Tuesday, 3 April 2007

Response to speranza nuova: who should pick up the bill for social assistance?

speranza nuova posted this comment in response to my posting on the TODAY article "How Many Portions Of Help, Sir?":

Hi Mr Siew,

While on this topic, I thought you might want to peek at an article written by one of my Singapore Angle colleagues:

On a Not Uncommon Line of Argument

It raises a difficult issue: Who should pick up the bill, when an elderly person's family has chosen not to provide support?

I thought this to be too important to bury in a comment, so I will respond to that article in this post. It has taken me a few days to write this.

Before I start, I will state for the record that I am fortunate enough to pay taxes (both direct and indirect), and a lot more taxes than what I directly receive from the system. (I am undecided on whether to put quotation marks around "fortunate" -- nobody likes paying taxes, but all things considered, including the fact that my revenue is almost 100% taxable income, I would rather be paying income tax than not. Unfortunately for me, I am not one of those lawyers whose salaries form the basis of the MR4 and SR9 benchmarks...) Please feel free to make of and extrapolate from that whatever you will.

Firstly, I'd like to take a step back from all that intellectualisation and rationalisation and philosophising in and around that article, and talk about what a society is or should be about.

To quote Wikipedia -- as unreliable as that can be for contentious issues:

"A society is a grouping of individuals, which is characterized by common interest and may have distinctive culture and institutions. ... In the social sciences such as sociology society has been used to mean a group of people that form a semi-closed social system, in which most interactions are with other individuals belonging to the group."

I guess that is the "technical" meaning. To that I would the concept of values -- a society is also characterised by a common (if not universal) set of values and goals/aspirations.

So what sort of values and goals/aspirations should Singapore as a society have? What do we want it to be? Is it enough for Singapore society to exist in purely economic terms? Or do we want it to be something more?

I for one want it to be something more. I want Singapore to be a society that cares for and looks after its under-privileged and the less fortunate. I want it to be compassionate and inclusive, as over-used as that term has become. I want it to to go beyond numbers and statistics and economics and cold logic. I want it to empathise and sympathise.

In short, I want Singapore to have a heart. And I do not think that that is necessarily inconsistent or irreconciliable with Singapore as a functioning, effective, successful capitalist economy plugged into a globalised world.

So let's go back to the article. As I see it, the problem is that the article is too intellectualised and overly-grounded in economic theory. It approaches the issue in a vacuum of economic theory. It is perfect fodder for technocrats, but it does not describe real life.

A government that is nothing more than a technocracy would make for a truly sad society. I do not think -- and I pray -- that we do not have such a government or such a society.

Yes, this is a more emotive and emotional approach than the stone-cold rationality and logic employed in the article. I do not see that as a flaw, but as a strength.

So let's move from a generalised critique to a more detailed examination of the article's points.

I have already defined what sort of society I want Singapore to be. In theory, this may be achieved by the efforts of the Government, non-governmental actors (such as private charities), or of both.

Zeroing in on the specific issue of the care of elderly citizens who are not being cared for by their children or family, I think the situation in Singapore is that both the Government and private charities play a role, under the so-called "many helping hands" approach. But the primary expectation is for people to take care of themselves, or for their families to step up.

My question is: what happens when people are not, for any reason (including their own financial irresponsibility), able to take care of themselves, and their families do not step up, and they somehow fall through the cracks of private charities? Do we then adopt a judgmental view of them and their actions and their irresponsibility, and deny them assistance on the basis that "they should have known better" and that doing so would be economically inefficient?

Government is about hard choices. But does the choice have to be so hard for other people?

It is fundamentally an issue of one's view on what is the acceptable/requisite level of economic (in)efficiency when allocating scarce resources. I think Singapore as a society can afford to, and should, allocate our resources in a manner that is less economically efficient, but more (to my mind) holistically beneficial. (And that is also my problem with the HDB's position when it comes to allocating rental flats and other forms of accomodation assistance to the needy. Denying help to people who are "financially irresponsible" is not, to my mind, defensible. Not in this day and age of plenty and prosperity.)

I do not advocate unlimited provision of assistance, but I do believe we can do more. It may be economically inefficient, but not everything can or should be reduced to a question of economic efficiency.

An analysis using only economic theory assumes that everything is quantifiable and reducible to value and utility -- well, can you quantify your soul? Can you reduce to a dollar value, or any other objective metric, the general feeling of well-being and security that comes from knowing that you will never be completely abandoned and left in the cold? (And while I do not intend to talk about Bhutan's happiness index because I think it is cliched, I do believe that it is cliched for a good reason. That example does show up the drawbacks of using economic theory as the sole analytical tool and economic efficiency as the only indicator of good governance.)

In a recent posting on Tomorrow.sg, a blogger wrote about how wonderful the UK NHS was -- because he and his wife were benefitting from it. Even though they were foreigners and neither citizens nor PRs. A good friend of mine, whose girlfriend's mum is terminal ill-health in Canada, shares the same view about the Canadian system, which is providing her with free medical care and at a qualitatively high level as well.

These systems are, by most conventional accounts, economically inefficient. But to their beneficiaries, they are important and give huge amounts of comfort. My memory of A-Level Economics is that economic efficiency is about matching cost with utility. So just how do we account for all that utility when assessing whether these public health systems are economically efficient? Do we simply ignore that, just because it is not quantifiable?

I would be the first to admit, that assessments of whether a non-quantifiable benefit is worth the economic inefficiency is inherently subjective. But an argument based purely on economic efficiency itself masks an underlying subjective view, that economic efficiency is the only (or primary) standard of evaluation of policy.

It is true that when I advocate more spending on helping the elderly for whom no other help is available or easily available, I am ultimately advocating how to spend other people's money. I pay a bit in taxes, but I am under no illusion about just how much I spend!

Having said that, the same is true of all public expenditures, even public expenditure on public goods. Take street lighting. The amount of benefit I get from street lighting does also depend on where I live, whether I drive, how far I have to walk to get home, etc. Or defence -- how much it means to me depends on how globally mobile I am, whether I can emigrate, whether I have overseas PR.

So even public goods benefit some more than others. We do not quibble with public goods on that basis. So why do we quibble with private goods on that basis?

If spending a bit more on this would deprive some others of Governmental expenditure, then that merits a closer scrutiny and more thinking about which resource utilisation is more meritorious. But I think our Government has enough money (theoretical Budget deficit notwithstanding -- mark my words, at the end of this Government's term, we will somehow still have accumulated enough surpluses for a generous benefits package) that it is not a zero-sum game.

In conclusion, I would say this. Government is not just about management. It is not just about managing dollars and cents, or an exclusive focus on ensuring an economically-efficient allocation of resources, or an overriding respect for private actors' freedom to allocate their property as they deem fit without state intervention. It is not just about cold hard logic and economic theory.

Government is about all that. But it is also about more. It is also about leadership, political, economic and most of all moral. It is about empathy and compassion. It is about caring and sharing, and ensuring that no one gets left too far behind.

And yes, it is about emotions. Because at the end of the day, people are people. People have hearts. People have feelings. People are not digits. And we always need to remember that.


Speranza Nuova said...

Mr Siew,

I think you may have misunderstood Huichieh's article. His underlying point was about whether the State should look after the aged, and whether it is wrong to expect children to take care of their parents.

I agree with you completely that we as a society must have a heart.

Yet some elderly parents are abandoned by their children -- not because these children cannot provide support, but because the children choose not to.

Who picks up the pieces when this happens? We can say it is the State, but the State is funded by taxes. So the burden is borne by all of us, including filial children from other families -- and some of these filial children are from poorer backgrounds than the unfilial.

You're right that we can't put a monetary value on some things:

- The joy an elderly parent feels from having their own family care for them, rather than a social worker or a paper cheque.

- Or the doubt gnawing at the soul of a filial child, as he wonders whether it's easier to join the ranks of the unfilial -- after all, other people are copping out and passing the buck to him, so why not join them in doing so?

One can certainly argue for more support to be given out, but I think one should also be candid about what one is asking for. e.g. Asking filial children to support other people's parents -- even when those other people are better off, could have done so, but didn't want to.

Siew Kum Hong said...

To speranza nuova:I don't think I misunderstood his article. It is just that he chose to frame his thesis in a very narrow manner, which tends to lead to a certain answer.

I believe that it is an inappropriately narrow frame of reference, and instead the issue needs to be considered in a wider context. I see no reason why I should limit myself to a frame of reference that is designed (whether intentionally or otherwise) to limit my response.

When you say "I think one should also be candid about what one is asking for. e.g. Asking filial children to support other people's parents -- even when those other people are better off, could have done so, but didn't want to.", what you are really driving at is that filial children are entitled to object to supporting the parents of others who are able but unwilling to support their parents.

My point was and is that that is a judgmental approach, and at the end of the day, as a society, we should help the needy elderly regardless of whether the circumstances in which they ended up being needy.

I acknowledge that there will be a strong likelihood of moral hazard there, in that it could encourage others to abandon their parents in the knowledge that society will pick up the tab.

But I believe that that is an economically inefficient outcome that a developed, compassionate society should choose to accept. Because the alternative is to harden one's heart to others' suffering, simply because of the inequity involved, even when one can afford to help. And then, to my mind at least, we become no better than the unfilial children who choose not to support their parents.

family man said...

Read this:


“The third outcome — and the most disheartening — is the bewilderment and disenchantment of the small pool of dedicated Singaporean volunteers in charity and community work, which will result in the pool becoming even smaller, firstly because these volunteers will now see very little in the way of inspiring example and secondly because they are unlikely to be replaced by a younger generation brought up on the raw economic imperative.”

This is insightful. It will be difficult to be a caring country judging by the way Catherine painted it. Same old, same old....

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