Society has developed six different kinds of societal arrangements for meeting human needs : mutual aid, charity-philanthropy, public welfare, social insurance, social services, and universal provisions (Handel, 1982).
Each arrangement has developed from people's responses to societal structures and from beliefs about human needs, the reasons people are unable to meet their needs, and what society's responsibility is in meeting these unmet needs.
Each arrangement has particular qualities that make it especially apporopriate for meeting particular kinds of needs under differing circumstances.
Each has advantages and disadvantages.
Today's socialwelfare system makes use of all six arrangements (see Table 1-1 for definitions of these arrangements).
Thus, in evaluating the U.S. social welfare system, it is important to understand the uses of each and to consider which arrangement is most appropriate to meet the specific needs of a particular circumstance.
Mutual Aid 상호부조
Mutual aid is the oldest form of social welfare.
It probably has been used ever since humans banded together in extended families or loose social groups.
It is, however, the least recognized and documented in social welfare literature.
Mutual aid is the expression of people's need to take responsibility for each other's well-being.
Friends and neighbors have provided for children when family capacity for care has broken down.
Social groups have cared for their own aged, weak, and deviant members.
Studies show that mutual aid mechanisms are present in primitive societies.
Imperatives for mutual aid a strong part of the traditions of Judaism and Christianity.
Mutual aid was present in the craft guilds of the Middle ages when they provided funds for the burial of members and the support of their windows and children.
It was present in various immigrant groups as they settled in ethnic enclaves in the United States and together provided for their own needs.
Ferdinand Tonnies (1855-1936), an early German sociologist, explored the relationships among people in the industrialization of society and used the term Gemeinschaft (a society using mutual aid to meet human needs) and the contrasting term Gesellschaft(individuals related through structures in the community) (Loomis, 1940).
In U.S. society, mutual aid is still very apparent in rural communities.
Farmers help each other during harvests.
Neighbors in small towns often come to depend on each other during a crisis such as a death or illness in a family.
Another good example of mutual aid is the self-help groups that have been particularly useful in meeting the needs of individuals in transition (such as Widow to Widow), those who are isolated and lonely (parents Without partners), and those who share similar problems (Alcoholics Anonymous) (Pancoast, Parker, and Froland, 1983).
The recognition of natural helpers as a resource is another manifestation of mutual aid.
In many communities (particularly in rural communities and in some urban neighborhoods) there are individuals who have won the trust and respect of the community and to whom people go for advice or for help in solving problems.
Another example of mutual aid is giving a fund-raising benefit for someone who has been injured or who has lost property through a disaster.
Mutual aid seems to work most effectively when the people helping and those being helped hold similar values, come from a similar culture, or have a similar lifestyle.
Such people have an egalitarian and reciprocal relationship in which a person is sometimes the helper, sometimes the one being helped.
Mutual aid has the advantages of being relatively nonintrusive, culturally relevant, fiscally inexpensive, nonstigmatizing, and relatively autonomous.
It seems to be less effective among people of different cultures, lifestyles, or ethnic groups.
It is usually short term and of limited financial commitment-for example, providing food for a family in times of illness or other distress, or providing shelter after a fire.
It requires a situation in which the helper has sufficient motivation, energy, and resources to provide the needed help.
It also requires that the helpee respond in a way that provides satisfaction to the helper.
Mutual aid is not appropriate for meeting all human deeds, but it is a very important arrangement that has always been a part of human society and one that deserves more understanding, attention, and appropriate use within the current U.S. social welfare system.
Mutual aid is usually found within a single class or group.
When stratification causes one group to acquire greater wealth and power, the mutual aid ethic is often transformed into the belief that the richer should help the poorer-or charity-philanthropy.
Charity-Philanthropy 자선사업
When societies began to stratify and develop a class structure, new means of helping became necessary.
With stratification came a differential distribution of power and resources, but the mutual aid ethic of responsibility for others persisted.
Two early European examples of this kind of social welfare are the feudal system and the Roman Catholic church.
Within the feudal system the lord of the manor was responsible for the well-being of those who lived on the manor: his underlings and serfs.
With the breakup of this economic system came a breakdown in the meeting of human needs that caused much unrest in the countryside.
During feudaltimes, the church also developed ways of meeting needs: hospitals, almshouses, and schools.
Gifts to the church were seen as gifts to the poor.
The tithe (giving one-tenth of one's income to the church) became expected of all.
Although this means of redistributing wealth was a way of carrying out society's social welfare function, it was also a means of social control.
To receive help meant, at least in part, adhering to accepted norms and behaviors.
For example, in response to help from the church individuals were expected to live by the teachings of the church and provide for their own needs as possible.
They were not to waste resources by in dulging in pleasure.
It is important to note that the church's charity was not governmentally administered or controlled.
It was a means for providing help based on the relationship of one social class to another.
Thus the helper assumed a position of power over the recipient of help.
In the nineteenth century, the U. S. social welfare system developed institutions and organizations that laid the foundations for the use of charity-philanthropy.
Individuals with wealth established and endowed schools and colleges, libraries, hospitals, orphanages, and homes for the aged.
Some people believed that those who were privileged with wealth should share with the less fortunate, particularly through the establishment and maintenance of institutions for the "uplift of the masses" or for those who needed care through no fault of their own.
On the other hand, society made sure that no help was given that would in any way deter the able-bodied from working to provide for themselves and their families (Bremner, 1960)
Two organizations are particularly important in describing the charity-philanthropy arrangement in the United States : the Charity Organization Societies and the settlement houses.
Although different in underlying philosophy, both originated in Great Britain in the latter part of the nineteenth century and were quickly copied in the United States.
The charity Organization Societies (COS), forerunner of the present-day Family Service America, originally functioned with "friendly visitors," usually women of the upper class who carried out their charitable responsibility by visiting poor women in an attempt to motivate them toward better ways of living.
The friendly visitor gave advice about such things as childrearing and housekeeping and warned against the evils of drink and idleness.
The system was based on the belief that poverty came from wrong living, misuse of money, excessive drinking, and immorality.
Money or other concrete aid was supplied only in exceptional situations for very short periods of time.
An extensive system of coordination and supervision developed.
The individual or "case" was the focus of attention, with emphasis on finding out why the person was having difficulty.
But the friendly visitor believed that the source of the difficulty rested sithin the individual's ways of functioning, that the poor had the means to overcome their problems, and that the friendly visitor could help the needy find their own means for overcoming difficulty.
This method of giving help became know as scientific charity.
It provided the beginnings of social work as a profession-the friendly visitor evolved into the caseworker.
On the hand, the settlement house was a place in the neighborhoods of low-income families, usually immigrants, where wealthy and privileged people could live among the poor.
Socially conscious clergy and university women were also apt to be found living in settlement house.
They believed that by becoming neighbors, they could bring about needed changes and thus meer human needs.
Another method was to invite neighbors into the settlement house for clubs and classes (group activities) that helped immigrants adapt to the new country and its way of life.
It was hoped that this would also demonstrate a caring attitude.
The settlement house workers believed that through club activities people could find enrichment and education that would lead them to a higher quality of life.
Rather than seeing the cause of problems as originating in individuals and their lifestyles, the cause was seen as resting in the environment and stemming from a lack of understanding about how to cope in new surroundings.
The settlement workers were also heavily involved in research to identify the factors causing need and in activities intended to eliminate the factors that caused the need (Bremner, 1964).
The COS and the settlement house engendered numerous private agencies.
This term emphasizes that the support and governance of such agencies come from private citizens, not government sources.
Included in this group of agencies are those supported by religious groups.
Today many of these agencies do receive support from governmental funds through grants and purchase-of-service contracts.
Some examples of private agencies include those concerned with the welfare of children(e.g., Children's Aid Societies), family counseling agencies(e.g.,Family Services), child guidance clinics and other mental health services, and community center and group service agencies(e.g.,YWCAs).
The advantages of private agencies are that they voluntarily redistribute resources and let people carry out their responsibilities for others in ways that are more personal than are government-controlled mechanisms.
The private approach has more flexibility, focuses on particular cases, and provides relative autonomy for the helper.
Because of the flexibility and autonomy, there is a capacity for experimentation and development of pilot programs not always possible in the government sector.
The private agencies have enjoyed an absence of government control, but as government has made its presence felt in many parts of our society, so it also has developed regulations for these agencies.
There are, however, disadvantages to the charity-philanthropy arrangement.
It does seem to reinforce class structure and thus can stigmatize the people receiving help.
With limited funds and other resources, it cannot meet all existing needs.
Because of its independent functioning, coordination of services has been difficult to achieve.
In addition, private agencies often seem to have difficulty responding to different cultural groups.
Finally, this arrangement can lead to an overemphasis on professionalism and an elitism that can be dysfunctional.
Despite its limitations, the charity-philanthropy arrangement remains an important component of our social welfare system.
Link mutual aid, it cannot provide for all human needs, but it can best provide for some needs, such as counseling people with problems in interpersonal functioning and developing new services, that mutual aid and government-controlled systems have difficulty providing.
It has been a means for identifying unmet needs and exploring or demonstrating through new programs and strategies means that might be useful in meeting the need.
However charity-philanthropy cannot expected to universally meet the need.
Public Welfare 공공복지
The third arrangement used in meeting human need is public welfare.
The essence of this component is government-regulated provision for and control of the needy by tax-supported financial aid and institutional care.
The arrangement uses local, stare, or federal tax monies to provide minimal support for people unable to provide for themselves.
The U.S. public welfare system generally traces its roots to the English poor law of 1601.
This law, discussed in greater detail later in this chapter, was a codification of laws that the British parliament had passed during the previous century to regulate begging and to establish government involvement in provision for the needy.
It reinforced the notion that the local community was responsible for the care of its poor.
The thrust of the English poor Law was carried over to the American colonies and their provision for their own poor.
What became known as indoor relief, or the care of certain persons in congregate-care institutions, became popular in the seventeenth and eighteenth centuries.
Poorhouses, hospitals, and orphanages were established.
Although many of these were privately supported and thus fall wothin the charity-philanthropy arrangement, many were also partially government supported.
State governments, in particular, became responsible for the care of some groups of people.
States established separate institutions for the retarded, the blind, the deaf, and the mentally ill.
In 1845, president Franklin pierce vetoed a bill that would have provided support for the care of "indigent insane persons" by the federal government, saying the federal Constitution did not provide power for this activity.
Thus the principle of local and state responsibility for care of the care of the poor remained operational until the 1930s.
The present U.S. public welfare arrangement began with the federal government's response to the Great Depression of the 1930s.
President Franklin Delano Roosevelt's New Deal policy, which provided work relief, reversed the thinking of the pierce veto and established the involvement of the federal government in providing public welfare.
The social security Act of 1935 with its numerous amendments is the basis for the U.S. public welfare system.
This act was an important part of the New Deal.
Certain categories of poor became the joint responsibility of state and federal government.
These include mothers(families in some cases) With dependent children(ADC, Aid to dependent Children, and AFDC, Aid to Families with Dependent Children), the aged(OAA, Old Age Assistance),the blind(AB, Aid to the blind), and the disabled(AD, Aid to the disabled).
This approach has come to be known as categorical assistance.
More recently (1972) all but ADC and AFDC have become the responsibility of the federal government.
General assistance, help given to those who do not fall into one of these categories, falls to state and local governments.
General assistance can be both money or in-kind provision.
Institutional care has been deemphasized and for the most part remains the responsibility of state and often of local governments.
In 1965, the Medicaid program(Title XIX) was added to the social security Act.
This amendment pays for medical care for the poor.
Fiscal responsibility for the programs is shared by the federal government and the states (Day, 1989).
The public welfare system has two major strengths.
The first is its universal quality: Anyone who meets stated criteria is covered.
Mutual aid and charity-philanthropy do not have this quality.
Thus, the public welfare approach provides a specified level of help to all who have an established degree of need.
This scope can be possible only with a relatively large and relatively stabel fiscal base.
Thus the second major advantage of this arrangement is its dependence on a tax base, providing a large and stable source of funds.
Because the federal government operates with a system of bureaucracies, such impersonal service delivery is not capabel of responding flexibly to individuals in need.
Bureaucracies often create a proliferation of rules, regulations, red tape, and paperwork.
All this reduces the government's capacity to respond to human need and increases the costs of supplying needed assistance.
It has been argued that a limiting feature of public welfare has been the principle of less eligibility-that is, the idea that individuals should not be provided for at a level equal to or higher than the level an individual working for a living can attain
This policy developed mostly from the belief that citizens do not want to pay taxes to maintain others in a equal or better lifestyle than they maintain for themselves.
The principle of less eligibility served as a "unwritten policy" for many years, keeping public assistance benefits generally at low levels.
Recently it has been argued that the combined benefits of welfare assistance, food stamps, and Medicaid, discussed in detail in subsequent chapters, have, in some instances, made public welfare recipients "better off" than some people who work at low-paying jobs with no benefits.
This issue has added to the controversy surrounding this arrangement for meeting human needs.
Another disadvantage of public welfare is the stigma that the dominant culture attaches to receiving public assistance of any kind.
This stigmatization is a major cause of the prejudice and discrimination that people who receive public assistance often experience.
This prejudice in turn affects their feelings of self-worth and thus further increases their need for support.
inflexibility in the government's response to diverse populations and diverse needs is another important limitation.
Thus, despite its mandate, public welfare does not serve all segments of U.S. society equally.
For example, under some circumstances it is not responsive to middle-aged adults who are unable to work because of mental or physical handicaps.
Currently, much discussion and debate has centered on public welfare, most particularly "welfare reform."
A political vow made by the Clinton Administration shortly after the 1992 national election was to "end welfare as we know it."
More recently, in the aftermath of the 1994 congressional elections, both houses of Congress have gone on record, promising to pass welfare reform legislation.
The current debate largely focuses on the concern that some poor people should be able to help themselves or may not be victims of circumstances beyond their control.
Behind this concern is an assumption that assistance for these "undeserving" poor should at best minimal.
Some of the questions involved include: Should such assistance be given only to those in certain particularly vulnerable categories-the aged, widows, children, or handicapped persons? Does public welfare discourage the abel-bodied from working?
What should be the response to extensive unemployment caused by disruptions in the economic system? Should help be in the form of institutional care, or should public welfare provide subsistence within the community?
If the latter, should subsistence be in the from of cash payments to the poor or needy, provision of commodities like surplus food, or payment of selected caregivers?
What level of care should be provided?
What are the responsibilities of relatives and the local communities for the care of their own?
Which level of government should be responsible for providing financial resources to support the disadvantaged?
Should welfare recipients be required to work as one condition of receiving aid?
Despite many questions and limitations, public welfare is the core of the current U.S. social welfare system, for it provides the income maintenance segment of the system.
Income maintenance provides financial assistance in the form of cash or a voucher given by government agencies to individuals and families when their incomes fall below a predetermined level (Wyers, 1987).
Examples of income maintenance services are Aid to Dependent Children, food stamps, and supplementary security income for the aged.
Without income maintenance, human needs cannot be met in contemporary U.S. society.
Social Insurance 사회보험
The fourth arrangement used in the social welfare system is social insurance.
Social insurance is a mechanism whereby (or employers and employees) are required to contribute to government-administered funds.
These funds then pay out benefits when the insured condition or status is reached by any contributor.
In the United States a group of insurance programs, including old-age and survivors insurance, disability insurance, and Medicare (medical insurance for those over sixty-five of age) are provided under the social security Act and its amendments (the same act that provides for social welfare benefits).
Workers have a certain percentage of their paychecks deducted, and employers are required to contribute; this money is paid into a fund that in turn pays benefits to qualified aged and disabled people.
This arrangement had its beginnings in Europe during the latter part of the nineteenth century, when first Germany and then Great Britain introduce health, old age, and accident insurance.
In the United States the first social insurance was Workers' Compensation.
This developed in response to the rise of industrial accidents that disabled breadwinners and thus plunged families into poverty.
Between 1910 and 1920 many states passed laws providing insurance and protection against the risk of income loss due to industrial accidents, and for the medical care needed as a result of such accidents.
Other types of social insurance are also a part of the contemporary U.S. social welfare system.
These are Old Age and Survivors Insurance, Unemployment Insurance, and Medicare.
Old Age and Survivors Insurance, now referred to as Old Age, Surivors, Disability, and Health Insurance (OASDHI), provides three types of benefits: retirement income, income to families of deceased workers, and income to workers who are permanently and totally disabled.
The benefits received depend in part on the worker's contributions to the fund: Those who have worked little receive little.
Since its inception in 1935, the program has gradually expanded to include more and more of the work force, but it is still not universal.
Unemployment Insurance operates from funds collected by a payroll tax, with each state setting up its own program.
Medicare, which came into being as a result of the 1965 amendments to the Social Security Act, provides health insurance for people over sixty-five.
It is co-insurance; that is, the recipient pays a part of the cost of health care.
The Medicare program is federally administered (Day, 1989).
Social insurance has several advantages.
Because individuals contribute to the funds they draw on when they meet the requirements for obtaining benefits, social insurance does not carry the stigma that other arrangements do
This arrangement also has a universal quality, although it is somewhat limited in that some people do not contribute and thus are not eligible for benefits.
However, the extent of the coverage is now so broad that social insurance can be considered almost universal.
It is also nonintrusive.
There is no investigation to establish need and there are relatively simple eligibility requirements.
There are, however, some disadvantage to social insurance.
Of current concern is the shifting population pattern, with many more older people receiving social security and fewer younger people contributing to the plan.
Whether the OASDHI fund can continue to provide the present benefits without increasing the level of contributions, raising the eligibility age, or finding new sources of funds is a real concern.
Also, as noted before, the rules and regulations of bureaucracy are often unresponsive to human needs in their individual and diverse forms.
The system has difficulty adjusting to these inequalities and changing social patterns.
The exclusion of housewives from primary benefits is an example.
Another limitation is that not everyone is part of the system.
Certain individuals "fall between the cracks."
Housewives, some seasonal workers, some state and local government employees, and some agricultural workers do not have social security coverage.
The program is not as universal as many would desire.
But social insurance, despite its limitations, has become a very important part of the social welfare system by providing income at times when people might otherwise have to depend on public welfare income maintenance programs.
Social services 사회서비스
Not all the social welfare needs that people have can be fulfilled merely by providing money.
Traditionally, nonmonetary types of help have come from mutual aid and charity-philanthropy.
Although mutual aid and private agencies have done a fine job, they have not been able to provide for all the needs or to provide universal coverage for even some of the needs.
The heart of social services comprises a wide variety of counseling services known as casework.
However, it also includes other kinds of services, such as information and referral, socialization and other group services, and supportive, services.
In addition, services that increase the capacity of communities to meet human needs are included in this arrangement.
Social services can then be defined as supplying nonmonetary help that directly or indirectly increases people's abilities to function in society (Kahn, 1979)
The roots of contemporary social services lie in the work of the COS and the settlement houses.
From these origins many agencies, services, and other provisions have grown to meet a wide variety of needs.
From the COS came the concept of helping people through a one-to-one relationship.
This led to an emphasis on casework as the vehicle for the delivery of social services.
The COS also pioneered much of the community organization approach, with its emphasis on coordinating services.
The settlement house movement initiated services to groups and to communities, to help people change their environment.
The many and varying uses of the social service model will become apparent in part Two of this book, where the various fields of service are examined
Until recently, social services tended to remain primarily within the charity-philanthropy arrangement.
Then some services, especially in the areas of child welfare and mental health, began to be provided by government agencies.
There was a gradual recognition that income maintenance programs alone could not fulfill everyone's needs.
The 1967 Social security amendments allowed state governments to provide services to ADC recipients.
Thus the social Security Act was broadened to recognize social services as a distinct arrangement.
When Title XX of the social security Act was passed by Congress, this amendment broadened the kinds of services offered and the criteria for who could receive such services.
Services like family planning and information and referral could be provided to everyone regardless of income.
With the rise of public social service and the use of public funds for grants and contracts for services, the social service arrangement seems a more accurate designation for many services provided by agencies formerly supported by the charity-philanthropy arrangement.
One of the advantages of social services is their individualized attention to the need and their specific response to the situation.
Response to diversity is much more possible than with other arrangements.
This arrangement also recognizes that needs exist that are not cause simply by inadequate income.
Social services also place an emphasis on the need for voluntary acceptance of services
There are, however, disadvantages to social service.
In many instances, it is a very intrusive kind of help, calling for delving into very personal aspects of people's lives.
Professionalism has produced other negative spin-offs.
one of them is that some social services tend to discourage the use of mutual aid or the informal helping system; professionalism has given helping an elitist flavor.
It has made certain kinds of help very expensive.
Sometimes it places a stigma on those who turn to it for help.
Also, help has not been available to all who need and could use it.
It should be recognized, on the other hand, that the professionalism of the social services has brought about a higher level of care and a greater capacity to help in circumstances that are beyond the capacity of the informal system.
Universal Provision 보편적 시책
Universal Provision is fiscal support or services given by governments to enhance the social functioning of all the people within a society.
Universal provision no means test; people do not have to show that they or their family fall below a predetermined income level to receive benefits.
No eligibility requirements are necessary other than that recipients belong to a particular category of people (those over sixty-five, children, etc.).
This arrangement has not been used in the United States to the extent it has in many other countries.
It must, however, be recognized as an option when discussing how the U.S. social welfare system can be more responsive to human needs.
Primary examples of universal provision in the United States are such public health services as the poison control centers or the centers for Disease control in Atlanta, particularly as they safeguard everyone's health.
The Older Americans Act of 1965 provides planning, social, and nutritional services for anyone over sixty years old, regardless of income.
Canada has three major universal provisions: Family Allowances, Old Age Security, and Medicare.
Family Allowances pays a set sum for every dependent child in a family.
Old Age Security pays a basic allowance to every person over sixty-fice years of age.
Medicare covers medical and hospital costs for everyone.
These programs are supported from the federal and provincial general tax funds.
One advantage of universal provision is that administrative costs are cut because everyone is covered, so eligibility processing is minimal.
Some of the cost is reclaimed since this income is taxable.
No stigma is placed on those receiving universal benefits; in fact, society recognizes that people through no fault of their own need subsidies.
In many countries, these provisions have become rights.
The major disadvantage is, of course, cost.
At issue is the question: Is it better to pay taxes and be protected, or is it better to provide for need on an individual basis (though each individual's personal effort and also through government programs)?
Each of the six arrangements with its strengths and limitations has developed within the U.S. social welfare system to deliver a particular set of benefits and services that meets certain needs in our society.
Understanding each arrangement is necessary for understanding the total social welfare system (see Table 1-2).