EU/Eurozone – Start Again or Plod On – A Social State
As part of economic liberty there is a need to ensure for a minimum of material security for the people. When someone without resources is hungry, sick, or freezing, freedom is not their first priority. Thus the need for a constitutional principle of a Social State in our modern and relevant democratic United States of Europe. Although I am not advocating a welfare state, as such, I am concerned that the nation states, either by themselves, or through international organisations, are continually unwilling, or unable to regulate the gap between the excessively rich, and the poor. Everyone should have the right to care and assistance in the case of inability of self-care, i.e. the care and means which are indispensable for the maintenance of human dignity. This is the extreme of the social state and there should be no need for debate regarding such provisions, albeit there are nation states within the EU that have no such provisions.
However the dimensions of a social state are far wider, e.g. in which the government undertakes the chief responsibility for providing for the social and economic security of its population, usually through unemployment insurance, old-age pensions, and other social-security measures. Provisions also include healthcare and education. But how do our nation states within the EU fair against some of the pillars of social justice?
It is not possible to analyse the existing structures of all the nation states in a blog, but our news reports show that there is widespread disparity, so I would like to examine what would be needed in our United States of Europe for the dominant issues, being healthcare and pensions.
The current EU/Eurozone member states have a variety of healthcare systems ranging from the UK NHS which provides healthcare free at source to everyone, to systems that are partially funded, or require health insurance in one form or another. Whilst the UK NHS is praised throughout the world recent years have demonstrated that such an all-inclusive welfare provision can become an excessive burden to the State finances. This is blamed primarily on an increasingly aged population. However the truth may be elsewhere as drug companies seek to ever increase their revenues in the name of more advanced research, and medical advances provide ever more complex treatment possibilities to keep people alive who would otherwise die from their ailment.
There have been some well recorded cases of people looking for assisted suicide without recourse to their assistance. I am of the firm belief that the people of Europe should have the right of self-determination regarding the termination of their life when all hope is lost in self-sufficiency. I am confident that I would not want my dignity and self-respect as a human being removed by some sanctimonious idea that I have no right to determine my own end. Thus a counterbalance should be included to enable people the right of assisted suicide without the need, time, energy and cost of high court consent. Any law can be abused but the rights of the majority should take precedence in this situation in order to preserve the rights of individuals. The resulting economic advantage both in State pension and healthcare cost is likely to be significant, and better spent on people who do want to live.
However this is only a small part of the problem. The health of a nation is a fundamental part of the nation’s GDP. Therefore the choice is realistic National Insurance contributions by all people and companies that adequately cover the provision of healthcare, or limit the type of healthcare that is free at the point of delivery.
My belief is that healthcare for children from conception to end of school age, and for people beyond State pension age should be free at the point of delivery in order to ensure reasonable health, and equality for all. But what happens throughout working age?
The health of the workforce of a nation is fundamental to maximise GDP per capita. So does the State ensure that medical treatment is available free at the point of delivery to maximise the contribution of the workforce, or does the state rely on the sensibility of people to save for sickness eventualities? Does the State take part payment for potential sickness through taxation and seek any excess over agreed limits should treatment exceed such limits from the person requiring treatment?
The next consideration is whether or not providing healthcare to all free at the point of delivery encourages abuse of the system and thus increase the burden of cost to the State? The lifestyle of many people today could be considered as self-abuse, so should such people be penalised as a means to encourage a change in behaviour?
My thought go back to a discussion with the then Health Minister in China in 2004 when I was trying to convince him that providing necessary free drugs to workers with AIDS, and thus keeping them productive, was beneficial to the economy. At that time the GDP per capita was around $3,600. The drugs needed would cost around $600 per year. Average wages were just $265 per month, or $3,180 p.a. thus putting the drugs out of reach of the worker. Assuming that the worker had a wife and one child of school age the inability of the father to earn would push all 3 members of the family into poverty (no social welfare), and the child would likely have no schooling. This would have a current negative impact on GDP per capita, and a detrimental impact on the future for the child, a potential future GDP generator. My argument was that, by the Government providing the drugs the GDP per capita of the worker reduced to $3,000, but at least it was positive, and it would improve the future GDP per capita of the child if healthy and having had an education.
Many drugs are not cheap, and are out of reach of many workers in Europe. Therefore the economic benefit of healthcare free at point of delivery for all is compelling. The focus of government is to ensure that the delivery of healthcare is managed in a cost effective way, and that any social behaviour issues are robustly addressed. One positive is the economies of scale of a United States of Europe negotiating with the pharmaceutical companies on the price of drugs.
In a modern democracy there has to be an assumption that everyone contributes to society whether working, mothers who stay at home to rear the next generation, carers, jobless who work with charities or teach soccer at the local youth club, etc. Under our baseline premise of a Social State principle the disadvantaged and the unfortunate losers will qualify for financial assistance in any event. Today, in the UK, people of pensionable age might not qualify for a state pension but they will receive a similar sum of money through various welfare support packages. It is unquestionable that the UK welfare system is overly complicated, and thus difficult to ensure that the correct level of support is given, where needed.
My view is that every able-bodied person (disabled will require a different structure) should have a basis state pension when they reach pensionable age (say 65 years old) – enough to subside. If people chose to continue to work past this age they would still receive their State pension (see ‘EU/Eurozone – Start Again or Plod On – Intro’ in this series). People who enjoy gainful employment for a number of years (say 30 years, which allows women to take time out to have children) should receive an incremental state pension to reflect a recognised contribution, having had deductions from their salary to cover this additional payment. This additional pension will allow a better lifestyle, and is geared around the concept that if you do not work in gainful employment then the state will only support you to a minimum level. Anyone who makes additional pension provision for themselves will still receive whatever State pension they have earned. The State pension would be exempt from taxation, nor be included in income for tax purposes. Tax would, however, be payable on income, including investment income, above the standard tax-free income thresholds to capture tax revenues from wealthier pensioners.
By instituting both of these provisions into every member state of our United States of Europe we would greatly satisfy a fundamental pillar of democracy, being ‘equality for all’, and prevent unnecessary economic and health migration across member states.
Thank you for your continued interest in this European venture.
This blog is part of a series of blogs called ‘EU/Eurozone – Start Again or Plod On?’ and which examine the framework for a truly United States of Europe, and what would be needed to achieve it. Look at the archive index to find other blogs in this series.
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