Targets and Taxes: Explaining the Welfare Orientations of the Australian Public

Australia's welfare model – targeted payments alongside low but progressive taxation – exemplifies the targeted approach, prioritizing the needs of poorer citizens within the constraints of low taxation. But does this approach match the welfare orientations of Australia's voters? Does the public hold other views about welfare, emerging out of competing interests in welfare debates? We consider results of two questions included in the Australian Survey of Social Attitudes 2005. The first question asks respondents about four welfare goals that outline competing welfare orientations: targeting poverty, expanding health and education, enforcing the welfare rules and reducing welfare. The second question asks about four taxation goals drawing on similar orientations as established for welfare: targeting tax cuts, taxing for welfare, enforcing tax rules and reducing overall tax. Asking about both enables us to tell whether voters approach tax and welfare ‘consistently’ and to see whether, in Australia's case, there is a preference for Australia's targeting model. We reach three conclusions: (1) voters hold diverse preferences about welfare and taxes, but the targeted model has a relatively strong voter base; (2) voters hold ‘pro‐welfare’ orientations, choosing poverty reduction and expanding public services over both paternalism and cutting welfare, and (3) multivariate analysis indicates a level of consistency in welfare and tax orientations among voters.     

“Respect for each gender”: Gender,equity and backlash in Australia's male health policy

Australia is one of the few countries which has specific health policies for boys/men and girls/women as distinct groups. In this article I present an analysis of the discourses of gender, equity and disadvantage drawn upon in Australia's men's health policy. Through comparison with the women's health policy, I show that a dual focus on the essential differences between men and women and the ways in which the health system has failed men contribute to an adversarial gender politics, positioning men and women as rivals with competing needs. Reflecting broader debates concerning the negative impact of societal change on boys/men, I argue that, in its current form, Australia's health policy both taps into and, crucially, legitimises backlash politics, enabling it to ‘pass’ as sound public policy.     

The challenge of quantifying national well-being: lessons from the Measures of Australia's Progress initiative

ABSTRACT

In recent decades, the use of gross domestic product (GDP) as a proxy for national well-being has been criticised on the grounds it excludes important social and ecological considerations. Several alternatives have been proposed that promise to generate more comprehensive and balanced quantitative measures of well-being, but all of these alternative indicators remain contested and controversial. This paper critically reviews Australia's contribution to this effort: the Australian Bureau of Statistics’ (ABS's) Measures of Australia's Progress initiative. Unlike many other alternatives to GDP, the Australian initiative does not settle on one measure but uses expert-mediated public consultation to establish a ‘dashboard’ of indicators. In so doing, this model makes explicit the serious challenges confronting efforts to coherently define and measure progress in late modernity. In its attempt to integrate diverse views on national progress, the ABS has created an ambiguous tool that is not being taken up in public and political discourse.     

Just deserts? ‘Privatisation’ and the history of deservingness in Australia's retirement incomes system

Over the last few decades, changes in Australia's retirement incomes policy, including the introduction of compulsory superannuation, have seen governments encourage individuals to provide for their own old age from private means. This process has been described as ‘privatisation’ of retirement incomes. However, beyond the ‘privatisation’ thesis, there has been little critical examination of what these changes have meant for the nature and relative importance of the different principles underpinning Australia's retirement incomes system. This paper aims to provide such an examination. Drawing on the principles of deservingness and need, the paper provides an historical analysis of the development of Australia's retirement incomes system, tracing how these two principles underpinned the first age pension and subsequently contributed to the emergence of compulsory superannuation. This approach provides a deeper understanding of how contemporary policy changes have altered the structure of Australia's retirement incomes system, arguing that there are important historical continuities as well as changes. It argues that the phrase ‘state‐supported private saving’, rather than ‘privatisation’, captures the nature of this contemporary reform process.     

‘Genuine’ refugees or illegitimate ‘boat people‘: Political constructions of asylum seekers and refugees in the Malaysia Deal debate

Immigration to Australia has long been the focus of negative political interest. In recent times, the proposal of exclusionary policies such as the Malaysia Deal in 2011 has fuelled further debate. In these debates, Federal politicians often describe asylum seekers and refugees as ‘illegal’, ‘queue jumpers’, and ‘boat people’. This article examines the political construction of asylum seekers and refugees during debates surrounding the Malaysia Deal in the Federal Parliament of Australia. Hansard parliamentary debates were analysed to identify the underlying themes and constructions that permeate political discourse about asylum seekers and refugees. We argue that asylum seekers arriving in Australia by boat were constructed as threatening to Australia's national identity and border security, and were labelled as ‘illegitimate’. A dichotomous characterisation of legitimacy pervades the discourse about asylum seekers, with this group constructed either as legitimate humanitarian refugees or as illegitimate ‘boat arrivals’. Parliamentarians apply the label of legitimacy based on implicit criteria concerning the mode of arrival of asylum seekers, their respect for the so‐called ‘queue’, and their ability to pay to travel to Australia. These constructions result in the misrepresentation of asylum seekers as illegitimate, undermining their right to protection under Australia's laws and international obligations.     

Ageing and Family Dependency

The ‘graying’ of Australia's population has generated much debate within government, demographic, health and social service circles in recent times. Current and projected shifts in population structure towards greater numbers of ‘dependent’ populations raise a number of complex issues in regard to resource allocation in both income support and service provision. Service issues revolve around questions of whether public or private provision will resolve the care issues for dependent elderly people. It is argued that contrary to popular opinion, family care is well entrenched within the framework of social care, and that the solution of community care, posited in relation to the rising levels of chronic illness and dependency within the elderly population, is actually an attempt to place more responsibility of care on to the family. It is further suggested that family care is, in fact, care by women who themselves are in a state of dependency. Citing evidence from a study conducted by the authors, the paper argues that family care imposes heavy burdens upon women and families and suggests that social policy should, firstly, actively bolster family care through the provision of supportive and supplementary services; and secondly, broaden its intent by exploring other options of care for elderly people. The latter response is important because without it, family care will only help to reinforce and sustain the dependent status of women.     

PHARMACEUTICAL BENEFITS IN AUSTRALIA AND SWEDEN: WELFARE POLICY AND THE COST OF PRESCRIPTION DRUGS

Pharmaceutical benefits provide a stable framework within which consumers, prescribers, suppliers, pharmacists and other actors undertake transactions. The state in effect delivers a good that enhances individual autonomy. A major reason for the legitimacy enjoyed by pharmaceutical benefits in both Australia and Sweden is that these programs have strong attributes of universalism (rather than targeting). Sweden's predominantly public health system allows greater scope for pharmaceutical policy innovation. Australia's Pharmaceutical Benefits Scheme (PBS), while historically resilient and effective, is now wedged precariously between traditional considerations of equity and public health on the one hand, and constant pressure for increased marketisation on the other.     

Labour Force Participation,Social Inclusion and the Fair Work Act: Current and Carbon‐Constrained Contexts

The notion that employment is a precondition for personal wellbeing and social inclusion is almost sacrosanct in Australian culture. Yet, the working and living conditions of Australia's low paid workers tells a different story. While labour market participation is a cornerstone of the Federal Government's Social Inclusion Agenda, it is recognized that low pay and poor job quality often derail this key objective. Indeed, the difficulty of ‘making work pay’ at the bottom end of the labour market is a social inclusion challenge that has yet to receive the policy or public attention that it warrants. This article considers what the Fair Work Act means for the social inclusion of disadvantaged workers, in the context of wider‐ranging strategies to address low pay. It concludes with some considerations of the challenges that a carbon‐constrained economy is likely to present for labour force participation as a remedy for social exclusion.     

Back at the Crossroads: The Slippery Fish of Australian Retirement Income Policy

Australia's retirement income arrangements had reached a policy crossroad by the early 1980s. Not unlike the proverbial slippery fish, the goals and roles of its constituent elements were very difficult to grasp. The ensuing reforms of the 1980s and 1990s brought increasing coherence to these arrangements. Some of the more recent changes, however, have once again introduced policy slipperiness through creating a system that is at odds with the intent of the earlier reform efforts. Indeed, Australia's retirement income arrangements have morphed into a system whose function is no longer simply to protect workers from the loss of earned income arising from retirement. The ‘zenith’ of this situation was reached in July 2007 when the major changes in superannuation announced in the 2006 federal budget took effect. Thus, Australia is once again back at a policy crossroad as far as her retirement income arrangements are concerned.     

A Comparison of the Effects of Material and Environmental Values on Vehicle Ownership

The results of a 1988 survey of Brisbane residents demonstrate a consistent linkage between the respondent's values and their preferences for vehicle ownership and use. Through the use of the ‘Dominant Social Paradigm’ - ‘New Environmental Paradigm’ theoretical framework (e.g. Cotgrove 1982) and the testing of ‘known groups’ (business people and members of the Rainbow Alliance) the following pattern emerged. The businesspeople were less willing to conserve fuel, and were more concerned with ‘comfort’ considerations when purchasing a motor vehicle than the Rainbow Alliance respondents who were more interested in utilitarian aspects. When subsamples with similar demographic/socioeconomic characteristics (males, respondents aged 35–49 years, respondents with household incomes between $20 000 and $49 999) were compared, the Rainbow Alliance respondents were more likely to own older, less valuable vehicles with small engines and manual transmissions. The businesspeople were more likely to own air-conditioned vehicles with poor fuel economy. This finding is an example of how people's values influence their vehicle purchasing decisions and is useful to policy-makers seeking to improve the efficiency of Australia's vehicle fleet.     

Do public pensions matter for health and wellbeing among retired persons? Basic and income security pensions across 13 Western European countries

Esser I, Palme J. Do public pensions matter for health and wellbeing among retired persons? Basic and income security pensions across 13 Western European countries Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. Mortality rates suggest that elderly people in the advanced welfare democracies have experienced dramatically improved health over the past decades. This study examined the importance of public pensions for self‐reported health and wellbeing among retired persons in 13 Organisation for Economic Cooperation and Development countries in 2002–2005. New public pension data make it possible to distinguish between two qualities of pension systems: ‘basic security’ for those who have no or a short work history, and ‘income security’ for those with a more extensive contribution record. For enhanced cross‐national comparison, relative measures of ill‐health and wellbeing were constructed to account for cultural bias in responses to survey questions and heterogeneity among countries in the general level of population health. Overall, better health is found in countries with more generous pensions, although the results are gendered; for women's health, high basic security of the pension system appears to be particularly important. Women's wellbeing also tends to be more dependent on the quality of basic security.     

ANCILLARY AND SPECIALIST HEALTH SERVICES: THE RELATIONSHIP BETWEEN INCOME,USER RATES AND EQUITY OF ACCESS

Australia's public health system currently provides substantial funding to, amongst its other objectives, ensure access to hospital, medical and pharmaceutical services by all families irrespective of income (McClelland, 1991, p. 6). However most ancillary services are not similarly subsidised and there is some evidence that income presents a barrier to the use of these services. There is also evidence that low income might also reduce access to specialist medical practitioner services which, while funded through Medicare, are less likely to be bulk billed than general practitioner services, and which therefore attract higher out-of pocket costs. In this study, the 1989–90 National Health Survey is used to examine whether there are indicators that low income reduces access to a range of ancillary services such as physiotherapy, optician services, chiropractic and dental services and to specialist medical practitioner services.     

Contextualising the ‘Crisis in Aged Care’ in Australia : A Demographic Perspective

Australia's ‘old‐old’ population is growing even faster than the total aged population and despite improved incomes, living conditions, health risk behaviours and health care this will result in a concomitant increase in the numbers of older people with disabilities. This paper examines ABS 2003 survey data on the incidence of disability among older Australians and their need for, and utilisation of, formal and informal care. It uses this as a basis for projecting the incidence of disability among older Australians and the need for informal and formal care up to 2031. These indicate there is a major challenge since the aged care workforce has grown only slowly in Australia and is concentrated in the older working ages presaging a loss of workers through retirement. There needs to be a significant effort put into attracting workers to both the skilled and unskilled parts of the aged care industry.     

WHO BUYS HEALTH INSURANCE? A SURVEY OF TWO LARGE ORGANISATIONS

Despite the importance of private insurance in the financing of Australia's health care system, there have been few studies of health insurance choice. A survey was carried out of employees of two large organisations to serve as a reference group for middle-income people in secure employment. Insurance was associated with income, age, marital status and history of medical costs; but not dependents or hospital expenses. Main determinants of level of cover were income and medical costs. In making decisions, information search was low and decisions seem to be made on the basis of simple risk aversion, influenced by insurers' advertising.     

Managing Communication: Appropriate Behaviour in Medical Consultations

The interaction process between doctors and their patients represents a relatively infrequently explored strand of medical sociology. This paper is primarily concerned with one aspect of the attitudes and expectations which both doctors and patients bring to their interaction—the role which the patient is expected to play in the medical consultation. The data provide a detailed picture of the sorts of things which it was felt that patients should and should not do. Furthermore, the data indicate a high degree of overlap between doctors' and patients' views on what characteristics are representative of ‘good’ and ‘bad’ patients. Finally, some consideration is given to the implications of what is seen to be ‘appropriate’ behaviour in medical consultations for broader health care outcomes.     

Ambiguity and Cooperation in the Implementation of Adult Protection Policy

Using a classification of public policy developed by Matland, we examine implementation of policy on adult protection as outlined in ‘No Secrets’, the government's guidance to local agencies. This policy appears to exemplify a ‘high‐ambiguity/low‐conflict’ model. Detailed interviews with staff charged with developing multi‐agency procedures, in local authority departments, health authorities, the police and the voluntary sector, confirmed the ambiguity of the policy and the uncertainty experienced by staff as a consequence. However, the interviews also revealed a number of areas of conflict, particularly as people gave precedence to their own professional norms and organizational priorities over partnership working.     

Major, Blair and the Third Way in Social Policy

Tony Blair's adoption of the catchphrase ‘the Third Way’ to précis New Labour's policy orientation allowed him to distance ‘New’ Labour from ‘Old’ Labour and to appropriate many of John Major's modifications to Thatcherism, albeit framed within a new political language. This article sets out the basic similarities and differences between the social policies of the Major and Blair governments, arguing that, although the policies have been presented within different discourses, there has been a marked similarity in policy content, with Major espousing Third Way policies if not Third Way rhetoric. Indeed, towards the end of his second term of office, Blair started to go beyond the Third Way and towards Margaret Thatcher's favoured model of spirited competition between public and private suppliers.     

Is ‘Candidacy’ a Useful Concept for Understanding Journeys through Public Services? A Critical Interpretive Literature Synthesis

Across the public sector there is concern that service uptake is inequitably distributed by socio‐economic circumstances and that public provision exacerbates the existence of inequalities either because services are not allocated by need or because of differential patterns of uptake between the most and least affluent groups. A concept that offers potential to understand access and utilization is ‘candidacy’ which has been used to explain access to, and utilization of, healthcare. The concept suggests that an individual's identification of his or her ‘candidacy’ for health services is structurally, culturally, organizationally and professionally constructed, and helps to explain why those in deprived circumstances make less use of services than the more affluent. In this article we assess the fit of candidacy to other public services using a Critical Interpretive Synthesis of three case studies literatures relating to: domestic abuse, higher education and environmental services. We find high levels of congruence between ‘candidacy’ and the sampled literatures on access/utilization of services. We find, however, that the concept needs to be refined. In particular, we distinguish between micro, meso and macro factors that play into the identification, sustaining and resolution of candidacy, and demonstrate the plural nature of candidacies. We argue that this refined model of candidacy should be tested empirically beyond and within health. More specifically, in the current economic context, we suggest that it becomes imperative to better understand how access to public services is influenced by multiple factors including changing discourses of deservedness and fairness, and by stringent reductions in the public purse.     

Local therapy facilitators working with children with developmental delay in rural and remote areas of western New South Wales,Australia: the ‘Outback’ service delivery model

Australia's dispersed population in rural areas contributes to poor access to therapy services and the inability of the existing rural therapy workforce to meet demand. As a result, rural children with a developmental delay wait a long time for therapy. This paper describes participant perceptions of a therapy facilitation service model that has worked to improve access to therapy for children in these circumstances. The model, given the pseudonym ‘Outback’, operates in rural and remote areas of western New South Wales. ‘Outback’ employs local people to work under the guidance of therapists based in larger centres to provide preschool children with developmental delays with access to therapy interventions they might not otherwise receive. A two‐stage case study design involving focus groups and interviews with the director, four therapy facilitators, nine therapists, and seven carers was used. Three themes were identified as central to the service model: 1) being part of the local community; 2) developing therapy facilitator knowledge and skills; 3) improving access to therapy intervention for children in rural and remote areas. The ‘Outback’ model demonstrates that appropriately supported, local therapy facilitators provide a flexible workforce adjunct that expands the reach of therapists into rural and remote communities and enhances service access for children and their families.