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Organizations that provide subsidized services to needy people are frequently discouraged from competing with one another. Many policymakers view the duplication of the competitive market place as wasteful, and stress coordination, not competition. They claim that quality can be controlled by direct regulation and by the participation of needy clients in suppliers' decisions. Many of these attempts to improve quality have, however, been failures. Direct regulation has proven expensive and has often been ineffective. Attempts to raise the quality of services through client participation on boards of directors and advisory groups have often floundered on the indifference and inaction of client representatives.

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