Social Policy Interventions and Health

It’s a breath of fresh air to read this so soon after reading about austerity. In fact, it seems like the CCT programs are the near opposite of austerity. If austerity is a direct cut to health programs in order to preserve economic standing, CCT programs in Latin American countries are an indirect way to improve health conditions by bolstering the economic standing of the poor at taxpayer’s expense. I can understand some reasons why a program like this would not take off in America – the heavy influence of conservatives and the stigma against welfare recipients, for example – although the reading did indicate that such policies were implemented in New York, despite facing opposition on two sides. The conservative criticisms of Opportunity NYC made me laugh, given how predictably out-of-touch-with-reality the critics revealed themselves to be with their statements. However, I do think that the liberal critics had a point. I think that when you offer people rewards based on certain “behaviors”, you walk a fine line that could eventually fall into respectability politics. What is a “good” welfare recipient? Who is deserving of aid and who is not, even though they’re all poor and starving? How soon until the conditionalities start to become subtly dictated by race, gender, sexuality, and class? While the Brazilian and Mexican CCT programs showed intense amuonts of generosity, all it takes is one corrupt program director to turn everything on its head.

This is an even more legitimate fear, in my opinion, when you consider that in “developed countries” such as ours, availability of healthcare has little to do with health equality. The example they gave, for example, of New Jersey Asian women living to 91 and Dakotan Native American men living to 58. The reasons behind this are easily uncovered through a quick game of Oppression Olympics. Comparing the treatment of Native Americans historically to that of Asian Americans will tell you all you need to know. So in America, where so many policies are dictated by racist, sexist, homophobic, or transphobic ideology on a subtextual level, would CCT programs be able to take hold without also being dictated by such prejudices, especially with the anti-Blackness and misogynoir that has taken root in American welfare discussions since the Reagan era? It would probably require a complete refocusing of welfare and how we as a nation view it. But we’d have to get past the conservatives on that one.

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