<< Back 11/27/02 The hidden price of government cost-cutting By David Teague I’m not one for sound thinking about finances, but there is one lesson I was taught a few years ago that I still use some today. It came from my friend Steve Jacobsen, who was then the business manager of the Baptist Peace Fellowship of North America, the first organization I worked for in Haywood County. He taught me that in planning what projects needed to be completed on a given day, or a given week, it was important to remember that each hour spent had a dollar value attached to it. In other words, if my biweekly salary worked out to $12 an hour, and the most important thing to do that day was get out a mailing, it meant the organization was paying $12 an hour for me to stuff envelopes. If somebody needed to go to Asheville for supplies, it meant that person’s hourly rate was going in part for driving a car and listening to the radio. In small agencies, helping out with these kind of things is a given since volunteers are usually in short supply, but it taught me a valuable lesson. As the old saying goes, time is money. I’ve been thinking about that adage recently as I contemplate some changes taking place in both our federal and state governments, both of which are trying to shore up weakening budgets. Let me mention two examples. First, National Public Radio reported that the Bush administration is thinking of opening up the Government Printing Office to competition. Since the 1860s, the GPO has run the federal government’s printing presses, providing librarians, researchers, teachers and citizens easy access to public documents. The list of print jobs ranges from printing pocket-sized copies of the Constitution to every word said in Congress. It also prints military histories, FAA guidelines, and handbooks for high school counselors. The GPO also acts as a liaison between federal agencies and thousands of private printers, farming out about 80 percent of its work. In the past, Congress has required virtually every branch of government to do its printing through the GPO, but the Bush administration believes these federal agencies should negotiate directly with private printers. In the NPR story, Angela Styles, with the White House Office of Management and Budget, said the administration wants to make sure that the forces of competition are working in the federal government. She also likened the GPO to a monopoly because it controls the dealings between most government offices and private printers, most of whom the Bush administration believes could get better prices if they negotiated themselves. Every agency already has its own procurement system, Styles said, which should make the shift easy. The OMB estimates this move could save between $50 and $80 million a year. Ah, but that’s where my friend’s sage thinking comes in. Time is money, and if this move toward more competition proceeds, hundreds of federal agency directors will now have to add the task of printing broker to their list of responsibilities. Such a move might give the GPO a leaner budget, but how much will it cost for these federal agency directors to broker printing deals? Who is calculating the cost of getting all these folks up to speed, not to mention the cost of the missteps they are almost guaranteed to make? In the scheme of things, whatever happens at the GPO might not have much effect on people’s lives, but similar changes now underway in North Carolina — also in the name of improving fiscal responsibility — almost certainly will. North Carolina is in the midst of overhauling its delivery system for mental health and substance abuse services, making the system more focused on community care and less dependent on state institutions. The changes will make each mental health system in the state a business entity that oversees the work of a network of private providers who administer mental health services. In this system, clients become “consumers” of mental health and substance abuse services. If it works the way it is supposed to, the state will be able to cut millions of dollars from the amount it spends for these services, and consumers will be able to get these services in their own communities. As the change is taking place over the next several months, hundreds of service providers will be leaving the public payroll, which, in theory, will save the state money. They will have the option of setting themselves up in private practice or joining new agencies that form to lease out services. Most service providers will likely face a loss of salary, benefits and even job security. The clients, or consumers, may be faced with getting the treatment they need in entirely new ways from people they don’t know. It may seem a little callous to link the suffering of people with mental illness to the changes that may occur at the government printing office, but I think there is a theme here worth noting. It is about weighing the hidden costs. If the GPO is split up, director Mike DiMario told NPR, the money that theoretically will be saved, might be gobbled up by error alone. Even if it’s not, its years of service have given the GPO the reputation of being the place to go for public information. The distribution arm of the GPO sends documents to libraries, congressional offices, Web sites and other sources, which means citizens have easy access to federal regulations, congressional proceedings and the general work of the federal government. Under the Bush plan, other government agencies will now be responsible for making sure the GPO gets copies for distribution. In federal agencies already struggling with the daily responsibilities of running their part of the government, how high a priority will it be to get such documents out in a timely way? If they are pressured to make it a priority, how will it affect their ability to focus on the problems at hand within their agencies? And, in the end, where will citizens actually see any cost savings — will these other government agencies just not report the time they’re spending as printing brokers? Obviously, the stakes are much higher when you weigh the hidden costs that may pop up in reforming North Carolina’s mental health system. Friends of Mental Health, a statewide advocacy group for mental health patients and workers, estimates that 80,000 to 100,000 people now receiving services will no longer qualify for services once the new system is in place because they will not fit into specific target populations. In an effort to survive, many of these people may turn to crime, such as prostitution or drug dealing, the advocacy group fears. The deep emotional cost not withstanding, how do we evaluate the added stress and financial costs this might bring to law enforcement and medical facilities? Who is evaluating the cost of the chaos and confusion as our service providers are trying to determine if they want to be part of this new system? In the end, like the GPO, the state may end up with a budget for the Department of Health and Human Services that looks leaner, but it won’t mean the costs have gone away. They’ll be showing up in dozen of other state agency budgets. This is not to say that mental health reform was not needed — in fact, most folks who are part of the system will tell you it was needed a long time ago. Maybe the government printing office needs a little shaking up, too. But let’s not let our government leaders get away with performing a little budget magic that looks good at first glance. Whether it’s printing government documents or caring for the mentally ill, those costs are going to land somewhere and our leaders need to be able to show us where. If not, we may end up paying in ways we can’t even imagine. (David Teague is free-lance writer and editor who lives in Waynesville. He can be reached at bestteague@aol.com)