Possibilities for Change

The developed nations of Western Europe and Canada have taken a very different approach to social welfare. There is little "public assistance" as such. Their specific "anti-poverty programs" are largely folded into social insurance. There is nothing similar to Medicaid, since everyone has access to tax-supported health care. In many nations every family with children receives various allowances, so a special program to poor families is less necessary. And those programs that are specific to the poor are still seen as "insurance," insurance for everyone against the possibility of becoming poor oneself.

Although many of the specifics of social welfare vary from country to country, one common element is universal health coverage. However this coverage is provided (and it is different in different countries), no one goes without health care; therefore, neither the month-to-month costs of health care nor medical emergencies throw people into poverty.


The Finnish System
It is instructive, I think, to take a closer look at the particulars of these social insurance programs in other countries to see what we Americans can learn from them. Because the approaches are so varied, it will be less confusing to use one country as an example. Since I am personally most familiar with Finland (my wife is Finnish) and have spent some time looking at its social welfare system, I will use that system as a particular example of what a program could look like.

Like every other Western developed nation except the United States, Finland provides universal health care coverage. Doctors work thirty-seven hours for the state (either in the public clinics or hospitals) and are allowed to have private practices on the side, which many (especially specialists) do. Individuals may go to the public clinics for a nominal fee (about $20 a year); necessary hospitalization costs several dollars per day. Finns may also decide to use the private system, in which case the state will pay approximately two-thirds of charges for covered services.

Perhaps the strangest (to American ears) parts of the Finnish system are their programs of Family Support and Home-Childcare Support. All families in Finland, regardless of income, receive allowances from the government for each of their children up to the age of 17. Interestingly enough, the allowance per child increases with every additional child, so that the family receives approximately $10029 per month for their first child but $200 a month for their fifth child. A family with three children, for instance, would receive almost $400 a month in total child support payments. A single mother receives an additional $40 a month per child from the state. In addition, a single mother is entitled to at least $125 per month in child support from the child's father, and the state takes responsibility for making sure it is paid, paying the mother any unpaid balance.30


Footnotes
²⁹ All dollar amounts are approximations based on actual figures in Finnish marks.
³⁰ A single mother with one child would, therefore, receive $265 per month for that child ($100 basic payment, $125 from the child's father, and $40 single-parent compensation. For two children she would be paid $535 a month in family support payments alone.