It can be argued that one of the most insidious single changes that have affected status relationships within the lower classes does not relate to the social action programs, but to the implementation of means tested programs (Murray 2015, 184). The importance of the sociological influence of being a public benefit recipient cannot be denied, as the threshold of family honor was crossed the moment low income families started to receive public charity, at least in the eyes of their counterparts. Decades after its implementation, social welfare and means tested programs continue to be part of society, their recipients amounting to dozens of millions (Ibid., 185).
Research studies in the area of social policy, have focused at times in the influence placed by modern American welfare systems among low income families, the disadvantaged, or those who are vulnerable, including children (Moffitt 2015, 1). The dynamics of the family nucleus have played a crucial role in the need for these public services, and both policy makers and researches have understood this. Social castes and racial make-up, along with the presence (or lack thereof) of certain family members (the father figure), are instrumental in the necessity, in many lower class families, to apply for government benefits, including welfare programs, as a mean to survive or improve their living conditions.
But welfare and social assistance programs are not the only issues that have been part of American social policy in the last 60+ years. Healthcare policy and education are as important and as ever-present in our society. Health policy on its own it’s considered a vague term that has been described at times at the type of policy that aims to have a positive impact on the health of a nation’s population (de Leeuw 2014, 2). Just like social assistance programs, policymakers and advocates for healthcare policy believe that a healthy society can be built and developed whenever there are policies in place that improve the conditions of the members of said society. Whether it is a safe and secure community, or the availability of adequate social services, including welfare, healthcare and public education, a healthy, successful society can only thrive if provided with this social tools.
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In America, the traditional structure of the healthcare system covers both public and private institutions, without a central planning or coordination (Cochran et al 2016, 263). Notwithstanding the radical changes experience by the healthcare system in the last few decades, it continues to be a very expensive and fragmented source of care. Managed care, PPOs, HMOs, private and public insurance plans: they all carry the stigma of never offering sufficient coverage for the insured, while the at the same time being billed exorbitant amounts by medical providers. Still, healthcare policy, while emerging in the 1960s by means of public benefits and social policy systems, entered a new arena in the 1980s when it was faced with the arrival of two complementary traditions: health behavior change and the emphasis in the development of supportive environments (de Leeuw 2014, 1).
Healthcare policy has encountered the numerous issues associated with a health system that continues to be broken and disorganized. The lack of coordination between multiple providers has led to an increase in costs, quality of care, and access to the most appropriate medical care and professionals (Barnes et al 2014, 1). Even with the advent of the Affordable Care Act, and the availability of Medicare and Medicaid for the lower classes, the American healthcare is far from refining a system that cannot reduce the costs of care, neither it can improve the experience associated it with, or provide same to all sectors of the population. To this ongoing social madness, we add the plight of the uninsured, either due to cost, or to legal status. Until the arrival of the ACA in 2010, more than 20 % of the American population under 65 lacked medical insurance coverage. But health insurance coverage is not a synonym to healthcare, and modern America is plagued with issues related to the lack of fitness, tobacco and substance addition, lack of adequate rest and care, etc. (Cochran et al 2016, 269).
The high costs of medical care prevent most Americans from having sufficient access to care, as insurance premiums place a burden a household budget. This lack of medical insurance coverage led in the 1960s to the implementation of the Medicare and Medicaid programs. The former was instituted as a supplement to Social Security in order to serve the elderly population, while the latter is regulated by state agencies (which use federal funds) to provide medical coverage for those individuals who are not able to afford care due to its high costs. Being the largest means tested program in the country when considering expenditure, Medicaid has been one of the main culprits responsible for government spending in the most recent decades (Moffitt 2015, 6).
When discussing the history and implementation of healthcare policy we first must have a good understanding of the process that leads to its development. This is crucial when both policymakers and advocates for a better healthcare policy seek to have a meaningful impact on the direction of the policy, as well as the objectives it plans to address. A proper application of theories of the policy process enables an appreciation of the determinants of policy choice (de Leeuw 2014, 3), including all causal effects and factors of political variables, including processes, structures, and outputs. Nevertheless, the evaluation of healthcare policy by analysts, especially when considering the terms of its intended goals, leads to a mixed reality. While various federal programs, including Medicare and Medicaid, have reduced the financial burden of healthcare for the elderly and the poor, the costs associated with this have skyrocketed in the last decades (Cochran et al 2016, 284). There has been a great improvement in health statistics and quality of care, but at the same time, this quality is not as good as it should be, when considering the spending and high, ongoing costs associated with healthcare and its corresponding social policy.
Social public policy as a form of public investment is not limited to healthcare or social assistance programs. Another crucial subject in the arena of social policy debate is education. The various sectors that cover a nation’s educational systems serve not only to provide education to members of society, but also constitute a significant element when building the labor market. Still, and notwithstanding the role of education in the development of a healthy society, educational systems and education policy have been historically neglected both by policymakers and researches on the field (Stasio and Solga 2017, 313). This is certainly an unfortunate situation, as it is important to understand the relationship that exists between good social policy, education policy, and the economic growth of a nation. There are many times when policymakers focus on spending on educational attainment, without making a distinction between primary, general, vocational, training, or adult education (Ibid.). This approach not only fails to address the real needs of the population, but neglects those requests made by educational institutions and stakeholders as related to good public policy.
In America, there is a conflict with regard to education policy simply because those decisions taken on this subject have some form of effect in the daily lives of every single American family. Due to the depth of this social impact, and the pluralistic nature of the American society, disagreements are always part of the policymaking process, where conflict and controversy are part of the education policy debate (Cochran et al 2016, 312). The American people have two expectations with regard to education policy, based on historical traditions and legal precedent: 1) education should be free and universal; and 2) control over education should be centered on the local levels. According to Bower, research on education policy and the reforms which are necessary to achieve success in the field generally focus on the issues that are taking place within the schools, without considering that there can be external factors that are major contributors to the gaps that exist between the different social classes and ethnicities.
This emphasis on the role of educational policies to improve the wellbeing of youth and those who benefit from the education system, lead to many of the current education policies to depend on the institutions themselves, and not in the students. Studies have shown that an individual’s educational level is a significant factor when considering overall wellbeing (Högberg 2019, 664). That leads us to think that the psychological wellbeing of students is an additional public health issue present in today’s society, particularly among youth and young adults. It is crucial for policymakers to understand that a proper education, notwithstanding any other familial or social factors that might exist, is of the outmost importance when shaping an individual’s life. However, another basic problem that exists in education has not changed in the last decades. Educational incentives that motivate youth and young adults to not only pursue education, but to work hard to achieve success has been part of public policy for ages. While there have been changes in the intellectual climate that have promoted educational reforms, some of which de-emphasize the role of the traditional classroom, there has not been a steady or sufficient support to improve the environment where students spend most of their days (Murray 2015, 173).
One of the most significant factors that is considered when discussing education policy, is the social mobility education brings to all members of society. For youth, as they are not established in the labor market, their social status is analyzed by the community when their parents’ social status and class is considered. This focus by society on social mobility and how education reshapes social background and the adult social class has been the subject of numerous research studies (Högberg 2019, 667). Children who come from high class families and upper social backgrounds are more likely to attain higher education levels, and consequently, they are able to reach higher social positions when they reach adulthood. On the other hand, children of the middle and lower classes, are not always able to attain those dreams due to the high cost of higher education and the policies that surround education quality in poorer neighborhoods (Ibid.). Therefore, there is a need for education reform and better policies that would not only address this issue but also provide additional opportunities to disadvantaged youth. Education can serve as an equalizing and leveling social institution, but at times it can also be part of a mechanism that maintains the existing stratification system (Cochran et al 2016, 318). But any attempts to promote education as an equalizer have been met with resistance at many levels, as some believe that it will serve to bring down those up high, and not raise up those who are in need.
The impact of social policy in the life of America cannot be underestimated. From social assistance programs, to the affordability and quality of healthcare, to the importance of equal opportunity when seeking education, changes in public social policy can be the difference between life and death, literally, for many Americans. For years policymakers and researchers have analyzed the impact of social policy in the American society. It is important to understand how the idea of a welfare state runs contrary to the spirit of America, not because Americans do not want to lend a helping hand to others, but because America is based in opportunity and growth, not stagnation and government based subsidies. There are times where action takes the place of inaction, which usually happens when policymakers do nothing to improve the system. When a policy exists as a potent, but fairly distant symbol for mass publics, then the details of its material design will rarely secure a public understanding of said policy (Soss & Schram 2006, 21). Those who are not affected by public policy seldom pay close attention to the changes that take place in the public policy arena, as generally new information or facts do not lead to the abandonment of old ideals or beliefs.
Given the inactivity that seems to take place with regard to government spending and the lack of real results in the field of social policy, many spectators of this tragicomedy ask themselves, why is not the government doing something about it? There is certainly lots of room for debate on the issue of social policy: the legislature, the media, cyberspace, and so forth. In principle though, society should be able to look into the science behind public policy to have a greater understanding about this do-nothing position (McConnell, and ’t Hart 2019, 645-646). At times, public policy it’s not what the government does, but what it refuses to do, or delays in accomplishing. This leads to another question then, isn’t this a breach of the contract that exists between the government and American society, as part of our covenantal form of government? If the government is enacting policy that is not leading to a significant change in society, then why are our taxes being used to promote and fund said policy (Murray 2015, 196)? Why should we support a system that is not making a meaningful change, which doesn’t correspond to the sociopolitical agreement that the government has offered to uphold?
This alleged breach of the principle of covenant between a nation’s government and its people is best described when society questions why give anything at all, if it is not being used for its intended purpose. The reality is that the quality of the outcome is never as good as expected. People are willing to participate in policy making not because they want to be part of the problem, but because they want to be part of the solution. Thus, people should study social policy and policy making in general, not only to better understand what the government does, but to have a clearer idea of the process that leads to the enactment of policy. (Birkland 2020, 77).
This means that restraint in public policy is just an aspect of policymaking, and not a failure by the government to fulfill its duty in the covenantal pact that exists between a nation and its rulers. Public policies are the main instruments which are used by the government to address social and economic issues, while also serving a second, more political function (Soss & Schram 2006, 17). Policymakers don’t serve just as problem solvers but are in fact political actors who must think ahead in the game of policymaking, before making any decision or taking an action that could undermine or improve their future positions. While many people believe that social policy only targets certain sectors of society, ignoring the needs of others, the process of policymaking is a complicated one, which at times cannot be fully understood, especially if its viewers are focused in the present, and do not seek out the future.
