The number of government-owned and operated public hospitals in the United States has declined dramatically over the past three decades. There were almost 2,000 public hospitals in the U.S. in the 1970s. There were only 1,045 public hospitals by 2011, and the trend is continuing for many of the same reasons North Kansas City is considering changing its hospital operational structure. Like the U.S. Postal Service, the model of a government-owned and operated public hospital facility is simply not nearly as effective as it used to be. There may be substantial public concern and political opposition to changes in hospital operations, but that will not change the long-term economic outlook of public hospitals.

The economic literature on the use of public-private partnerships and toll roads (the two are generally related) to provide highways is clearly positive. This includes economic analyses of PPPs that do not support their use in many other public services. Simply put, the use of public-private partnerships to fund and operate transportation infrastructure has been studied and found to be an effective method of meeting the public interest.

Senate Bill 795 would create a land bank in Kansas City. Proponents have argued that, given the foreclosure crisis, they have to do something about vacancy. I do not dispute the fact that vacancy is a public policy concern. However, there is no evidence that the land bank legislation proposed here will be an effective mechanism for getting vacant property back into private, productive use, nor is there any apparent evidence that the system of dealing with vacant property already in place in Kansas City is inadequate.

Think, if you will, about the difference in the taxes that property owners pay to fund local parks and the entrance fee your family pays to visit Yellowstone National Park. That is the appropriate framework to begin discussing toll roads. Everyone in the community can access local parks so general taxes support their existence. A much smaller percentage of people visit Yellowstone each year, and those people support it with an admission fee. Interstate highways are like Yellowstone — admission fees (tolls) are the preferred means of funding.

A recent Show-Me Institute study documents the extremely large costs and very questionable benefits that a significant investment in high-speed rail would bring Missouri. Other estimated figures that have been publicized regarding the construction of high-speed rail left out cost overruns, operating expenses, repair and maintenance, and more. The burden for those additional costs would fall on the state of Missouri and its taxpayers — not the federal government.

In order for MoDOT and other transportation agencies to have the ability to seriously consider public-private partnerships — state officials would be well advised to consider passing wide-ranging enabling legislation that would authorize agencies, particularly MoDOT, to enter into these types of projects when careful analysis has deemed them to be both viable and beneficial.