Here in Australia, people getting unemployment benefits have to perform certain obligations in order to qualify. Centrelink describes it as having to “actively look for work, accept suitable work offers and undertake extra activities to improve your chances of finding work.” The extra activities are various training and volunteering programs, and Work for the Dole. The main utilitarian rationale for the latter is that work of any kind is beneficial for the unemployed. But more importantly, from a conservative political standpoint (remember it was the Coalition under Howard that introduced it), is that it cracks down on so-called ‘dole bludgers’. The media release announcing the policy in 1988 tries to disguise that sentiment behind formal language, but the meaning is clear: “reduce abuses in the payment of unemployed benefits and encourage the voluntarily unemployed to secure genuine employment.”
It harks back to the concept of ‘deserving’ and ‘undeserving’ poor first articulated in the 16th century. In modern terms we might talk more about ‘free-riders’ than ‘sturdy beggars’, but the idea’s essence is the same – those who can work, but choose not to, should not be supported in the same way as those who genuinely cannot be employed. The purpose of modern “mutual obligation” is twofold – to weed out the undeserving, and to move as many as possible into the deserving category.
Now it seems that the obligations imposed on welfare recipients in order to discover who is deserving and who is undeserving are being taken in an entirely new direction by politicians in the US. Eight states are preparing to start drug-testing people as a condition of getting welfare. One proposal is a 2-month grace period to “get clean” before having assistance cut off, and the others are similar, though some suggest random drug-testing a proportion of claimants instead of every single one.
The language being employed by supporters of these policies shows that they are unashamedly appealing to worries the taxpayers might have about the undeserving poor. These lines are typical: “the problem of illegal drug users abusing our public assistance system…Any good parent would clearly choose their children’s best interests over illegal drugs…Opponents of this bill are enablers of bad (illegal) behaviour”.
According to the polls published on that site, it’s a popular proposal. There are protests from civil libertarians and a host of NGOs, but the apparent general feeling among voters is that drug users belong squarely in the ‘undeserving’ category.
There are parallels between that kind of logic and the some ideas about the issues surrounding universal healthcare and lifestyle factors. The reasoning is that, because healthcare is largely provided by the state, and some people (whether by smoking, being fat, drinking, whatever) impose greater costs on the system, then the state should act to change their behaviour or curtail their benefits. It is perfectly logical in its way, but only because the presumption underlying it is that some people are less deserving of taxpayer funds. This is, in fact, one of the key problems with starting from the premise of government-provided goods and services – it implies that there must be some sort of mutual obligation performed by the recipient in order for them to ‘deserve’ access.
It’s an attempt to deal with systemic misaligned incentives. That is, if you’re going to get treated regardless of what you do to yourself, you have less incentive to take care of yourself. But that shows up the weakness of looking at the problem within a social-democratic framework – instead of correcting the incentives by making the patient pay for their own decisions (as would be the case in a liberalised healthcare system), the supporter of subsidised healthcare has to resort to heavy-handed, intrusive and expensive methods. Banning certain foods, the whole anti-smoking movement, limiting advertising, mandating maximum waistlines… these are all examples of where such a mindset can take you. It begs the question – where next? The answer could be quite scary.