiency and effectiveness of service delivery under this model. Conversely, there is mounting evidence about the negative impacts. In rural areas this includes the erosion of community service obligations, less collaboration and greater secrecy between agencies, the reduction of choice, limited opportunities for local planning, cost shifting, and threats to continuity of care. This paper concludes with a call for greater application of the ‘public benefit’ test under the provisions of the National Competition Policy, and the development of more sophisticated frameworks for assessing the contestability of welfare services. Social workers have a leading role to play in challenging the dominant ideology of competition-orientated welfare reforms.

Contestability and social justice: The limits of competitive tendering of welfare services

This paper critically analyses competitive tendering as a model for the provision of welfare services. Competitive tendering, driven by National Competition Policy and other imperatives for greater efficiency and a smaller public sector, is now used extensively by governments to fund welfare services. However, the suitability of this funding model to welfare services generally, and specifically welfare services in non-metropolitan areas, can be criticised on both theoretical and empirical grounds. Competitive tendering is grounded in economic rationalist, urbo-centric assumptions that are largely inappropriate for welfare provision, and have limited validity in rural areas. There is little rigorous empirical evidence of improved efficiency and effectiveness of service delivery under this model. Conversely, there is mounting evidence about the negative impacts. In rural areas this includes the erosion of community service obligations, less collaboration and greater secrecy between agencies, the reduction of choice, limited opportunities for local planning, cost shifting, and threats to continuity of care. This paper concludes with a call for greater application of the ‘public benefit’ test under the provisions of the National Competition Policy, and the development of more sophisticated frameworks for assessing the contestability of welfare services. Social workers have a leading role to play in challenging the dominant ideology of competition-orientated welfare reforms.

What is a Community Service Obligation (CSO)? An Analysis of the Issues Involved in Identifying and Accounting for CSOs within Public Sector Organisations

he meaning of the term ‘community service obligation’ (CSO) has been a point of conjecture in recent years. This paper highlights the importance of CSOs within the context of the accountability of public sector organisations. In particular the paper advocates the need to formulate an agreed definition of a CSO. The paper seeks to distil such a definition by using academics and GBE representatives as authoritative opinions.

In Defence of Competition: The Successful Application of Competition Policy in NSW Rail

This paper argues that recent rail reform in NSW has been successful. NSW rail is now not only more cost effective, but also offers improved service and safety levels to its customers. As such the NSW rail reforms have been of benefit to the community as a whole, and have laid the groundwork for a resugence of the rail sector. Despite the criticism surrounding recent job losses, it is argued that the reforms have reinvigorated an industry that had been caught up in an ever decreasing vicious circle. The success of the 1996 reforms have been dependent upon a reform model that mixes factors such as vertical separation and independent regulation with government provision of targeted community service obligation payments. This paper argues that the most important ingredient for rail's future is the removal of the enormous bias in government tax and user charging policy against rail and towards road transport. In addition to keeping faith with the traditional National Competition Policy agenda, nothing is more important than that Australian governments address this continuing and debilitating bias against rail transport.

Community service obligations and their implications

In Australia, Government Business Enterprises (GBEs) are in the process of review so that they may eventually be run on commercial lines in a competitive environment. Some of the services that are provided, particularly by the monopolistic utilities, are non‐commercial but are required under various governments’ social policies. The GBEs that can identify and cost these community service obligations can be recompensed from the budget. The problems and benefits of the identification, costing and funding processes are discussed as well as some concerns raised by the corporatisation process.

Corporatisation and Community Service Obligations: Are They Incompatible?

This article asks whether corporatisation is compatible with the notion of community service obligations (CSOs). Corporatisation provides only a minimal framework for the identification of social objectives as CSOs and their funding by government from budget. The community has certain expectations of utilities in relation to CSOs, which may be different from expectations held by governments. Models of corporatisation which have two shareholding ministers with competing objectives introduce a further potential source of conflict.Historically, the characteristics of a CSO are ambiguous (IC 1991:81) and this presents difficulty in their costing and identification. Governments and corporatised entities have attempted to clarify the issues of definition, identification and costing. These and other issues such as transparency, budget funding, coverage, jurisdiction, public interest and community spirit are discussed in the context of corporatised government electricity utilities.