History and philosophy of social work in the United States

¶ … Philosophy of Social Work in the U.S.

The basic concerns of social welfare - poverty, disability and disease, the dependent young and elderly - are as old as civilized society itself. The means by which these concerns are addressed were once limited only by the laws of survival. Sharing another person's burden meant weakening one's own standing in the struggle of daily existence. However, as societies evolved, the dependence between members increased, so, as individuals became vulnerable, the society as a whole was affected, and systematic responses to disrupting factors were introduced.

Since the needs and the ability to provide for those needs are different in each society, there is no universal solution to the welfare problem. In some countries there is a firm distinction between social services (health care and education, which are meant to serve the entire population), and welfare services (aid directed towards vulnerable groups - the poor, the disabled or the delinquent. Another classification puts social services into the following categories: remedial services, which are designed to address the basic needs of individuals suffering from chronic or acute diseases, preventive services, which intend to reduce the pressures and obstacles of the distress caused by illnesses, and supportive services, which attempt to maintain and improve the functioning of individuals in society through employment, educational, health and other programs.

Social welfare services were initially emergency measures that were applied when all else failed. In today's world they are considered a necessary function of any society and a means to rescuing the endangered and fostering a society's well-being. The majority of social services are rendered to people who are unable, whether temporarily or permanently, to cope with the problems of everyday living. Recipients of this individual-based program are families facing the loss of income, illness or desertion, children and youths whose physical and moral welfare is at risk, the unemployed, the sick, the disabled or the elderly. Whenever possible, the social services also try to address the threats to family and personal independence.

The social services have constituted a mixed economy of welfare in advanced societies, an economy that involved statutory, voluntary and private sectors of welfare provisions. The role of personal services is very important, despite the fact that they account for only a small part of total welfare expenditures.. The most important increases in expenditures have occurred in social security systems, which are designed to provide assistance to specific categories of population on the basis of universal and selective criteria. The social security systems have gradually developed, beginning with the 1880's, and this development included fundamental change in the scope and aims of social policy, but also dramatic shifts in expert and popular opinion regarding the significance of social and personal causes of need.

There was widespread opposition in the United States towards social programs before the 1930s. The Great Depression changed all that. Federal intervention became necessary and increased as time passed by. Earlier government activity was reduced to unimportant initiatives at state or local level. The Social Security Act of 1935 not only provided federal grants for state and local public assistance to the elderly, dependent, blind and disabled children, but also set-up a federal old-age insurance scheme and financial support for unemployment insurance plans built according to federal guidelines. A provision for survivors was added a few years later, and one for disability followed.

One of the most important influences on the global development of social programs was that of Lord William Beveridge, who submitted to the Government in 1992 a report in which he stated that it is the responsibility of the Government to maintain full employment and that family allowances for all children after the first, health care programs for the entire population and a unified national scheme of social insurance run by states, backed-up by a social scheme at a national level, run by the central government should be immediately introduced. The United Kingdom applied Lord Beveridge's program from 1948, although making some compromises and modifications.

The period of rapid economic growth that began after World War II and ended as the oil crisis put a stop to the world's economy was a time of quick and important expansion for social insurance policies. Pensions were linked to the inflation rate, thereby protecting the aged, dynamic pension formulas indexed past pension contributions to the earnings at the time of retirement, flexible retirement providing for part-pension and part-time earnings in the years before retirement was introduced, equal social welfare rights for men and women appeared, providing for all disabled people on the foundation of the degree of disability, rather than the cause of disability, recognition of the additional needs arising from disability and of the needs of persons caring for the disabled, introduction of parental allowances in addition to family allowances or extension of same health-care right to all citizens were measures that found their way into the legislation after World War II.

The perception about social security services changed a lot in the United States in the last hundred years. The need for such services is evident and America would not be what it is without those services. However, there are sufficient critiques of the U.S. social programs, which never seem to envelop all the persons in need of help and to cover all the needs they should.

Budget cuts and lack of skills in managing social security funds have often lead to the impossibility of actually getting the job done. Images with homeless people sleeping in boxes and under bridges or not getting medical treatment because they do not have insurance are known all over the world and are not something for America to be proud about. Still, there are many persons who consider that 'freeloaders' plague the system without contributing to it in any way.

There are many variables that need to be considered when analyzing a social security program. The methods of provision for such programs are numerous and should be balanced with caution, in order to achieve the desired effect. An overview of these methods could prove useful. Many countries have adopted state schemes of compulsory insurance, although they once held employers legally liable for compensating victims of work accidents and for paying for their medical care.

Certain employers may be required to contribute to a provident scheme in order to provide a lump-sum payment in the event of death or disability or on retirement. The difference from a social insurance scheme is that each worker usually has his/her personal account from which he or she can draw, if certain events occur. The essential difference is that there is no pooling of risks among members, as there is in a social insurance scheme.

Compulsory social insurance provides medical benefits and cash benefits in such cases as sickness, disability, widowhood and old age. These are essentially a tax on earned income. Employers have always tried (and succeeded in some cases) to transfer the burden of their part of the contribution to consumers (by charging higher prices) or to their own employees (simply by paying less cash). The social insurance approach has several disadvantages, when it comes to meeting social needs or reducing poverty. Benefits should be paid to those who have contributed, so persons who never worked cannot benefit from such schemes. Another problem is that, if benefits are related to the amount paid, women, for instance, are discriminated, because they had to face family responsibilities. The most important issue is that, if benefits are linked to earnings, the people who are most likely to need them, the poor, will not actually be protected.

To fight these problems, some countries have made certain benefits available to all residents and financed them out of taxation. The most common example is the family allowance. The provision for children should not depend on the parent's employment status. The tendency is to apply this principle to medical benefits, since all citizens have a right to health care.

Another solution to the general problems of society, aside from social insurance and benefits to all residents is social assistance. The idea is based on the concept of need, so declarations of income, family size and other circumstances are required. Income and capital of a person are taking into consideration when assessing his/her chance to be included in such a program. In some countries, social assistance plays a residual role, by providing a less favorable level of support than social insurance benefits do. In other, and the United Kingdom is such a country, social assistance plays a considerable role, its purpose being to supplement social insurance benefits for those without other sources of income, as well as providing for those without rights to benefits.

The United States use the social assistance concept to meet the medical care needs of low-income persons under the Medicaid program. Only households headed by a single parent are eligible for the Aid to Families for Dependent Children Program, which creates incentives for desertion or fictitious desertion. Other programs for the blind, aged and disabled are also applied. The general problem of the social assistance concept is the eligibility issue. Conditions are very restrictive, and so they should. Too much benefits would lead people into thinking that the Government will provide for them, at the expense of others, which is not what politicians desire (maybe communist rulers do, but this is not the object of this paper). On the other hand, few benefits or no benefits at all would mean that the purpose of the program - i.e. social protection - is not achievable.

One other aspect of the way U.S. citizens (and people from other countries, for that matter) look at the social assistance programs is the stigmatization such a program brings to an individual. No one likes to admit that he/she is in desperate need of help, so people are reluctant to apply. Perhaps some media campaigns against that perception would make a difference.

Another method would be to apply negative income taxes. Canada has such a program, based on the income statements a person submits. It basically involves paying an additional sum to an individual according to the needs the Government feels that that particular individual has. Still, this is a very bureaucratic approach, as money is needed when poverty strikes, not at the end of the fiscal year.

The researchers who have studied the differences between the American and the European welfare system have arrived to not so flattering conclusions for the United States system. The American welfare state is smaller than its European counterparts when it comes to percentages of the Gross National Product spent on social welfare. It seems to be less inclusive and generous, but more fragmented. Social programs have been reluctantly received by the American people and although some initiatives have imposed themselves, there are many core social programs that have never materialized.

The explanations offered for this phenomenon are impressive, at least at a scholarly level. However, all these debates were not followed by any actual application, due to the lack of governmental capacities. Researchers define the welfare state as an instrument of social control or of social betterment, a part of the state or a stage of development of capitalist countries, a minimal social insurance for the middle classes, safety net for those in need, or, in a very general way, everything that the government does to improve the well-being of individuals and families. The definitions do not include elements such as how the goals are to be achieved, or what is the form that these goods and services must take in order to accomplish the desired objectives.

Many countries, and the United States are a notable example, rely on indirect spending in order to promote social welfare, along with other various direct and indirect tools. Tax expenditure, for instance, is the most important form of indirect social spending in the United States, and is accompanied by loan guarantees for education and housing programs. Such programs give a sample of how large and complex the American welfare state really is.

The Congress has typically been presented as an impediment to the American welfare state. This assumption is based on the fact that the authority in the Congress is extremely fragmented and that the historical prominence of conservative southern Democrats often dilute or block social welfare legislation. As far as public opinion is concerned, it would seem that support for social welfare policies in the U.S. have generally remained stable and solid form the 1970s to this day, despite serious increases in opposition to income maintenance and related "welfare" activities. Americans, who traditionally do not favor social programs, have rejected cuts in welfare programs and have lately manifested their support toward such initiatives.

Social welfare programs around the world generally have the same structure as the one applied in the United States. The most advanced programs in the world are those put in practice by the European countries, and especially by Scandinavian nations, such as Sweden, Norway or Denmark. Europe is well-known for its propensity towards rest and relaxation, when compared with the United States or Asian countries, such as Japan. Sometimes, one could ask where does all the money come from. The French, for instance, have intensive social welfare programs, and they are not too keen on working. Higher taxation and no growth are the characteristics of most European countries, especially because of these social programs.

After all, Americans are reluctant to give a large part of their income in order for some other people to benefit from it. For people in Sweden this is the normal way of life. There are now a lot of immigrants who are completely satisfied with receiving social aid from Swedish authorities and not working. Still, such policies are not acceptable.

It is obvious that each country has its own particular social security legal provisions, and the systems vary, but not so wildly as to be completely different. As far as public opinion is concerned, most people act like the Americans: they support welfare programs when recession strikes, but do not encourage them in times of economic boom. No surprise here.

In most countries, a major part of the cost of social security is paid for by employers and employees, with proportional contributions. These contributions may be divided equally between them, except for the cost of the occupational injuries schemes, which is normally a task for the employer. In other cases, the employer could pay up to twice as much as the employee does. Most national legislations provide a ceiling, or a level of earnings beyond which the contribution becomes flat-rate, although Sweden or Switzerland, for instance, do not apply this principle. The maximum varies from around 50% above average earnings (France, Italy or Ireland) to twice the average earnings (Germany, the United Kingdom, or the United States, for that matter). Some countries, such as Norway, go even higher.

Some portion of funding is met by taxation. The taxes normally fill the gap between the amount of contributions and the proceeds available for this endeavor. Most Western European countries tried in the 1970s to shift the burden of financially supporting social security programs from employers onto taxes (Ireland, Denmark, Portugal, the Netherlands, Italy and the United Kingdom) or to employees (France, Germany and Austria).

There are also isolated cases where taxation does not cover even a small part of the costs of social welfare programs: Ethiopia, Malaysia and Singapore are such examples. At the other extreme are the countries in which most of the costs are covered by taxation and only a few are supported through contributions: Denmark, Australia and New Zealand are such countries. The United Kingdom finances its programs half with taxes and half with contributions.

The percent of Gross National Product allocated to social security expenditures is much higher than it was in the first half of the 20th century and there is a significant difference between developed and developing countries. Sweden spends about 32% of its GNP on social security programs, Belgium, France, Denmark, and the Netherlands between 25 and 30%, Austria, Germany, Norway, Ireland or Luxembourg between 20 and 25%, while Australia, Japan, New Zealand, the United States or the United Kingdom barely exceed the 10% level. High costs usually go hand in hand with high levels of social security benefits and with costly systems of providing health care. Some countries have permitted health care costs to continue to rise because of the capacity of this sector of the economy to provide for jobs and avoid high rates of unemployment.

The principle one could draw from analyzing this data is that, on an international scale, social security spending varies in direct proportion to the respective standard of living: the more affluent the country is, the more it spends on social security. The proportion of elderly people in the population is also a factor that needs to be observed. Another variable is the time period when the legislation was introduced. High spenders apparently introduced social program in a very early stage.

Exceptions are always close by: Japan and the United States have high standards of living and a high proportion of elderly, compared to the low budget they have for social security, while New Zealand spends very few if we consider the fact that pensions were introduced here in the 19th century.

Global perspectives are not really something to debate, since all countries have specific problems, specific concepts about those issues and very particular methods of solving those problems. The Swedish model is completely opposite to the American model, although both systems try to obtain the same thing: protect the needy. The philosophy that works so well in Sweden could never be imported to America, simply because people would reject it without giving it a second thought. Therefore, globalization in the area of social security will be possible, if ever, only gradually, and along with the uniformity of the peoples' needs and ways to act.

There have been numerous debates on whether it is better to let private persons set-up social welfare funds and programs, or to let the Government control the system. There have also been questions on whether it is advisable to allow local authorities to manage the programs, or to make the federal government responsible. These questions have been answered very differently around the world. It is a well-known fact that the first social security programs were run by private persons, such as the employers who wanted to increase the security of the people working for them. However, such a system has the major flaw that it only includes certain categories of people and that the benefits are extremely diverse across the economy. The risk for such an initiative is also great.

Another system would involve the government's centralized commitment toward building and applying a social welfare program, unified for the entire economy. Such programs have proved financially unstable, as many Eastern European countries have showed (Romania, Bulgaria, Hungary etc.), so the governments in those countries have decided to let private operators take charge of the social security funds and programs. However, legal provisions are very tight, and so should they be, considering that the old age and health of millions depend on the financial soundness of the plans of these operators. Risk pooling is also a very important aspect of these political, legal and administrative structures.