If we are prepared to tolerate income management for people receiving welfare benefits, why shouldn’t the Government step in to manage the income of all Australians?
OK, so that’s not exactly what public health expert Professor Stephen Leeder is saying in his article below, but it’s one inference you might draw. Here is his analysis of the arguments for and against income management:
“Noel Pearson has been one of the most articulate critics of social welfare for Indigenous people. He argues instead for employment opportunities that provide skill development, self-esteem among those doing the work, the community of working with others and more. Money dished out without accountability or expectation beyond sullen gratitude and no complaints in the name of welfare robs the recipients of their humanity and dignity.
Yet employment cannot be created everywhere and there are many people for whom work is impossible (a segment of people with mental illness and with prohibitive physical handicap) and who a caring society has a strong moral reason to support. Henderson, in his ground breaking report on poverty in Australia in 1975, advocated for universal basic income. It was never taken up.
Now interest is growing in segmenting welfare payments to pay for food, clothing, housing or whatever. To some this seems paternalistic. To others it is preferable to general welfare payments that enable a minority to pursue inimical and antisocial goals such as drunkenness, child neglect and so forth. Depending on the moral and practical acceptability of the approach, it is possible to think of a world where such payments were linked to the purchase of fresh rather than fast food and so on.
Expert economists could identify the up and down sides of this approach and the social welfare experts would doubtless have strong views, pro and con, depending on their views of the desirable society. Health is but one aspect of this.
It is always useful when confronted with a complex solution to ask again what the problem is for which it is the answer. The health problem seems to be that when poor people are given welfare payments, they may not use it for healthy purposes. By hypothecating welfare to health promoting behaviours we seek to promote health. That’s the idea.
As a democratic society we take no interest in what adults buy with their money in general. We tax tobacco a lot and alcohol a bit, but beyond that, nothing.
I see no reasons to adopt a different approach for people in receipt of welfare payments when it comes to their own health. We either do it for all voting adults or none.
However, a different case could be made for those who are unable to make discretionary choices – children and severely disabled adults. A fiduciary duty to these people suggests that it would be acceptable to allocate to their carers money for specific purposes and to hold them accountable for spending in certain ways. It could be tested.”
• Stephen Leeder is professor of public health and community medicine at the University of Sydney and director of the Menzies Centre for Health Policy