Co-Opting Voluntarism? Exploring the Implications of Long-Term Care Reform for the Nonprofit Sector in Ontario
Bibliographic record
Abstract
Within public policy discourse on health care restructuring and voluntarism, the nonprofit sector is now expected to play an active and direct role in the provision of health care services. The viability of the nonprofit sector to take up this role, however, remains unclear. This paper explores the changing role of nonprofit organisations with respect to the provision of long-term care in Ontario, Canada, where extensive restructuring of public services occurred during the 1990s. Drawing on a critical review of legislation, government policies and documents, and stakeholder reports, the authors present a comparative study of two distinct long-term care reform models, featuring public and private provision, respectively, which were developed by ideologically opposed provincial governments. The results indicate that despite unanimous promotion of voluntarism (and the attendant ascendancy of the nonprofit sector) as a central feature of health care restructuring, the divergent reform models actually trap nonprofit organisations between direct incorporation within public provision on the one hand, and direct free-market competition on the other. The findings suggest that underscoring long-term care reform in Ontario, and elsewhere, is the co-option of the nonprofit sector, which resonates with concern for its ability to replace effectively the public provision of health care services. The results also point to the need to conceptualise the consequent actions taken by nonprofit organisations in order to inform current debates surrounding health care restructuring and voluntarism.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".