The unbearable loneliness of the welfare states

Yesterday I wrote about the political divisiveness and the need to find a middle ground where the different camps could meet, and how both the excess and the defect of anything are typically bad outcomes, whereas the sweet spot lies somewhere in the middle. Reflecting on the post I started to think about the the difficult balance in the amount of services provided by the government, and immediately came back to the 2015 documentary "The Swedish Theory of Love", which analysis the social impact of the widespread offer of services by the Swedish government.

Government-provided safety nets are not new, but they show different degrees of adoption and different interpretations in each country. On one end of the spectrum are the so-called "failed states", where the state is little more than a bunch of money-sucking bureaucrats which only collect taxes and provide no services: if you want police, health or education services, you better be ready to choke up the money to pay for it or, in the best cases, rely on (foreign) charity institutions to provide them for you. In this situation every citizen is left to fend for themselves and it is not infrequent the arise of parallel entities that provide government-like services. This is the sad case of Hezbollah in modern-day Lebanon or the Mafia structures of Cosa Nostra in Sicily and Camorra in Naples since the 18th century: when the state is unable to provide policing, justice or assistance to the widows, these institutions fill the gap and claim the respect of their member and a non-negligible leverage on them. To a lesser extent, almost all Mediterranean cultures rely heavily on the networks of families and acquaintances, a custom that dates back to Ancient Rome, where patronage relationships where commonplace.

Photo: Josema Alonso

This reliance on the community has typically been bi-directional: you rely on the community to support you, but the community also relies on you supporting anyone else. It has also been based much more on good will than on pure accountancy. If someone happened to need the support of the community more often than others, they should get it anyway. As long as the repeated assistance did not bring the society to the end of its resources, those with no need for assistance could call themselves lucky and continue to contribute their effort as implicitly agree. As you can see, this is the basis for the way some health insurance systems (particularly in Western Europe) work today. Everyone pays on a regular basis (with the rich typically paying higher fees than the poor) and whoever is in need of medical attention shall receive it essentially for free. Healthy people might claim that they are paying for services that they are not using, but the fact that they could be served at the drop of a hat if ever they have an accident or are found to have a serious but dormant illness should cover this concern.

One point that often goes missing in the discussions about welfare services is that state provisions tend to lack on the emotional side. Back in the days were medical attention was mostly conducted at home, you would have the visit of a doctor to give you the professional advice, but then your family would typically lean in to provide their support, comfort you and assist you in any possible ways. In a hospital, on the other hand, business is typically conducted in a much more pointedly way, focusing on covering all the necessary aspects, but not more, and in particular avoiding a huge investment of time of the nursing personnel. As a result, it is not infrequent that hospital patients improve in their physical health but see their mental health deteriorate.

A similar thing happens with the assistance to minors in need. Back when this was left for families to deal with, an orphan could land in an uncle or aunt's house, people who might not be best suited to actually host them, but at least they were there most of the time. Social workers often have to deal with several cases in the same day, which leaves little room for an emotional connection in support of the child (which otherwise might also be counterproductive since the presence of the social worker in the child's life can be fleeting).

Extreme cases of government reliance, as depicted in the Swedish documentary, result in situations like grown-up daughters and sons feeling exempt from the duty to visit their elderly parents. Given that all the essential needs (housing, food, health) are covered by their retirement services, there is (in their view) no urgent need to pay them a visit other than for the company. Sadly, spending an afternoon having tea with an elderly person typically ranks low in the list of possible leisure activities, so it gets constantly relegated to the benefit of more enticing alternatives to the point that they never get to see their parents. In fact, it is not all that rare in Sweden that someone passes away of old age and it is only noticed by the neighbors or the cleaning crew only days or weeks later. Is this really what we want from life?

Circling back to the idea of the middle point, I have to admit that my point has migrated over the years. I was always very independent, relying as little as I could on the resource and the attention of my family and working my own way in life, but I have come to realize that this leads strongly in the direction of loneliness. The fact that you can pay for your rent does not mean that you will have a friend to talk to when you need one. Your health insurance will have you covered during your illness, but that does not mean that somebody will be holding your hand at your bedside. Relying on your family and friends can make you both dependent on them and a burden, but a getting all your needs cover by the government (or your employer, it does not make much difference) makes for a very lonely living. I having been trying to strengthen some of the ties that have been neglected for a long time, and the situation is improving. I will keep you posted with my progress. Have a nice evening.