Welfare State ...No Thank You

A welfare state is an ideal state model where the welfare of citizens, economic and social, is provided for by a state that not only assumes this responsibility but defends its exclusive right in doing so (although it may share it with other independent institutions). The objective is social protection…a guarantee of conservation of human dignity, fair treatment of citizens and the effort to solve their ordeals in an efficient and effective manner. The developed world has achieved perfection in its design and implementation of such a state, whilst the developing world (or part of it) is improving its systems and institutions for that end. A state where people’s needs are met, where health, education and decent living are responsibilities that the state assumes in full accord with its citizens is the objective. A culture of well-being is the supreme goal.  

However, the utopian scenario is, well, utopian. Perfection in a public administration is an unrealistic (and quite arrogant) concept. Each system has its flaws and defauxs; even those designed with the best intention and good will have their share of cons. For instance, a country as developed and the USA where the defence of human dignity and protection of citizens’ well-being are founding pillars has its share of mistakes in its understanding and implementation of its welfare state model. Let us take healthcare as an example, which failed miserably and had to be rescued by the Patient Protection and Affordable Care Act (AKA Obamacare) with the ambitious goal of enrolling 6 million people into private health care plans via the Affordable Care Act. The goal was ambitious but was met as 7 million people enrolled for private coverage. The new law, notedthe Los Angeles Times, "has spurred the largest expansion in health coverage in America in half a century." So this affordable health insurance should solve an important problem in the US society, even if it means that citizens have to pay from their own pockets to ensure receiving tis vital service. A country that spends trillions on weapons is asking its citizens to enrol in private health schemes.  Where welfare in that is, I am not quite sure.

    This Act would have appalled and caused mass demonstrations in European countries which frowned upon such a solution. Let’s take Spain for example, an excellent model of supreme health services, where citizens, foreigners, tourists and illegal immigrants all have access to free, immediate and excellent health services. Retired European senior citizens flee to sunny Spain feeling confident that they would be in safe hands. They know that they will be taken care of without any discrimination or additional payments. The health system is very well designed and transparent, where citizens are assigned to a health centre and a set of doctors to consult when in need with zero charge. That is indeed a state that cares about the wellbeing of its citizens, as no one would worry about being unattended in times of need. Or is that so? The problem with a highly organized and regulated system is that it tends to kill the human and social aspect. As a patient you become a number…that number gets you to that only hospital, to that only doctor and to that only appointment. You can’t choose your healthcare practitioner, nor can you tailor your appointments to your needs, nor can you establish a personal relation with any of the staff. You are identified by an ID that dictates your future when it comes to health issues and how they are addressed. You don’t exist outside that number. That sense of security suddenly fades in a moment of emergency or illogical and inexplicable worry. The system does not identify worry as a reason to access such services. Surprisingly, a non-welfare state offers –sometimes- a relief dose much needed in these advanced systems. Let us take Jordan as an example, a country that does not enjoy an efficient healthcare service, but is one where one can feel secure nonetheless. You do exist outside your ID number. A telephone call can solve a problem or push a date back. Logic, compassion and common sense are not limited by bureaucracy and systems. Your confidence stems not from the quality of the system but the quality of the staffs’ character and morals. The social ties and cultural background in this county, as may be in other countries I assume, are a solid rock to many…a safe place to fall back on. Welfare, in my opinion, is a sense of security, confidence that when in need someone will help in a personalized manner. It is not paying little money in a private health scheme with a fancy name, neither is it a blind treatment of ailments in a manner void of any compassion or interest. It is indeed a prompt response, a flexible attitude and a personalized treatment. To conclude, welfare means different things to different people and different nations. My personal understanding of it has been strengthened and rooted thanks to my experience with Jordanian healthcare. Not a welfare state perhaps, but one of welfare health providers.