My recent contact with the National Health Service made me return to this article. The author is a Finnish American citizen, Anu Partanen, who gets constantly questioned about the strong welfare state in Finland. People keep telling her that it all sounds nice, but the social solidarity of Nordic countries, which is the bedrock of welfare states, doesn't exist in the USA and so the level of taxation to support comprehensive welfare systems wouldn't be possible. Her answer is simple:
Why is the NHS politically untouchable (though infinitely reorganisable)? The answer is easy. We all use it. Birth, death, childhood, and old age are universal. And we all get ill. Sometimes those illnesses are life threatening and because of the NHS you don't die or become bankrupt. The point is that we think about us, our families and friends. We don't get carried away by a warm fuzzy feeling as we watch belligerent drunks at bus stops or neo-Nazi thugs parading in the streets thinking, "Isn't it wonderful that they are protected by the NHS." No, we think isn't it a bloody good idea that if one of these bastards takes a swing at us we can get patched up at the local hospital. The ultimate, total justification for all welfare provision is self-interest.
So why then do we insist on framing the debate in moral terms? Because that is what we do on both the left and right.
The left version is that a civilised society should care for the weakest and most vulnerable of our society. It's a charitable impulse that is sometimes described as social justice. It's also a moral belief that I share. The trouble is that it invites the response, 'why should I pay for someone else?' The left replies by calling the objectors greedy or selfish, a moral condemnation. This may be true, but calling someone greedy doesn't stop them being greedy, so the argument becomes pointless.
Right wing moral arguments are all about who deserves support and who deserves 'encouragement.' They divide the world into the deserving and undeserving poor or 'strivers and shirkers.' The result is a two track welfare policy. There is charity for the deserving, but sanctions for the undeserving. Those sanctions are dressed up in moral language as a way of encouraging people to get into work and save themselves from sin. Things like the 'bedroom tax' encourage people to give up living in larger homes and move into smaller, and mainly non-existent, accommodation. It's critics all focus on the moral arguments about spare rooms being used for disabled equipment and other such scandals, rarely on the policy itself.
This might appease the greedy, but it creates problems and undermines the case for welfare states. And, of course, the boundaries are never clear cut. The Tories have got into huge trouble by attacking Tax Credits, which go to low paid people in work, and benefits for the disabled. Both groups are seen as 'deserving' and rebellions in their own party has forced them to backtrack. We have even seen tentative attempts to introduce morality into the NHS with suggestions to exclude the obese or smokers from treatment unless they change their wicked ways. The anomalies and inconsistencies are so great that these seem to have faded away.
I have another suggestion. Let's bin all the moral arguments. And although I do think that there are strong collective and economic arguments for welfare provision, let's not bother with those either. Instead we should make the case for the individual benefit of good public services and comprehensive social insurance to everybody. Though collective means are the instrument to ensure security, the result is enhanced individual liberty. In that way, we are drawn towards universalism instead of judgemental conditionality, and to schemes like universal citizens' incomes, which have been advocated on both the left and right.
Then what would matter is that political debate on public service will not be about morality, but quality. This was something that New Labour understood, but then they blew it by thinking that good quality could be delivered through the imposition of centralised managerial control and grotesque bureaucracy.
The key to building the sort of social democratic consensus on wider welfare that has sustained the NHS is to see it as a system that benefits us as individuals, rather something that is done to others on the basis of disputable moral grounds.
But this vision of homogenous, altruistic Nordic lands is mostly a fantasy. The choices Nordic countries have made have little to do with altruism or kinship. Rather, Nordic people have made their decisions out of self-interest. Nordic nations offer their citizens—all of their citizens, but especially the middle class—high-quality services that save people a lot of money, time, and trouble. This is what Americans fail to understand: My taxes in Finland were used to pay for top-notch services for me.Yes, the real argument for welfare states is self-interest. They are a good idea. For you. You benefit directly and indirectly. If not in the present, in the future. It's obvious.
Why is the NHS politically untouchable (though infinitely reorganisable)? The answer is easy. We all use it. Birth, death, childhood, and old age are universal. And we all get ill. Sometimes those illnesses are life threatening and because of the NHS you don't die or become bankrupt. The point is that we think about us, our families and friends. We don't get carried away by a warm fuzzy feeling as we watch belligerent drunks at bus stops or neo-Nazi thugs parading in the streets thinking, "Isn't it wonderful that they are protected by the NHS." No, we think isn't it a bloody good idea that if one of these bastards takes a swing at us we can get patched up at the local hospital. The ultimate, total justification for all welfare provision is self-interest.
So why then do we insist on framing the debate in moral terms? Because that is what we do on both the left and right.
The left version is that a civilised society should care for the weakest and most vulnerable of our society. It's a charitable impulse that is sometimes described as social justice. It's also a moral belief that I share. The trouble is that it invites the response, 'why should I pay for someone else?' The left replies by calling the objectors greedy or selfish, a moral condemnation. This may be true, but calling someone greedy doesn't stop them being greedy, so the argument becomes pointless.
Right wing moral arguments are all about who deserves support and who deserves 'encouragement.' They divide the world into the deserving and undeserving poor or 'strivers and shirkers.' The result is a two track welfare policy. There is charity for the deserving, but sanctions for the undeserving. Those sanctions are dressed up in moral language as a way of encouraging people to get into work and save themselves from sin. Things like the 'bedroom tax' encourage people to give up living in larger homes and move into smaller, and mainly non-existent, accommodation. It's critics all focus on the moral arguments about spare rooms being used for disabled equipment and other such scandals, rarely on the policy itself.
This might appease the greedy, but it creates problems and undermines the case for welfare states. And, of course, the boundaries are never clear cut. The Tories have got into huge trouble by attacking Tax Credits, which go to low paid people in work, and benefits for the disabled. Both groups are seen as 'deserving' and rebellions in their own party has forced them to backtrack. We have even seen tentative attempts to introduce morality into the NHS with suggestions to exclude the obese or smokers from treatment unless they change their wicked ways. The anomalies and inconsistencies are so great that these seem to have faded away.
I have another suggestion. Let's bin all the moral arguments. And although I do think that there are strong collective and economic arguments for welfare provision, let's not bother with those either. Instead we should make the case for the individual benefit of good public services and comprehensive social insurance to everybody. Though collective means are the instrument to ensure security, the result is enhanced individual liberty. In that way, we are drawn towards universalism instead of judgemental conditionality, and to schemes like universal citizens' incomes, which have been advocated on both the left and right.
Then what would matter is that political debate on public service will not be about morality, but quality. This was something that New Labour understood, but then they blew it by thinking that good quality could be delivered through the imposition of centralised managerial control and grotesque bureaucracy.
The key to building the sort of social democratic consensus on wider welfare that has sustained the NHS is to see it as a system that benefits us as individuals, rather something that is done to others on the basis of disputable moral grounds.
1 comment:
This is an excellent case for the type of individualism that would appeal to conservatives as well as the left, and your post should be waved under the noses of policy-makers everywhere. Before you get carted off :)
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