Intended for healthcare professionals

Letters Assault on universalism

Stop blaming the unemployed and focus on universal system of mutual security

BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e537 (Published 24 January 2012) Cite this as: BMJ 2012;344:e537
  1. Ben R Barr, consultant in public health1
  1. 1University of Liverpool, Department of Public Health and Policy, Institute of Psychology, Health and Society, University of Liverpool, Whelan Building, Liverpool L69 3GB, UK
  1. benbarr{at}liverpool.ac.uk

McKee and Stuckler indicate that one strand of the “assault on universalism” is to vilify the “undeserving poor.”1 Those who wish to reduce welfare support argue that the welfare bill is rising and unsustainable because of the number of people on out of work benefits. To justify the £4bn (€4.8 bn; $6bn) cut to out of work benefits, the coalition government associated the fact that the “welfare bill has risen by 45% in the past 10 years” with the “5 million people who are on out of work benefits” and suggests this rewards “social failure.”2

The portrayal of the workless poor as the cause of unsustainable welfare spending is disingenuous. Welfare expenditure has escalated because improved life expectancy has increased the proportion of the population above the state pension age and not because of increased public spending on out of work benefits. Expenditure on out of work benefits has actually declined slightly, particularly in more deprived areas. Furthermore, expenditure on benefits to pensioners has increased more in the most affluent areas. The higher life expectancy in these areas results in an older population and a higher proportion of the population claiming pensions. These trends will continue to diverge if health inequalities persist (figure).

Figure1

Expenditure on benefits to pensioners (basic state pension, pension credits, and winter fuel allowance) and on out of work benefits (job seeker’s allowance, employment support allowance, incapacity benefits, and income support)3 in most affluent and most deprived fifth of local authorities4 adjusted for inflation to 2010 prices. Predicted level estimated by applying 2010 expenditure per head to national age specific population projections5

The principle of the universal welfare state is that society as a whole benefits from the redistribution of support between groups and across the life course. Support for each group cannot be seen in isolation. Inequality in educational and employment opportunities means that greater welfare support is needed for those out of work in poorer areas, while the existence of health inequalities means that greater public resources are directed to support elderly people in more affluent areas.

Rather than victim blaming, we need to focus on a universal system of mutual security. The sad truth is that poor people save the state money in benefit payments—by dying earlier.

Notes

Cite this as: BMJ 2012;344:e537

Footnotes

  • Competing interests: None declared.

References

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