Centralized Health Care and Libraries

President Niyazov of Turkmenistan has truly centralized the hospital care and the libraries of his country. He closed all of them outside Ashgabat, the capital city.

"Why do we need such hospitals?" he said. "If people are ill, they can come to Ashgabat." ...

At the same time, the president has also ordered the closure of rural libraries, saying they are pointless because village Turkmens do not read.

Not surprisingly, no one in Turkmenistan has complained:

Criticism of the president is not allowed in Turkmenistan, but civil rights activists abroad say he has destroyed social services while spending millions of dollars of public money on grand projects, such as gold statues of the leader and a vast marble and gold mosque, one of the biggest in Asia. [Thanks to BrianF for the link]

This extreme example highlights a major problem when the budgets of bureaucrats are scrutinized but with little or no attention paid to the transportation costs borne by users of publicly provided facilities. In Ontario, we are facing closures of schools and hospitals in lower population areas, and few if any of the studies consider the increased transportation costs of the users.