This article responds to Tibor Machan's criticisms of government provision for needy citizens. It argues that although charity may be morally worthy, private charity is inadequate to the task of providing our fellow citizens with the security they deserve; the tremendous social good of secure access to a life of dignity can only be produced by a public social safety net. Moreover, individual rights to property do not stand in the way of providing a public social (...) safety net. Since there are social inputs in wealth creation, reasonable levels of taxation do not violate people's rights to their wealth. (shrink)

This article teases out the relationship between family form and the state's social safety nets around healthcare, showing the deep unfairness of measuring social safety nets by whether a couple marries. By continuing to tie healthcare benefits to specific family structures, we perpetuate the “galloping” inequality marking America today.This article concludes that, whatever happens with the thousands of benefits given to married couples in other domains, social policy should move beyond marriage with respect to healthcare. (...) Delinking support for healthcare coverage and services from family form is just, better assists struggling families, and is in our collective self-interest. (shrink)

Whereas using artificial intelligence (AI) to predict natural hazards is promising, applying a predictive policing algorithm (PPA) to predict human threats to others continues to be debated. Whereas PPAs were reported to be initially successful in Germany and Japan, the killing of Black Americans by police in the US has sparked a call to dismantle AI in law enforcement. However, although PPAs may statistically associate suspects with economically disadvantaged classes and ethnic minorities, the targeted groups they aim to protect are (...) often vulnerable populations as well (e.g., victims of human trafficking, kidnapping, domestic violence, or drug abuse). Thus, determining how to enhance the benefits of PPA while reducing bias through better management is important. In this paper, we propose a policy schema to address this issue. First, after clarifying relevant concepts, we examine major criticisms of PPAs and argue that some of them should be addressed. If banning AI or making it taboo is an unrealistic solution, we must learn from our errors to improve AI. We next identify additional challenges of PPAs and offer recommendations from a policy viewpoint. We conclude that the employment of PPAs should be merged into broader governance of the social safety net and audited publicly by parliament and civic society so that the unjust social structure that breeds bias can be revised. (shrink)

Millions of Americans are dependent on what is often called the “safety net.” These loosely-organized networks of health and social service providers serve the many Americans who are uninsured, dependent on public coverage, or for a variety of reasons unable to access other private systems of care. The Institute of Medicine report, America’s Health Care Safety Net: Intact but Endangered, called attention to both the fragility and the resilience of this health care safety net. The IOM (...) report underscored the critical importance of the safety net to the health and well-being of millions of individuals and called for efforts to strengthen it and improve the nation’s ability to monitor its viability. Given this central role, any health care reform efforts need to be fully informed by an understanding of what the safety net includes, how it is financed, and how it is responding to a series of challenges it now faces. (shrink)

Approximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute (...) therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment. (shrink)

Working in an urban safety net facility, my colleagues and I daily face any number of challenges. In some respects, an undocumented immigration status is just another one of those challenges. However, it is a particularly interesting one given the context created by political, social, and ethical debate about immigration.

Large-scale data systems are increasingly envisioned as tools for justice, with big data analytics offering a key opportunity to advance health equity. Health systems face growing public pressure to collect data on patient “social factors,” and advocates and public officials seek to leverage such data sources as a means of system transformation. Despite the promise of this “data-driven” strategy, there is little empirical work that examines big data in action directly within the sites of care expected to transform. In (...) this article, I present a case study on one such initiative, focusing on a large public safety-net health system’s initiation of sexual orientation and gender identity data collection within the clinical setting. Drawing from ethnographic fieldwork and in-depth interviews with providers, staff, and administrators, I highlight three main challenges that elude big data’s grasp on inequality: provider and staff’s limited understanding of the social significance of data collection; patient perception of the cultural insensitivity of data items; and clinic need to balance data requests with competing priorities within a constrained time window. These issues reflect structural challenges within safety-net care that big data alone are unable to address in advancing social justice. I discuss these findings by considering the present data-driven strategy alongside two complementary courses of action: diversifying the health professions workforce and clinical education reform. To truly advance justice, we need more than “just data”: we need to confront the fundamental conditions of social inequality. (shrink)

ABSTRACT:Officials must understand why and how the public lost confidence in the federal government’s ability to manage financial turmoil. Officials outsourced to private parties responsibility for monitoring and policing the safety-net exposures that were bound to be generated by weaknesses in the securitization process. When the adverse consequences of this imprudent arrangement first emerged, officials claimed for months that the difficulties that short-funded, highly leveraged firms were facing in rolling over debt reflected only a shortage of aggregate liquidity and (...) not individual-firm shortages of economic capital. Then, in September 2008, the president and other officials created an unwise sense of urgency that delays in implementation show to have been greatly exaggerated.That authorities and financiers violated common-law duties of loyalty, competence, and care they owe to taxpayers indicates a massive incentive breakdown in industry and government. Taxpayers deserve a thorough-going reorientation of: (1) how regulatory agencies report on their regulatory performance and back-room interactions with Congress and the Treasury, and (2) the contract structures and performance measures used by the financial industry and its government overseers. (shrink)

The United States, unlike all other industrialized nations, does not have a comprehensive public system for financing health care. Nevertheless, the magnitude of America's public health care financing effort is remarkable. Of the one trillion dollars the United States spent on health care in 1996, almost half, $483.1 billion, was spent by public programs. In 1995, Medicare—our social insurance program for persons over sixty-five and the long-term disabled—overed 37.5 million Americans; Medicaid—our program for indigent elderly and disabled persons and (...) indigent children and their families—covered 36.3 million. In 1996, Medicare and Medicaid spent $203.1 and $147.7 billion, respectively. The payment policies of these massive public health care programs have a profound effect on the provision of health care.Many of the recipients of Medicare and Medicaid suffer pain. In 1994, 376,200 Americans over age sixty-five died of cancer. Virtually all of these would have been Medicare recipients, and as many as 70 percent of them died in unrelieved pain. Nearly four million Americans over sixty-five endured the pain of inpatient surgery in 1995, again nearly all of whom were Medicare recipients. (shrink)

The overriding goal of health reform is to provide every American affordable access to adequate health care. Yet in every national effort to date, the focal means to this end has always been health insurance. Massachusetts is congratulated for having achieved nearly universal insurance coverage, and congressional Democrats are aiming for the same. But what if they don't succeed? Even in Massachusetts, 167,000 residents remain uninsured. Is it still possible to provide adequate access to medical care for those without insurance? (...) If so, shouldn't we reframe social goals to achieve universal access through any means possible, whether or not insurance is involved? (shrink)

Policy decisions during and after the New Deal tied the U.S. social contract to the employment contract, by conditioning eligibility and benefit levels for core welfare-state programs on work status and performance. The resulting system of social provision, however, embodied a set of assumptions about labor-market conditions that began to unravel with the structural economic shifts that began in the mid-1970s. Work was expected to provide open doors to employment, stable floors of security and stability over time, income (...) ladders promising adequate and rising earnings, and safety nets providing public and/or private protections against unforeseen or unavoidable hardships. Each of these assumptions was undermined by fundamental changes in the market, and this, in turn, has redefined patterns of social provision. As a result, core welfare-state programs have become less effective at meeting their own objectives of providing adequate social protections for rising numbers of working Americans. These trends preceded the recent recession and weak recovery, and cannot be reversed by the return of robust growth or pre-recession employment levels, in the absence of more fundamental change in the social contract. The roots of the current dilemma lie in the 1930s-40s, when politically mobilized employers fought alongside conservative policymakers to constrain the scope of the original system of social protections during and after the New Deal. In recent decades, they have battled to keep even this limited system from reaching those it was intended to assist, by blocking or limiting reform initiatives in areas such as employment policy, the minimum wage, health and pension insurance and modernization of the unemployment compensation system. (shrink)

In this brief paper, offered as a policy viewpoint, I introduce what I believe to be a novel concept for supporting individual citizen interaction with the U.S. Federal government, termed the individual social account. I explore whether and how the concept might be implemented so as to strengthen the U.S. social safety net and further citizen trust and responsibility in e-government interactions. I illustrate and develop the concept as a platform for reform and suggest and discuss design (...) criteria, surfacing various issues. I conclude with additional thoughts with which to stimulate further research and discussion of the concept and its practicalities. (shrink)

This paper examines racial discrimination and algorithmic bias in predictive policing algorithms (PPAs), an emerging technology designed to predict threats and suggest solutions in law enforcement. We first describe what discrimination is in a case study of Chicago’s PPA. We then explain their causes with Broadbent’s contrastive model of causation and causal diagrams. Based on the cognitive science literature, we also explain why fairness is not an objective truth discoverable in laboratories but has context-sensitive social meanings that need to (...) be negotiated through democratic processes. With the above analysis, we next predict why some recommendations given in the bias reduction literature are not as effective as expected. Unlike the cliché highlighting equal participation for all stakeholders in predictive policing, we emphasize power structures to avoid hermeneutical lacunae. Finally, we aim to control PPA discrimination by proposing a governance solution—a framework of a social safety net. (shrink)

This paper examines the conservative point of view about distributive justice. The first section explains the methodology used to develop this point of view. The second section describes one conservative point of view and briefly provides empirical evidence that it reflects the viewpoint of many ordinary conservatives. The third section explains how this conservative view can ground objections to social safety net programs, using as examples the recent health reform legislation and more extensive proposals for a true national (...) health system. The fourth section sketches ways that non-conservative philosophers might try to refute those objections. Examining a conservative point of view leads to several important conclusions. One is that the conservative point of view is not properly represented in contemporary philosophical discussions. Another is that the conservative point of view cannot be refuted by appealing to existing egalitarian writings. A third is that if progressive philosophers such as myself want to address the conservative point of view, we must expand the range of issues that we discuss in contemporary political philosophy. Doing so is a vital task, because otherwise we ignore the political views held by as much as half the American population. (shrink)

Chronic deficiencies of the Greek welfare state and the introduction of austerity measures as part of the international financial bailout agreements have created an explosive cocktail of poverty and social exclusion that severely tested the resilience of the frail social safety net and the demands of equity. The score on the indicators of social quality has worsened considerably as the Greek welfare system was overhauled. This article examines the four conditional factors of social quality from (...) the viewpoint of socio-economic policies and everyday experiences in Greece during the crisis. (shrink)

The election of Donald Trump has exposed American society’s profound crisis of hope. By 2016 a generation of shrinking employment, rising inequality, the attack on public education, and the shredding of the social safety net, had set the stage for stunning insurgencies at opposite ends of the political spectrum. Against this dire background, Ronald Aronson offers an answer. He argues for a unique conception of social hope, one with the power for understanding and acting upon the present (...) situation. Hope, he argues, is far more than a mood or feeling—it is the very basis of social will and political action. It is this kind of hope that Aronson sees brewing in the supporters of Bernie Sanders, who advocated the tough-minded and inspired disposition to act collectively to make the world more equal, more democratic, more peaceful, and more just. And it was directly contrasted by Trump’s supporters who showed a cynical and nostalgic faith in an authoritarian strongman replete with bigotry and misogyny. Beneath today’s crisis Aronson examines our heartbreaking story: a century of catastrophic violence and the bewildering ambiguity of progress—all of which have contributed to the evaporation of social hope. As he shows, we are now in a time when hope is increasingly privatized, when—despite all the ways we are connected to each other—we are desperately alone, struggling to weather the maelstrom around us, demoralized by the cynicism that permeates our culture and politics, and burdened with finding personal solutions to social problems. Yet, Aronson argues, even at a time when false hopes are rife, social hope still persists. Carefully exploring what we mean when we say we “hope” and teasing hope apart from its dangerously misconstrued sibling, “progress,” he locates seeds of real change. He argues that always underlying our experience—even if we completely ignore it—is the fact of our social belonging, and that this can be reactivated into a powerful collective force, an active we. He looks to various political movements, from the massive collective force of environmentalists to the movements around Sanders and Jeremy Corbyn, as powerful examples of socially energized, politically determined, and actionably engaged forms of hope. Even in this age of Donald Trump, the result is an illuminating and inspiring call that anyone can clearly hear: we can still create a better future for everyone, but only if we resist false hopes and act together. (shrink)

Despite 40-year-old evidence of childcare challenges limiting women’s participation in agriculture in the United States, it was not until a major societal crisis, COVID-19, that farm organizations and policy makers began to recognize that these challenges negatively impact the farm enterprise. Among farm persistence and farm transition scholars, farm households’ social and economic needs, including childcare, have also been underappreciated despite the constant exchange of time, money, and energy between the farm household and the enterprise. We use survey responses (...) from 729 U.S. farm families to understand how children and their childcare needs shape the farm enterprise and the extent to which childcare arrangements, farm individuals and households, and farm enterprise characteristics interact with these decisions. A high proportion of respondents made changes to adapt to the needs of children with the greatest impact on farm productivity, followed by impact on the structure of labor on- and off- the farm, and impact on the farm enterprise structure. These impacts likely have short- and long-term consequences on the trajectory of the farm enterprise and well-being of the household. Different decisions required a different calculus and the trade-offs that respondents considered were shaped by access to a support system, access to financial resources, and specific needs of the children. Last, the limited variations across the four decisions for a number of farm individual and household characteristics hint both at the universality of being a farm parent needing to constantly adapt amid high rates of childcare challenges and inadequate social safety nets. We conclude our article by discussing the implications of our findings along with future research avenues. (shrink)

This article develops contractarian business ethics by applying social contract arguments to a specific question: What are the pre-legal (or moral) rights and responsibilities of corporations? The argument uses a hypothetical social contract to show the existence of for-profit corporations in democratic capitalist societies is consistent with Rawls’s fundamental principles of justice. Corporations ought to have recognised their rights to be autonomous, to pursue private purposes, and to engage in economic activities. Corporations have a responsibility to respect the (...) freedom and human rights of all people, and not to interfere with government programs that ensure people have the education and training they need to find and keep corporate employment and that provide a safety-net that prevents destitution. If corporations have any other rights and responsibilities, those rights and responsibilities need to be established by actual social contracts, probably in the form of legitimate democratic processes. (shrink)

According to John Tomasi's Free Market Fairness, there are serious constraints on what a liberal state may do to promote economic justice. Tomasi defends this claim by arguing that important economic liberties ought to be regarded as “basic” and given special priority over other liberal concerns, including those of economic justice. I argue that Tomasi's defense of this claim is unsuccessful. One problem takes the form of a dilemma: depending on how the claim is formulated more precisely, Tomasi's argument seems (...) either to be compatible with standard (e.g., Rawlsian) liberalism or to tell against even the minimal taxation that would be necessary to support the social safety net he supports. Second, granting “basic” status to economic liberties would in many cases defeat the goal, self-authorship, that Tomasi sees himself as sharing with other liberals. Third, contrary to Tomasi's suggestions, no inconsistency arises when liberals (such as Rawls) refuse to recognize the economic liberties as basic. Fourth and finally, the special significance that Tomasi attaches to agency does not provide any additional reason for accepting Tomasi's conclusions. (shrink)

Contemporary Chinese society has witnessed ongoing complex institutional and cultural reconfiguration, driven by the transition from the socialist planned economy to marketization and later its deep engagement in globalization and neoliberalism. In this reshaping of Chinese society, tradition and modernity, the resurgence of patriarchal Confucian tradition, the socialist version of modernity, the capitalist version of modernity, and the socialist heritage intermingle, and all seem to define a mosaic temporality.Facing the increasing uncertainties of the market, family members in post-reform China have (...) to stick together as an economic safety net, emotional harbor and spiritual fortress. Chinese parents heavily invest in their children and continue to support them in their adulthood; whereas, the youth is under great obligation to providing old age care for their parents; and parents may regard this heavily-invested offspring as their private product. This resurgent but modified familialism, is not an exact replication of traditional familialism, but is definitely different from the family modes featured by individualism in Western contexts. Mosaic familialism is characterized by a sequential symbiosis between parents and children facing financial constraints and unforeseeable uncertainties with a lack of a social safety net. At the same time, patriarchal Confucianism is rejuvenated to a certain degree, women’s traditional wife and mother role is once again stressed, if not glorified; and the neoliberal discourse articulating personal choice and responsibility, but not individual right, stands by seamlessly. Parents and children, husband and wife are dependent on each other in the intimate family, following a clearly gendered pattern. (shrink)

The Welfare State is a key policy issue of the 1990s. The essays in this book depart from much of the recent economic debate in emphasising the positive contributions of the Welfare State, and in assessing its efficiency in relation to the objectives which it is intended to achieve. These objectives are not just the alleviation of poverty but more broadly the provision of security and the redistribution of income. Part A of the book sets the current debate in the (...) context of the current evidence about income inequality and poverty in Europe. Part B analyses the existing role of the Welfare State, with particular reference to retirement pensions and unemployment benefit. Part C investigates proposals for reform and security. What is the case for greater targeting? How can we design a social safety net? What is the future of European social protection policy? (shrink)

Should you be targeted by police for a crime that AI predicts you will commit? In this paper, we analyse when, and to what extent, the person-based predictive policing (PP) — using AI technology to identify and handle individuals who are likely to breach the law — could be justifiably employed. We first examine PP’s epistemological limits, and then argue that these defects by no means refrain from its usage; they are worse in humans. Next, based on major AI ethics (...) guidelines (IEEE, EU, and RIKEN, etc.), we refine three basic moral principles specific to person-based PP. We also derive further requirements from case studies, including debates in Chicago, New Orleans, San Francisco, Tokyo, and cities in China. Instead of rejecting PP programs, we analyse what necessary conditions should be met for using the tool to achieve social good. While acknowledging its risks, we conclude that the person-based PP could be beneficial in community policing, especially when merging into a larger governance framework of the social safety net. (shrink)

Alfred Müller-Armack was one of the very important policy-makers who initiated the West-German economic recovery after WWII. He devised the underlying economic program of the so-called “German Miracle”, which was not a miracle at all. It was the outcome of a rigorous rule transformation from the bankrupt central planning of the Nazi- regime to a market economic order based on the principles of classical liberalism combined with a social safety net for all who suffered from the terrible consequences (...) of war destruction. He called his program “Social Market Economy”, thereby expressing that the risky game of the market needs a social safety net to make his program acceptable for the majority of the German citizens.Müller-Armack was not only the Head of the Central Policy Unit at the Federal Economic Ministry under Ludwig Erhard for twelve years but also a well-known university teacher of economics. In the tradition of Max Weber he combined this subject with the theory of economic sociology, and especially, the sociology of religion. In this respect he was an early author in the field which nowadays is named “cultural economics”. His publications on the impact of religious beliefs of greek-orthodox societies on the economic performance of South-East European countries are still of great interest for the present debates about the economic consequences of Islam.Alfred Müller-Armack fut l’un des très importants politiciens qui initièrent l’économie de l’ Allemagne de l’Ouest après la 2ème Guerre Mondiale. Il conçut dans ses grandes lignes le programme économique du soi disant « Miracle Allemand ». Ce fut le résultat d’une règle rigoureuse de transformation à partir de la faillite de la planification centrale du régime Nazi vers un ordre marchand fondé sur les principes du libéralisme classique combiné à un filet de sécurité sociale pour tous ceux qui avaient souffert des conséquences terribles des destructions de la guerre. Il appela son programme « Economie sociale de marché », exprimant ainsi que le jeu risqué du marché nécessite un filet de sécurité sociale pour rendre son programme acceptable par la majorité des citoyens allemands. Müller-Armack n’était pas seulement le chef de l’unité politique centrale au ministère fédéral de l’économie sous la direction de Ludwig Erhard pendant 12 ans, mais également un professeur très réputé d’économie à l’université. Dans la tradition de Max Weber, il associe ses sujets avec la théorie économique de la sociologie et plus particulièrement, la sociologie de la religion. Dans cette mesure, il fut un pionnier dans le champ de ce que l’on appelle aujourd’hui « l’économie de la culture ». Ses publications sur l’impact des croyances religieuses des sociétés grecques orthodoxes sur la performance économique des pays du Sud-Est Européen restent d’un grand intérêt pour les débats actuels au sujet des conséquences économiques de l’Islam. (shrink)

Ronald Dworkin's theory of equality of resources makes extensive use of markets. I show that all these markets rely on one specific neoclassical conception of the ideal market in full equilibrium, as analyzed by Debreu. This market must be understood as operating under circumstances of certainty, and this is incompatible with several components of Dworkin's account. In particular, it does not allow one to hold people responsible for their option luck, and it implies a high social safety net (...) rather than insurance schemes for addressing brute luck. I conclude by outlining an interpretation of equality of resources that takes the ideal market seriously. (shrink)

This article aims to examine the Lithuanian housing policy system, with a special emphasis on social housing issues. This study is based on 20 semi-structured interviews with the decision makers and recipients of social housing. The analysis reveals the issues related to access to social housing, management and administration issues, problems related to stigmatisation of social housing recipients, and their overall satisfaction with the provided support.The study shows that accessing social housing and living in (...) class='Hi'>social housing is not an easy task. Social housing recipients have to wait in queues for a long time, experience stigmatisation and constant fear that they may lose their social housing due to a strict income monitoring. On the other hand, the municipality tries to provide friendly strategies to solve individual cases and looks for the best solutions possible to meet the needs of social housing recipients. The findings show that massive privatisation in Lithuania created a dualistic housing market favouring home ownership and marginalising social housing as a safety net for the most vulnerable people. At the same time, a massive home ownership society formed a safety net for many, with family ties playing a crucial role. Housing safety is offered as a part of social assistance programs for the most vulnerable parts of the population. (shrink)

Loren Lomasky is a leading advocate of a rights-based libertarian approach to political and social issues. This volume collects fifteen of his articles that have appeared since his influential volume Persons, Rights, and the Moral Community alongside one new essay. The volume represents Lomasky's more recent efforts at constructing the underpinnings of liberal rights theory, in which he formulates a series of questions about the nature and scope of rights and rights holders.Among the questions Lomasky addresses: In what way (...) is classical utilitarianism fundamentally illiberal? To what extent might utilitarian cost-benefit analyses be admissible within rights-upholding political theory? Does it even make sense to speak of maximizing liberty? How can this be understood in Hobbesian, Kantian, and Rawlsian theoretical settings? In a world in which rights-talk is ubiquitous, what is the role of traditional virtues such as loyalty and charity? Is it inconsistent to espouse both an austere classical liberalism and a social safety net? Liberalism is most often presented as a theory about the internal contours of the state, but how does it speak to the relationships between one state and another? Between the state and would-be immigrants? In a world displaying massive cross-border inequalities, does justice require the extension of aid from the rich to the poor? The book opens with an unpublished essay, "Everything Old is New Again: The Death and Rebirth of Classical Liberalism," which features a history of the century-long decline of traditional liberalism and its remarkable, unanticipated return to vitality in the second half of the 20th century. It then offers the prospectus for a libertarian research program for the next half century. (shrink)

Comprising almost a third of greenhouse gas emissions and having an equally prominent role in pollution of soils, fresh water, coastal ecosystems, and food chains in general, agriculture is, alongside industry and electricity/heat production, one of the three biggest anthropogenic causes of breaching the planetary boundaries. Most of the problems in agriculture, like soil degradation and diminishing biodiversity, are caused by unfit uses of existing technologies and approaches mimicking the agriculturally-relevant functioning natural ecosystems seem necessary for appropriate organization of our (...) toxic and entropic agro-technologies. Our thesis is that eco-curative and sustainable uses of agro-technology require a paradigm shift from the chemical model of agro-systems to the ecological system-design model of agriculture. Particularly, following the new biomimetic paradigm of ecological innovation, we question in what sense can we mimic natural solutions in agriculture. We discern among Integrated agriculture and Permaculture, analyze their biomimetic status from the perspective of the philosophy of biomimicry, and argue that the former nature-mentored approach is a more appropriate solution for sustainable broadscale agriculture necessary for the growing world. However, it is not clear how this agricultural bio-integration will interact with the predicted automatization of work, urban demographic momentum, and the Earth system instability, and can the Permaculture alternative emerge as a social safety-net for the anticipated technologically-redundant or economically or environmentally endangered workers. We argue both for the importance to understand Permaculture as a social safety-net and as experimental testing ground for cutting edge biomimetic technologies. (shrink)

Many critics of the legalization of physician‐assisted death oppose it in part because they fear it will further disadvantage those who are already economically disadvantaged. This argument points to a serious problem of how economic considerations can influence medical decisions, but in the context of PAD, the concern is not borne out. We will provide empirical evidence suggesting that concerns about money influence medical decisions throughout the full course of illness, but at the end of life, financial pressure is much (...) more likely to influence a decision to pursue or reject aggressive life‐extending care than it is to influence a request for PAD. We will also address the question of whether financial pressure as a result of being poor—particularly in the context of an inadequate social safety net—robs people of their autonomy, rendering their informed request and consent invalid. We argue that it does not. We will emphasize the impracticality and injustice of rejecting the role of poverty as a legitimate factor in decision‐making, the irrational distinction between PAD and withdrawal of life‐sustaining care, and the more appropriate focus on the great flaws in the American health care system. (shrink)

Giubilini and Minerva ask why birth should be a critical dividing line between acceptable and unacceptable reasons for terminating existence. Their argument is that birth does not change moral status in the sense that is relevant: the ability to be harmed by interruption of one's aims. Rather than question the plausibility of their position or the argument they give, we ask instead about the importance to scholarship or policy of publishing the article: does it to any extent make a novel (...) or needed addition to the literature? Giubilini and Minerva's argument is remarkably similar to one advanced by Michael Tooley in ‘Abortion and Infanticide,’ almost 40 years ago. There have been immense changes in the intervening 40 years: in the ability to diagnose conditions early in pregnancy, in genetics and in the availability of in vitro fertilization; in understanding of the capabilities of persons with disabilities; in law; in economic support and access to healthcare for pregnant women and their children; in social customs and arrangements; and even in philosophy, with developments in feminist thought, bioethics and cognitive science. Some of these changes have been for the better, but others, such as the unravelling of social safety nets, have arguably been for the worse. Any or all of these changes might give rise to moral reasons for the relevance of birth that were not available 40 years ago. These changes might also be relevant to the identification of cases, if any, in which ‘after-birth abortion’ might be considered. If context is relevant to the applicability of moral reasons—as for theorists of justice in the non-idealised world it surely should be—it is questionable whether a view of the birth-line that ignores contextualising change can be adequate. (shrink)

To effectively teach the United Nations Sustainable Development Goals to enhance corporate social responsibility, we need to understand the predictors of business student predispositions towards the SDGs. We examine whether location, authoritarianism, religiosity, and individualism influence university business student SDG preferences. Results indicate authoritarian and religious business students emphasize SDGs with an orientation towards the health and economic well-being of their local communities. The results also indicate the most significant factor in predicting SDG preference was university location. Southeastern U.S. (...) students were more supportive of people/prosperity-oriented SDGs, indicating greater concern with the social safety net and basic human needs, whereas Hawaiian students were more supportive of planet-oriented SDGs indicating greater concern for environmental issues. Implications for teaching SDGs to university business students are discussed. (shrink)

More and more development projects are using group or community approaches to disseminate technology and resources. It is believed that using such an approach will provide a safety net as well as social control to ensure the sustainability of the technology and resource. However, little is known of the exact process and social networks that are mobilized and used in using such an approach. Particular attention is devoted in the paper to gender differences and the concept of (...) social capital for analyzing social networks. Cases and the analysis were drawn from Heifer Project International's efforts to disseminate improved goat breeds through a village group process in Tanzania. An examination of these case studies shows that internal processes are crucial in understanding technology transfer. In all groups, a person's social capital did determine whether a member got a goat, and a person's ability to access and manage information also played an important role. Of all the groups, the most successful and sustainable had a history of interaction and were involved within several projects in which the members met each other in different arenas. (shrink)

For transition economies, income inequality is positively correlated with the share of output produced in the informal economy. Increases in income inequality also tend to be correlated with increases in the share of output produced in the unofficial economy. These hypotheses are supported significantly by empirical data for sixteen transition economies between 1987 to 1989 and 1993 to 1994. Various causal mechanisms may operate in both directions, an increasingly large informal economy causing more inequality due to falling tax revenues and (...) weakened social safety nets, and increasing inequality causing more informal activity as social solidarity and trust decline. (shrink)

This article examines the affordable housing market to develop a new way to understand the problem of co-optation in participatory urban governance. Through a case study of the Chicago metropolitan area, it uses data from 105 in-depth interviews—supplemented with ethnographic, archival, and secondary data—to shed light on the circumstances in which poverty-managing organizations compete for the resources necessary to house marginalized populations. Findings show how community-based groups, which have long housed the poorest neighborhoods and residents, are systematically excluded from access (...) to development capital in favor of other “grassroots for hire” organizations more amenable to the elite co-optation of grassroots empowerment—a process referred to as co-optation by cohort replacement. The article discusses implications of these findings for the study of urban development, participatory governance, and the changing social safety net. (shrink)

Among the most striking developments in the process of economic transition has been the very diverse paths these economies have taken with respect to income distribution, with some maintaining degrees of equality similar to the socialist era while others now exhibit degrees of inequality noticeably greater than any advanced market capitalist economies. We argue that these outcomes reflect divergent dynamics with multiple equilibria wherein the pattern of income distribution interacts with the level of corruption and the breakdown of the public (...) sector and social safety nets, with the possibility of societies going sharply in one direction or another. This argument is supported by empirical data linking income inequality and measures of the size of the unofficial economy in a set of fifteen transitional economies. (shrink)

Since the collapse of the Soviet regime, post-communist states have rapidly learned the modern face of slavery. Slavic women have been trafficked to the sex markets of Western Europe, Asia, and North America. The surge in human trafficking is the result of numerous factors, including the dramatic fall of the economic system and complete deterioration of the social safety net. This paper explores the causes and conditions of the growth of the trade in persons in the region, the (...) profile and typical behavior of the victims, and the public perception of the trafficking problem. It identifies the inefficiencies behind the national and international responses to trafficking and the complications for policymaking associated with the stigma attached to sex workers. (shrink)

Ideologues of the American Dream doctrine assume that state intervention aimed at providing social safety nets for citizens and reducing economic inequality, restricts freedom and undermines individual opportunity. This assumption is the result of empirical misinformation and, more fundamentally, a conceptual mistake. Robust empirical data indicate that economic equality, far from stifling initiative or undermining opportunity, is conducive to social mobility.

Jane Addams, Florence Kelley, and second-generation Hull House activist Grace Abbott were at the forefront of a reconstruction of early twentieth-century American democracy. They worked to reframe U.S. political democracy, expanding its focus beyond individual rights to caring for the social community. The movement away from laissez-faire government toward state and federal legislation protecting children, women, and workers was often halting, sometimes stymied by public opposition, and other times blocked by Supreme Court decisions. Grace Abbott’s social and political (...) philosophy demonstrated her training in law and political science and was influenced by her direct engagement with her Hull House neighbors. Abbott was a skilled social science researcher who saw public research as a way of crossing and blurring epistemological class boundaries, creating pathways for the general population to understand the burdens others faced. Through her leadership of the Immigrants’ Protective League and the Children’s Bureau, Abbott argued that the democratic state should be responsible for extending legislative protections into the social and industrial realms to protect vulnerable and dependent populations. Her work was essential to the continuing evolving supportive structures of governmental programs and social safety nets that are taken for granted by many Americans today. (shrink)

A question arising from the COVID-19 crisis is whether the merits of cases for climate policies have been affected. This article focuses on carbon pricing, in the form of either carbon taxes or emissions trading. It discusses the extent to which relative costs and benefits of introducing carbon pricing may have changed in the context of COVID-19, during both the crisis and the recovery period to follow. In several ways, the case for introducing a carbon price is stronger during the (...) COVID-19 crisis than under normal conditions. Oil costs are lower than normal, so we would expect less harm to consumers compared to normal conditions. Governments have immediate need for diversified new revenue streams in light of both decreased tax receipts and greater use of social safety nets. Finally, supply and demand shocks have led to already destabilized supply-side activities, and carbon pricing would allow this destabilization to equilibrate around greener production for the long-term. The strengthening of the case for introducing carbon pricing now is highly relevant to discussions about recovery measures, especially in the context of policy announcements from the European Union and United States House of Representatives. Key Policy Insights: • Persistently low oil prices mean that consumers will face lower pain from carbon pricing than under normal conditions. • Many consumers are more price-sensitive during the COVID-19 context, which suggests that a greater relative burden from carbon prices would fall upon producers as opposed to consumers than under normal conditions. • Carbon prices in the COVID-19 context can introduce new revenue streams, assisting with fiscal holes or with other green priorities. • Carbon pricing would contribute to a more sustainable COVID-19 recovery period, since many of the costs of revamping supply chains are already being felt while idled labor capacity can be incorporated into firms with lower carbon-intensity. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS l. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[1] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[2] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. ll. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[3] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[4] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[5] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[6] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[7] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[8] In democratic societies, one must take into consideration community morals and values.[9] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[10] lll. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[11] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[12] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[13] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[14] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. lV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[15] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[16] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[17] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[18] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[19] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[20] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[21] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. Vl. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[22] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[23] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[24] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. Vll. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [1] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [2] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [3] Moss, p. 1295-1298. [4] Moss, p. 1296. [5] Moss, p. 1295-1298. [6] Moss, p. 1295-1298. [7] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [8] Cohen, p. 1299-1301. [9] Moss, p. 1297. [10] Cohen, p. 1300. [11] Cappelen, p. 478-480. [12] Cappalen, p. 478-480. [13] Cappelen, p.479. [14] Cappelen, p. 479. [15] Cappelen, p. 479 [16] Cohen, p. 1301. [17] Cappelen, p. 478. [18] Cohen, p. 1299-1301. [19] Cohen, p. 1301. [20] Cappelen, p. 476-480. [21] Cappelen, p. 476-480. [22] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [23] Kawachi, p. 18-33. [24] Kawachi, p. 18-33. (shrink)

Payers have shaped the healthcare system in the United States as fee-for-service has facilitated a care model that prioritizes volume over the sake of patient care. This worsens health disparities, especially in safety net facilities where ancillary social work is both necessary clinically and completely uncompensated. Using concepts from Iris Marion Young’s Responsibility for Justice, it can be concluded that payers have a moral responsibility for reimbursing social care to address historical injustices. In this article, I describe (...) the ethical hazards in paying for social care and propose a way to finance this through value-based payments. (shrink)

I provide a defence of the classical liberal tradition (from Locke and Smith to Hayek and Tomasi) as a blueprint for a 'bleeding-heart libertarian' framework of society. Such a society defends three principles: 1) Freedom from private coercion (Private Property), 2) Freedom from public coercion (Limited Government); and 3) Within these limits, the provision of a limited range of public goods and public welfare (Limited Welfare State). I show that principles can be abstracted from a reading of the classical liberal (...) tradition. Then, through an extensive analysis of Locke, I show the importance, and consequentialist justifications, of the Three Principles for any liberal welfare state. Through a critique of Nozick, I show the inadequacy of the hardcore libertarian interpretation. Then, I show that John Tomasi, Adam Smith and Friedrich Hayek have all defended versions of limited welfare states. On this basis, I propose that the Basic Income Guarantee (BIG) is a good example, supported by Hayek, Buchanan and Friedman, of a welfare principle that is compatible with bleeding-heart libertarianism. I believe we can justify, on the basis of a consequentialist theory, that the limited welfare state, which combines welfare with liberty, and the free market with a social safety net, has highly beneficial effects on the society. It thus suggests itself as a viable competitor to rights-based libertarianism and more expansive social liberalism. (shrink)

Healthcare systems in Singapore, Hong Kong, and mainland China are strikingly distinct from those in the West. Economically speaking, each of the aforementioned Eastern systems relies in great measure on private expenditures supplemented by savings accounts. Western nations, on the other hand, typically exhibit government funding and wariness about healthcare savings accounts. This essay argues that these and other differences between Pacific Rim healthcare systems and Western systems should be assessed in light of background Confucian commitments operating in the former. (...) In the Confucian context, bioethics and healthcare policy have a unique content, texture, and set of implications that often affront Western assumptions about the appropriate individual autonomy of patients and the appropriate character of social safety nets for healthcare. (shrink)

In 1997 the women-run nonprofit organization Dress for Success opened its first location with the aim of empowering low-income women by providing gently used suits for job interviews. Drawing on eight months of fieldwork in an affiliate office, we analyze cross-race and cross-class interactions between privileged volunteers and low-income clients to demonstrate the emergence of what we term “neoliberal maternalism.” Historical forms of maternalism—the mother-centric voluntarism aimed at assisting indigent families a century ago—emphasized women’s domesticity and promoted the earliest welfare (...) provisions. We suggest that neoliberal maternalism, instead, works alongside welfare retrenchment by insisting that single mothers become self-sufficient workers. Similar to earlier maternalisms, the benevolence of affluent volunteers serves to reinforce class and race superiority while producing moments of genuine care and connection. We argue that while all forms of maternalism come with a related body politics aimed at disciplining the bodies of othered women, neoliberal maternalism carries a distinct body politics that, rather than regulating the home and reproduction, intrusively enforces ideals of aesthetic labor required for the postindustrial service economy. Finally, we suggest that retaining maternalism as an analytic framework is particularly important for investigating the influence of neoliberalism and the eroding social safety net on interactions between women. (shrink)

There is evidence of continued food insecurity and malnutrition in Pakistan despite significant progress made in terms of food production in recent years. According to “Vision 2030” of the Planning Commission of Pakistan, about half of the population in the country suffers from absolute to moderate malnutrition, with the most vulnerable being children, women, and elderly among the lowest income group. The Government of Pakistan has been taking a series of policy initiatives and strategic measures to combat food insecurity issues. (...) These range from increasing production to food imports, implementation of poverty reduction strategies, nutritional improvement programs, as well as provision of social safety nets. The article aims to instill some fresh thinking into the debate regarding the challenges of food security. It underscores the limitations of hitherto policy response, and suggests crucial measures to improve the present grim scenario. Policy makers, planners, practitioners, and academicians in countries with comparable socio-political and economic setup can view this discussion as a case study and may apply the findings in their domain accordingly. (shrink)

Consumer bankruptcy scholars typically stress either a structural or a cultural account of individuals’ problems with debt. Drawing on the history of poverty research, this article argues that research on consumer overindebtedness and bankruptcy should avoid the pitfall of seeing structural and cultural factors as opposing explanations. Deregulation of the credit industry and an incomplete social safety net are key structural conditions that lead to a culture hospitable to overindebtedness. Furthermore, the interaction of structure and culture has practical (...) policy implications. Structural changes such as interest-rate deregulation inevitably transform both business and consumer culture. Policies designed to create a different consumer culture will have a hard time when pitted against strong structural causes of overindebtedness. At a minimum, efforts to create a culture of personal financial responsibility need a strong structural base, such as public education starting at a young age, and could easily require a generation or more to take hold. (shrink)

The world is at an inflection point. Advancing technologies are creating new opportunities and challenges. Great demographic changes are occurring rapidly, with significant consequences. Governance everywhere is in disarray. A new world is emerging. These are some of the key insights to emerge from a series of interdisciplinary roundtables and global expert contributions hosted by the Hoover Institution. In these pages, George P. Shultz and James Timbie examine a range of issues shaping our present and future, region by region. Concrete (...) proposals address migration, reversing the decline of K-12 education, updating the social safety net, maintaining economic productivity, protecting our democratic processes, improving national security, and more. Meeting these transformational challenges will require international cooperation, constructive engagement, and strong governance. The United States is well positioned to ride this wave of change--and lead other nations in doing the same. (shrink)

There is evidence of continued food insecurity and malnutrition in Pakistan despite significant progress made in terms of food production in recent years. According to “Vision 2030” of the Planning Commission of Pakistan, about half of the population in the country suffers from absolute to moderate malnutrition, with the most vulnerable being children, women, and elderly among the lowest income group. The Government of Pakistan has been taking a series of policy initiatives and strategic measures to combat food insecurity issues. (...) These range from increasing production to food imports, implementation of poverty reduction strategies, nutritional improvement programs, as well as provision of social safety nets. The article aims to instill some fresh thinking into the debate regarding the challenges of food security. It underscores the limitations of hitherto policy response, and suggests crucial measures to improve the present grim scenario. Policy makers, planners, practitioners, and academicians in countries with comparable socio-political and economic setup can view this discussion as a case study and may apply the findings in their domain accordingly. (shrink)