Health Care and Government

EYE ON THE PIE: Sometimes competition is a bad thing

May 8, 2006

You are getting older, living alone. You want to continue living where you are. You don't want to move in with your children and you think they might not want you. You don't want to move to some assisted-living place and give up so much of what you have known for so long. You are disabled or otherwise unable to cook for yourself.

Where do you turn? Your first thought is Meals on Wheels. You (or a member of your family) are computer-literate and the Web site for the Meals on Wheels of America Association comes up on your screen. But there are 31 listings for Indianapolis, eight for Terre Haute, five for Bloomington, Columbus-four.

I tried to count the total listings in Indiana on the MOWAA Web site but gave up after 170 and was only nine letters into the alphabet. But each listing is not a Meals on Wheels service provider. Many listings are for sites where meals are served to seniors, but they are not places that offer delivery of meals to the homebound, regardless of age.

In Indianapolis, Meals on Wheels operates exclusively on private funds with no government assistance. It is overwhelmingly self-supporting, with less than 10 percent of its operating budget coming from the United Way. A small fee ($5 per day) is charged to clients who can afford that amount.

The Indianapolis operation uses nearly 90 percent of its private donations for client services. MOW serves 400 to 500 clients, every weekday (except holidays), delivering two meals a day with the help of 1,500 volunteer drivers. Its food suppliers include eight hospitals and six health care centers. Since starting this effort in March 1971, MOW has delivered 5.5 million meals.

To become a client of MOW, a person needs a doctor's prescription. The meals themselves are prepared consistent with the doctor's recommendations. MOW offers frozen foods for weekend meals and for emergencies (when volunteers might not be available to make deliveries).

Recognized for excellence across the nation, MOWAA has a special day each year during which local mayors join volunteers to deliver meals to surprised and delighted clients.

In every community where a MOW operates, it needs more volunteers to make deliveries, to cover more routes. As more and more of us live longer and stay alone or as couples in our own homes, the need for MOW increases.

But all is not necessarily tranquil in the world of MOW. The national Web site describes MOWAA as "the oldest and largest organization in the United States representing those who provide meal services to people in need." This suggests they are differentiating themselves from "newer and smaller" organizations.

The MOW of Indianapolis Web site is explicit. It says, "In Indianapolis, there are two types of meal-delivery services for the elderly and homebound. One type is funded through federal and state appropriations. The other, which describes Meals on Wheels Inc., is powered by volunteers and donations." This statement is followed by five points differentiating MOW from its competition.

What's wrong with this picture? Here in one corner is an experienced private agency (MOW) providing properly nourishing meals in a timely fashion. In the other corner is the challenger, a government-funded entity that has somewhat different standards for serving its clients.

Some communities do very well bridging this public-private chasm and their clients benefit from their cooperation. In other places, the two sides appear to be squared off against each other. Aren't there better uses of scarce philanthropic funds (public and private) than agencies competing with each other?



Marcus taught economics more than 30 years at Indiana University and is the former director of IU's Business Research Center. His column appears weekly. To comment on this column, send e-mail to mortonjmarcus@yahoo.com.
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