The Leader of the Opposition would equally be of the view that he needs to see fairness and equity in the way in which scarce resources are allocated. Can he justify a change by his members’ on the basis that a Government decision to offer medical cards to well-off pensioners, to senior civil servants, High Court judges, property tycoons, Ministers of State and hospital consultants has been condemned? Let the Opposition tell me where there is fairness and equity in that.’
Mary Coughlan’s defence of withdrawing medical cards was nothing short of pathetic. She is now trying to play Dr. Robin Hood – taking free medical care from the rich and giving it to the poor. The property tycoons reference really got me. Here is a Tanaiste, a minister in past governments that shelled out money to property tycoons by the bucketload. It’s not just the massive tax reliefs – a property tycoon on €500,000 is now over €32,000 better off from Governments cuts in the top rate of tax. And now, the Tanaiste is equating a pensioner on €241 per week with a property tycoon.
Noel Dempsey’s defence of the withdrawal of the medical cards had a more thought-out ideological basis – he attacked universalism.
‘It’s meant to be a saving in the budget but it’s also meant to be an effort to get away from the idea of universality to target resources more directly to those that need it.’
Ah, so there we have it. Abandon universalism, take up the cudgels of means-testing, cut costs, and help out the poor more. There’s much meat in this debate, but let’s first look at the contradictions inherent in this position. For how far does Minister Dempsey want to to take this?
Do we means-test free travel passes? I know it boils my potatoes to sit next to a property tycoon on the 123, knowing he’s travelling free on my dime. Indeed, it freaks me out seeing High Court judges driving on the road outside my house for free – shouldn’t they be means-tested for using my road? And what about social insurance – that consultant doctor standing in the dole queue picking up the same amount of benefit as a laid-off plumber?
What about education? Shouldn’t primary education be means-tested? Should little Johnny Smurfit be getting this resource free? Should pimply-face Johnny Smurfit be allowed to graduate to secondary school without first being means-tested? And shouldn’t he be means-tested before flushing the toilet at home – I mean, look at all that free water the super wealthy are getting?
Here’s a win-win idea: means-test people’s use of the Guards. If senior civil servants were means-tested they’d be less likely to report burglaries or golf-course muggings. We could save on resources and our crime stats would plummet.
The problem with the Minister’s argument for selectivity is that it is, itself, selective. Why give some things free and not others? And if there is to be selectivity – one might think that health, one of the most basic needs, would be well down the list.
These are long-standing arguments. Noel Browne wasn’t brought down over the Mother and Child scheme per se, but rather over his insistence that it shouldn’t be means-tested (a means-tested scheme was to be introduced eventually). Though the opposition to universality wasn’t based on budgetary concerns (it was the fear of socialised medicine and abortion – all because the ‘middle class’ would get the provision for free), it showed the problems with universal state provision.
Indeed, so entrenched was opposition to universal state provision that Sean Lemass conspired with Donagh O’Malley to by-pass the Cabinet when introducing free secondary schooling, so fearful was he that it would be defeated or watered down.
It’s not just that means-testing is, in principle and by every measurement, a poor substitute for a comprehensive welfare system. It forces people to label themselves – as poor, or deprived, or alienated; it never reaches the categories it is intended to (the take-up rate for Family Income Supplement is estimated to be only 40 percent while Child Benefit has a 99 percent take up); it is expensive and bureaucratic with extra costs needed to monitor against fraud; indeed,it actually invites fraud as people on the margins understandably hide income and wealth; they can create enormous income traps (the withdrawal of rent supplement is one example); they can create perverse disincentives to work when taking a job means losing benefits, such as a medical card; it’s all that.
Nor is it that conservative Governments prefer means-testing because cutbacks usually affect a politically weak class – the poor; whereas universal payments in which everyone has a stake are much harder to take on. Witness the medical card phenomenon, and compare that with the cutbacks in educational programmes for the disadvantaged.
Rather, the debate goes to the heart of citizenship. In the past, battles were fought out on the ‘political’ terrain – over voting, access to justice, gender and race (the latter still being fought out in my home country’s Presidential election). These were, and still are, crucial battles that have to be fought over time and time again. But the rise of social democracy in modern economies took this battle of citizenship to a new level and created the welfare state. Universal entitlement – funded either through central taxation (the NHS) or through social insurance (many Continental models) – is an indispensable element of citizenship under a social democratic consensus. Grounded in collectivity, in solidarity: universalism at its best provides for all those in need and is paid for by those with the means. You might call it ‘actually existing social democracy’.
But, as always, the proof is in the pudding. And Maeve-Ann Wrenn provides this in dollop-fulls. Her forensic analysis of the health improvements in older people, using Census data, suggests clear and quantifiable results from the extension of the medical card scheme. Yes, other factors may have been in play but such factors also reflect a social solution (better housing is one). In short, from this small example of better health effects on older people we can glimpse the social benefits that accrue from universal entitlement – just as no one doubts at all the enormous benefits of free secondary schooling.
Here is the future. Here is the terrain that the Left must fight on. Away from the budgetary numbers and borrowing requirements, the fight for a better society must be waged on many fronts. And one of those is universalism. In lean times, we may not be able to extend it to the extent we would like, but we must fight like hell to hold what we have.