Social Welfare Policy Analysis and Choices

Hobart A Burch

• Publisher: Routledge
• Year: 2013
• Print ISBN: 9780789006028
• eBook ISBN: 9781136382437
• Topic: Medicine
• Subtopic: Health Care Delivery

Social Welfare Policy Analysis and Choices gives you a thorough introduction to social welfare policy analysis. The knowledge you'll gain from its pages will enable you to understand and evaluate individual policy issues and choices by exploring the possible choices, the effects and implications of each alternative choice, and the factors that influence each choice.

Social Welfare Policy Analysis and Choices provides frameworks for making basic social policy choices and applying them to specific instances. You'll find its depth of insight into the larger framework in which social policy decisions are made--beliefs, values, and interests--and its historical perspective on current "new" issues unique and invaluable. The book's approach is to develop a framework for looking at the underlying issues, ideologies, social and economic forces, culture, and institutionalized inequalities that are constant within this changing mass. Specifically, SocialWelfare Policy Analysis and Choices provides frameworks for looking at beliefs about:

• human nature
• the nature of society
• ways of thinking
• values and the moral and ethical implications of those values
• roots of those values in religion, culture, historical traditions, myths, and rationalized self-interests

The insight offered in Social Welfare Policy Analysis and Choices will allow you to determine your own positioning; understand for strategic purposes what direction opponents, potential allies, and others are coming from; and develop a priorities perspective to guide compromises when the optimum policy is not attainable.

PART I:
POLICY CHOICE
AND INTERVENTION

Chapter 1
Social Welfare Policy:
When and Where?

The pilot of the state who sets no hand to the best policy, but remains tongue-tied through some terror, seems vilest of men.

Sophocles, Antigone

This strategy represents our policy for all lime. Until it's changed.

Marlin Fitzwater,
White House Spokesperson

Smoking tobacco is legal. One-quarter of us do. Three-quarters do not.

• Should smokers be permitted to deprive others of their freedom to work in a healthy atmosphere by imposing the unpleasantness and health risk of their secondhand smoke on coworkers? Can co-workers reasonably deprive smokers of their freedom to smoke comfortably eight hours per day?
• On the average, smokers have significantly higher health costs. Should nonsmokers be expected to subsidize the extra cost of smokers’ habits through higher premiums on their group insurance? Should smokers, as with accident-prone drivers, be relegated to a higher premium assigned risk pool? Should their emphysema in old age be treated at public expense through Medicare and Medicaid?
• If the numbers were reversed, with 75 percent of the population being smokers, should answers to these questions be different?

Mrs. Brown and Mrs. Green are single parents with school-age children. Mr. Brown died. Mr. Green just took off. Neither mom is employed; both receive government support.

“Welfare” and food stamps combine to give the Green family an income of half the official poverty line used by the Bureau of the Census. (In 1995, the poverty level for a family of four was $15,662 |Ambert, 1998].) To be eligible, Mrs. Green must seek, and take, a job regardless of the pay or working conditions. The Brown family receives triple that amount from Social Security. To be eligible, Mrs. Brown must not seek and take a job.

• Should these families be treated differently? Why?
• Should staying home to care for her children be required of one and forbidden to the other? Why?
• Does it “all depend”? If so, on what?

We buy our appliances in the open market. The electricity to run them is available only at a fixed price from a commercial monopoly in New York City and a government monopoly in Omaha.

• Is the public interest better served by monopolistic “public utilities” than by open competition? When? Why?
• Should utilities be socialistic, as in “conservative” Nebraska, capitalistic, as in “liberal” New York City, or nonprofit citizen co-ops, as in rural North Carolina? Why?

All of the above are social policy questions. This book does not answer them: it can't. As will be discussed in Chapters 4 and 5, before-the-fact vantage points have selected, defined, and colored both the perceived reality of what is and the vision of what ought to be. These vantage points vary among different classes, interest groups, subcultures, and sects in our society, and among individuals within each group.

This book does provide tools to help understand the facts required to answer those questions, by examining:

• the realities as you see them and what your perception is based on;
• the realities as others see them and why;
• key possible choices;
• the values and interests (whose?) affecting your choices;
• the professed rationales of opposing policy positions, the de facto values and interests upon which they are based, and their hidden agenda, if any;
• where special interests conflict, whose take priority, and/or how might they be balanced and why; and
• what is best for general welfare—and whether, in relation to the policy question, there is an unequivocal “general welfare” at all.

Social policy is a complex mixture of overlapping, inconsistent, and often contradictory intents and behaviors that affect different people in different ways. Our tools for understanding this complexity are concepts and frameworks that organize and distill key elements from the mass of detail. A concept is “a generalized idea of a class of objects.” Concepts may be organized into a framework, “a structure serving to hold the parts of something together,” or a model, “a representation of a social pattern.”

These policy analysis tools are inherently selective and never exactly fit the disorderly reality with which you are dealing. You should neither accept the ones in this book as “the truth” nor reject them outright for their imperfections. Use these tools, but develop your own as well.

WHAT IS SOCIAL POLICY?

Policies are “courses of action, whether intended or unintended, that are deliberately adopted or can be shown to follow regular patterns over time” (Tropman, Dhuly, and Lind, 1981, p. xvi).

Social policies “have to do with human beings living together as a group in a situation requiring that they have dealings with each other” (Ibid.).

Welfare is “the state of being or doing well: the condition of health, prosperity, and happiness; well-being.”

Social policies may be good or bad. Slavery was a bad policy; public education is a good one. What is the difference? The bottom line for every social policy is how it affects the welfare of human beings, collectively as a society and individually within that society.

Micro, Macro, and Mezzo Policy Levels

Edwin Chadwick compiled a macro-oriented report on poverty in 1842, Report on the Sanitary Condition of the Labouring Population of Great Britain, in which he concluded that “the amount of burthens produced [by “epidemics and all infectious diseases”] is frequently so great as to render it good economics on the part of administrators of the Poor Laws to incur the charges for preventing the evils that are ascribable to physical causes” (quoted by Fraser, 1973, p. 57). According to Trattner (1994, p. 142), “Probably no single document so profoundly affected the development of public health.”

This was a remarkable turnaround from a micro-oriented report on poverty eight years earlier, Report of His Majesty's Commissioners for Inquiring into the Administration and Practical Operation of the Poor Laws, which placed total blame for poverty on individual victims and was the rationale for the punitive microinterventions of the 1834 British Poor Laws Reform Act—and for American public assistance during the past thirty years.

Policy may address micro, mezzo, or macro levels. Policy actions may strategically intervene at any or all levels. Analysis at one level commonly creates policy implications for the other two levels. For better or for worse, “it's all in one piece.” Indeed, one can make a good case for synergism: “the simultaneous action of separate agencies which together have greater effect than the sum of their separate individual effects.”

An illustration of this is the case of TV personality Kathy Lee Gifford. She was a longtime advocate and contributor at the micro policy level to direct services for needy children. Shocked to learn that her popular clothing line was manufactured in part by children for starvation wages under unsafe and abusive conditions, she moved to the mezzo (middle) policy level by demanding from the manufacturer that no garment bearing her name be made under such conditions. She also moved to a macro level by seeking to persuade the U.S. government to strengthen and enforce trade policies that prohibit imports manufactured abroad under inhumane conditions— even if that manufacturer is itself an American corporation.

In contrast, at about the same time, a basketball superstar was informed that a comparable situation existed in the manufacture of the line of sneakers that he promoted. He responded that he had nothing to do with that part of the business.

Often even effective microprograms do not by themselves cut the mustard. The 1960s’ micro-oriented work and training programs appear to have been effective for hundreds of thousands of individuals and probably contributed to the largest short-term reduction of poverty in the history of the United States. Yet, it was also a period of great unrest—the urban “rebellions” or “riots,” according to your ideological viewpoint. As the coordinator of NIMH (National Institutes of Mental Health) research on those riots, my conclusion coincided with those of Aaron Wildavsky:

A recipe for violence: promise a lot, deliver a little…. Try a variety of small programs, each interesting but marginal in impact and severely underfinanced. Avoid any attempt at solutions remotely comparable in size to the dimensions of the problem you are trying to solve, (quoted in Dolgoff, Feldstein, and Skol-nick, 1997, p. 97)

The Six P's

Policy does not exist in a vacuum. It is part and parcel of a collection of related activities, which we can call “the six P's.”

Policy analysis (PI) develops an overall framework for policy action (P2), which works to get a policy adopted and carried out. The analysis incorporates such areas as beliefs and values, mission, existing circumstances, intents, directions, and boundaries. It addresses political, planning, program, and project factors that are likely to affect policy choices, particularly in relation to their feasibility for successful policy action.

Politics (P3), said Otto von Bismarck, is “the art of the possible.” It is a give-and-take decision-making process, based on power and persuasion, that affects policy in several ways. First, in policy analysis, politics is a common process used to sort out the relative priority of stakeholders’ conflicting interests and values. Second, it is a key feasibility process for testing what the traffic will bear. Third, it is a necessary policy action method to get the policy enacted, implemented, and accepted by those whom it will affect.

Planning (P4) is “any method of thinking out actions or purposes beforehand.” It is concerned with determining how to get from here to where we want to be, developing a course of action that will do the job, and organizing a detailed strategy to carry it out. A “plan” itself is the road map for a chosen course of action, a draft or blueprint which reflects the results of a planning process up to that moment in time. As new input and perspectives based on data, experience, further reflection on values and priorities, and unexpected obstacles or opportunities are encountered, the original plan is revised and updated as appropriate.

A program (P5) is a tangible means for carrying out policy: “an outline of work to be done; a prearranged plan of procedure.” Programming is a planning process to implement a policy. It develops clearly defined middle-range goals and the means to meet them. In administration, a program is an ongoing mechanism (“structure of delivery”) to carry out a set of specific activities that deliver the product/result called for by the policy, be it universal health care, clean water, retirement benefits, treatment of clinical depression, or adoption of handicapped children.

A project (P6) is “a unique piece of work having a finite life and producing an identifiable product or achieving a specific aim on time and within specified resource limits” (Canadian Government, 1982, p. 82). Project planning is the nitty-gritty of achieving a limited concrete objective derived from a policy. Demonstration projects are often a stepping stone within a policy action plan. These projects test new approaches or methods on a small scale, in only one or a few specific settings.

THREE POLICY SECTORS

The Public Sector

Public social policies exist at the federal, state, and local levels. They are not difficult to identify. You can find them in the Bill of Rights and in statutes that regulate the safety of workers, set up Social Security pensions, allow tax credits for day care expenses, etc.

These policies are elaborated upon and applied by administrative regulations and guidelines. The public welfare agency I worked for had a foot-thick manual of directives and guidelines on exactly how the poor were to be aided.

When we disagree on what a public policy means or whether it is being properly carried out, our courts clarify the policy. Sometimes this can have a major social policy impact. Thousands of allegedly “separate but equal” schools had to integrate in 1954, when the Supreme Court ruled that segregation by race was inherently uneq...

Table of contents

• Cover
• Half Title
• Full Title
• Copyright
• Contents
• About The Author
• Preface
• PART I: POLICY CHOICE AND INTERVENTION
• PART II: FOUNDATIONS FOR CHOICE: BELIEFS, VALUES, AND INTERESTS
• PART III: FUNDAMENTAL VALUE CHOICES
• PART IV: ECONOMIC AND SOCIAL MARKET CHOICES
• PART V: HUMAN SERVICE DELIVERY CHOICES
• Bibliography
• Index