Guidelines for Action
Together the difficulties described in this chapter suggest that there are clear limits on what government can successfully accomplish in the field of public social provision. There are some meritorious provision objectives that we cannot reasonably expect to fulfill. And expectations for the United States should probably be narrower than those for nations in which popular orientations toward government are more encouraging and public experiences in dealing with resource inadequacy problems are broader. In recognition of the particularities of the American case, I propose four simple guidelines for social programs designed to realize basic socioeconomic rights.[30]
First, these social programs should not expect or require dramatic changes in the activities of any of the actors—public officials, private service providers, recipients, and so on. Realizing basic socioeconomic rights will require some important changes in existing American practice, and incremental changes are not necessarily more apt to succeed than sharp ones.[31] Nonetheless, we can reasonably expect that, when a worker who has disciplined herself or himself to living within her or his income across a working life of four decades receives a pension, he or she will use the pension to support her or his needs responsibly in retirement. But asking for dramatic changes in recipients' activity may be asking for trouble, as we learn when the public schools try to educate a child whose home and peers provide little positive reinforcement for doing well in school. In general, we can expect better outcomes if public social policies do not require people to undertake new, complicated activities that are incompatible with their cultural traditions, preferred life choices, or professional norms.
Second, social programs that require less complicated cooperation from actors—recipients, and public facilitators, or private providers—are apt to be more effective than those requiring more. Disbursing pensions to the elderly, for example, is easier than delivering medical care to the poor in part because the former can be accomplished after a one-time enrollment on the pension distribution list, while the latter requires a series of cooperative endeavors: the sick must consult health-care professionals whenever ill-
ness strikes, these professionals must be willing to provide care, and the recipients must follow their advice. To the degree that complicated cooperation is unavoidable, there are some benefits to centralizing its management and oversight within sophisticated professional bureaucracies.
Third, social programs are apt to produce more encouraging results if their design allows recipients, facilitators, and providers to keep their social status and personal dignity intact. Both specific design features and the general character of a program's targeting and visibility are at issue. A program, such as AFDC, that in effect penalizes efforts at self-support even as American culture creates expectations of self-support is incoherent and stigmatizing. And while there are exceptions, such as veterans' benefits, for which narrow targeting works, generally the more universal program targeting becomes, the less stigmatizing recipient status is apt to be. Broadly targeted programs also tend to have a better public image because elites are less likely to build destructive features into programs that serve broad constituencies. Additionally, inclusive programs that address the most frequent social hazards facilitate public empathy with the plight of program beneficiaries. The visibility of programs, particularly their visibility as social programs, is relevant here as well. Neither suburban commuters who make daily use of interstate highways explicitly constructed for defense purposes nor wealthy citizens whose tax breaks are presented as necessary prerequisites to economic recovery are perceived, by themselves or generally, as recipients of "welfare."
Fourth, social programs are more likely to achieve their objectives if all parties see the program requirements as consistent with desirable prior or concurrent activity. In broad terms, recipients need to know that benefit rights are earned by prior or concurrent contributions, and providers must feel that the services they are delivering meet contemporary professional standards.
Unfortunately, these four guidelines cannot be applied with equal ease (or sometimes even at all) in every instance. Social insurance programs directed toward episodic disruptions of income hold the greatest potential for fitting fairly well with all four. Such programs do not by nature require extensive changes in recipient activity; complicated cooperation can usually be left to centralized state bureaucracies; and rights are earned through prior, respon-
sible activity that leaves the recipients' social status and self-respect unsullied.[32] Programs that entail the delivery of social services run afoul, minimally, of the second guideline. They require complicated cooperation from both recipients and relatively autonomous service providers, and many of these complications cannot be centralized.
Programs directed at persistent resource inadequacy face more difficult problems still. Generally these programs serve recipients of low socioeconomic status, and if they try to comply with the first two guidelines, they run afoul of the second pair and vice versa. That is, if a program does not ask recipients to substantially change their activities, then the general public is not likely to view recipients as engaging in responsible behavior, and recipients' social status, if not self-respect, is apt to suffer. The AFDC program has tried to cope with this dilemma in a variety of ways, but with no great success to date. If a program takes the contrary tack, it may well run into the problems associated with expecting dramatic behavioral changes and introducing forms of complicated cooperation.
The more general point is that modern governments, which necessarily rely on the impersonal operations of bureaucracies, are better suited to working with people's aspirations, opportunities, and capacities—as social insurance objectives generally allow—than for changing these factors, as programs targeted at severely disadvantaged recipients sometimes attempt to do. Program recipients nestled within the mainstream culture can usually take effective advantage of social programs to accomplish some objective they value—medical care, education, income maintenance—and to accomplish it in a socially approved way. But people located on the margins of society have greater difficulties, both with the bureaucratic mechanisms and the program objectives. Programs designed to help these people enter the mainstream may require complicated changes in recipients' activities; narrow targeting tends to stigmatize recipients; and efforts to link benefits to activities approved of by the mainstream public may seem insulting or menacing to recipients.[33]
Surely public programs can seek to ease the lives of socially disadvantaged citizens. But public efforts to "reform" the poor are frequently not necessary and, necessary or not, are only marginally
productive.[34] Rather than imposing mainstream standards, public programs should try to work with whatever desires the disadvantaged have to merge with the socioeconomic mainstream by facilitating and supplementing their constructive efforts to do so. Little good can be expected of programs that force people into destitution in order to qualify for public social provision and that subsequently discourage their efforts at self-support.