Health & welfare in a small farm future, Part 4

Here’s the final instalment in my series on health and welfare in a small farm future.This one started life as a draft book chapter, subsequently unpublished, and is herewith being put out to grass unamended as a blog post. Let me know if you’d like a full citation for any of the references at the end.

As previously related, I’m currently hard at work on a small writing project, so please forgive me if my activity on this blog takes a downturn over the next couple of months.

As proverbially social animals, humans look to each other for support through the vicissitudes of individual and collective life – sickness and disability, childhood and old age, mental and social needs, poverty and indigence, legal justice. Different political traditions or ideologies offer competing and often somewhat idealized visions of the good life, and how these vicissitudes can best be negotiated through it.

My account of a household-based small farm future is no exception. As I see it, household farming can bring multiple benefits to those that live it. The provisioning of healthy wholefoods through often vigorous activity promotes physical health. Working with intimately-known others within a wider community gives a sense of purpose and agency that promotes mental health. A carefully-constructed small farm society creates opportunities for almost everyone. Its norms of work and sharing help minimize indigence and squalor and promote care across the life-course. In this view, small farm society is almost its own welfare system. But, as with every political vision, no doubt the reality falls somewhat short of the ideal. And in any case, we need to attend precisely to those processes of careful construction in order to approach the ideal. How would people take care of each other in a small farm future?

Historically, the main institutions people have developed for collective welfare are:

• families or kin-groups
• self-organizing religious, civic or community organizations of one kind or another
• centralized states

In the wealthy countries today, centralized states have gradually come to assume extensive responsibility for the welfare of their subjects, arguably eroding the capacities of other, non-state institutions to do the job. Recent years have seen rising criticism from the political right of statist approaches to welfare, which has manifested in pushing back the responsibility for welfare onto families and civic organizations precisely when other demands and erosive forces have weakened their ability to assume it. Still, the truth is that the greatest burden of social care has always fallen outside the state onto kinsfolk – women in particular. Yet despite the conservative move against statist welfare, government welfare expenditures in the rich countries have only increased in recent years[i]. In fact, modern states are sometimes called ‘welfare capitalist’ to capture their dual role of fostering the capitalist economy and disbursing a portion of its product as social benefits.

In most plausible scenarios for humanity’s future it seems likely that there’ll be less financial capital available to pay for formal state welfare services, and probably less extensive networks of state infrastructure able to provide them. Certainly, this would be the case in the kind of small farm society that I’ve been advocating – a potentially troubling fact to reckon with. On the upside, it’s possible that while consumer demand in ‘welfare capitalist’ societies for both welfare and capital goods are almost unlimited, those in a small farm society would be more modest. This is partly because the demand for welfare is a function – potentially a ‘dysfunction’ – of all a society’s other activities. The self-reliant welfarism of a small farm society may therefore reduce its demand for formal welfare services. Another possible upside is that, like small-scale farming, human service jobs are generally high in labor-intensity and low in capital or carbon-intensity, and would therefore be especially complementary to a sustainable small farm future.

These upsides don’t short-circuit difficult questions – Who would pay for welfare? How, and how much? Who would provide it, who would receive it, and who might miss out? And what purposes would it serve, exactly? I can’t answer those questions in detail, but hopefully I can lay out some grounding principles and visions, which are most easily broached through reviewing the nature of state and non-state forms of welfare, as laid out in the table below.

Table: Welfare regimes, their strengths and weaknesses

The strengths and weaknesses identified in the table aren’t simply facts. To some extent, they represent characteristic political ideologies – broadly speaking, with the left in favor of state solutions and conservatives disfavoring them against non-state or private solutions. The right-hand side of the table conflates various non-state forms of welfare, which should probably be separated – private (family), community or commons, private market, religious and charitable – though arguably these do have some shared characteristics. Political views are such that there’s no universal agreement on the strengths and weaknesses of different forms of welfare, but most people will probably appreciate there’s at least some force to all the views encapsulated in the table. Below, I briefly review them before attempting a synthesis in the context of a small farm future.

Universal state provision of welfare can (#1) build a sense of shared community and participation within the political community. In Britain, for example, the National Health Service (NHS) is widely cherished for making healthcare available to all freely at the point of delivery based on need rather than ability to pay, standing in an important sense for what unites people as a nation. But in practice welfare is rarely universal, usually involving some kind of (#2) closure based on citizenship, insurance payments or other entitlement criteria. If this is true of state provision, it’s even more so with non-state welfare, which invariably comes with (#3) strings attached. This encompasses ability to pay in marketized welfare, or with the quid pro quo expectations of charitable donors like churches or individual ‘big men’, whether it’s a local landlord helping defray a tenant’s welfare costs or global ‘philanthrocapitalists’ like Bill Gates or Bono mobilizing for human welfare within conservative models of the capitalist status quo. Sometimes, especially where the writ of the formal state doesn’t run, welfare services are provided by criminal or terrorist organizations as a way of building local support, but with clear and troubling expectations placed on recipients. Within families, the provision of welfare can replicate existing power structures, often to the disproportionate benefit of senior men.

Another potential benefit of state provision is (#4) efficiency. For example, making books and magazines available to the public on a short-term or shared basis via a library is – in addition to the other benefits of public study space – a more efficient resource use than a system based on individualized purchase. A counter-argument from the right is that such collective provision (#5) erodes personal responsibility for self-care and distorts market signals for the efficient matching of supply with demand – as, for example, in the stereotype of the ‘welfare mother’ having too many children and doing too little work in response to child support payments. The evidence for this counter-argument generally is weak, and in any case neglects the wider contexts that condition human behavior[ii]. But it’s surely true that universal provision (#6) can remove welfare from the sphere of personal experience, which has potential downsides. For example, having lived for portions of my life with the responsibility of collecting my own water and generating my own electricity I’d suggest there’s an economy of scale to public provision of these utilities, but self-provision does tend to concentrate the mind regarding unnecessary use. More widely, inasmuch as we decide, for example, that care of children or elders is best left to paid professionals there are dangers in dividing people from one another across the life-course, whatever the other benefits.

As I’ve already suggested, the (#7) ‘self-welfare’ of the household or family farm can substitute for a good deal of formally-provided state welfare services, albeit with the danger of unequal internal power relations (#3). But it can’t provide everything. Often, wider (#8) local communities organize to self-provide welfare in a similar way, and with similar potential drawbacks.

It’s arguable that formal, state-provided welfare services themselves constitute a form of community self-organization achieved by predominantly (#9) working-class and minority activism to shape the nature of the modern state – for example maternity and childcare benefits that make child-bearing and rearing a public responsibility rather than a private burden that falls (#10) disproportionately on women and poorer families. On the other hand, it’s arguable that putting private welfare in the hands of the state makes people – working-class people in particular – subject to (#11) disciplining and regulation in state hands, and to increasingly pervasive and totalizing regimens of (#12) state surveillance that are often discriminatory. Historically, the distinction between the so-called ‘deserving’ and ‘undeserving’ poor has been endlessly recycled. Those defined in the ‘undeserving’ category have often been subjected to punitive regimes of welfare or its withholding that amount to blaming the victim[iii]. In early modern England, for example, widowed mothers of young children resident in a parish (sometimes known as ‘goodies’) were identified as worthy recipients of parish relief, while penniless male vagrants wandering in search of work or succor got shorter shrift, without much attention to the processes that had divorced them from land and sustenance[iv]. Perhaps the most stigmatized ‘vagrants’ or ‘undeserving poor’ in the rich countries today are undocumented international migrants – often represented negatively in much the same way as their early modern counterparts as aggressive young men on the move.

State discrimination extends into other kinds of ‘deviance’. For example, the 1988 Local Government Act in the UK forbade local councils from promoting homosexuality or teaching it as a “pretended family relationship” in schools. The act was fully repealed in 2003, and legislation enabling same-sex civil partnerships and later marriage was in force across most of the UK by 2014. No doubt this reflects changing social attitudes, but arguably the impetus for the partnership legislation had its basis in a conception of property-holder rights grounded in (#13) non-state, individualist identity activism. So ‘progressive’ change can come from market-based claims against the state rather than attempts to wrest control of state disciplining from within[v] – a point that fits with my arguments earlier in favor of inalienable private property rights. But it must be emphasized that whether we’re talking about working-class activism within the confines of state welfarism, individualist identity-based activism against it, or any other kind of claims-making within or against the state, people always jockey for position within the parameters of whatever socioeconomic structures they find themselves in at a given time. However obvious this point is, it’s easy to drift into arguments about the inherent advantages of ‘the market’, ‘the family’, ‘the state’ or ‘the commons’ as if these are invariant things with fixed characteristics that operate outside history. The truth is that in differing historical circumstances it may make the most sense to press claims for maternity care, say, or poverty relief within different combinations of any of these state or non-state structures.

Despite the disciplinary motivations of the state, one claim that’s often made in favor of state welfare is its superior potential for (#14) rational and fair universal coverage – as in the support for the British NHS. By contrast, welfare in the hands of more limited non-state actors can suffer from patchiness and (#15) poor coverage (‘postcode lotteries’), or come with (#3) strings attached. At worst, non-state welfare can be (#16) unfair, arbitrary or even abusive. Consider a situation in which children are viewed essentially as the property of their fathers, or in which local ‘justice’ is dispensed by vigilantes. On the other hand, the same accusation can be leveled at state welfare services – at best, (#17) unresponsive ‘one size fits all’ solutions, at worst flagrant abuse such as children’s homes rife with physical or sexual abuse, or police departments acting as paramilitary enforcement agencies for (#12) discriminatory surveillance and punishment[vi].

The universalism of state welfare can be compromised by (#18) both middle-class capture and middle-class flight. Examples of middle-class capture include locational advantages for accessing state services (such as the gentrification processes underlying the coincidence between ‘good’ schools, ‘good’ areas and ‘good’ students, or the similar ‘inverse care law’ in healthcare, where medical services are concentrated where they’re least needed[vii]) or the tendency for social policies favoring wealthier people (like low inheritance tax) to gain greater political traction than those favoring poorer ones (like high unemployment benefit). Examples of middle-class flight include market purchase of superior services (like private schools or health services) leaving state provision in the form of poorly-funded ‘Cinderella’ services with (#19) stigmatized clients and overworked, low-status employees. This contrasts with (#20) the more personalized client-focused services available within the private sector.

With good universal state provision, again there’s (#4) an efficiency argument for (#21) public sharing of expensively-trained and expert services (surgeons, for example) and directing them where they’re most needed. But there’s the counter-argument that (#22) professions tend to colonize aspects of life that ordinary people previously took care of themselves, thereby regulating them through closed ‘expert’ knowledges that often deliver more benefits to the expert or the state than the client[viii]. Similarly, (#23) welfare bureaucracies can become overly concerned with the size of their budgets and their political influence rather than staying focused on their service aims. Against this, there are strong arguments for (#24) re-empowering individuals or publics as their own experts, who are best placed to know what they need or want. The counter-argument to that counter-argument is perhaps made most forcefully in relation to various ‘alternative’ health therapies, which are dismissed for their (#25) lack of professionalism, lack of rigor, or outright quackery in respect of expert knowledges where, the argument goes, people aren’t best placed to know what they need.

It’s plain from this account that here, as ever, we face a range of trade-offs, compounded by differences of opinion that push the favored option one way or another according to one’s politics. So the notion that we can construct an idealized welfare system to tick all boxes is a non-starter. But perhaps we can say that welfare systems scoring high in columns 1 and 3 of Table 3.3 and low in columns 2 and 4 are preferable. And we can also say in view of the other arguments in this book that the ‘self-welfare’ system of household farming (#7) will likely loom large in the future, with support from collective self-welfare (#8). The future shape of the state is uncertain – we’ll consider it in more detail in Part IV – so the crucial relationship between localized ‘self-welfare’ and the wider state is difficult to construe. It seems likely that states will have less money to spend on welfare, and will therefore cede ground to local self-welfare of the kind that emerged, for example, in the wake of Greece’s financial crisis[ix]. So the biggest challenge may be in avoiding the outcomes in column 4 of the table.

In an influential book, sociologist Gøsta Esping-Andersen described three kinds of welfare regime in modern rich countries that provide food for thought in contemplating a small farm future[x]:

• ‘Liberal’ regimes involving a limited safety-net of means-tested assistance, often stigmatizing to its recipients.

• ‘Conservative’ regimes favoring family-based self-care, offering only limited support on the basis of traditionalist and gendered views of family structure.

• ‘Social democratic’ regimes offering universal access to high-quality welfare while decommodifying services to prevent differential access through private markets – therefore imposing a potentially high price for welfare services and incentivizing high employment to pay for them and a pre-emptive approach to minimize costs.

To my mind, the social democratic option is preferable, at the potential risk of some of the negatives in column 2. But in a small farm future, the fiscal capacity to provide extensive welfare would be lessened (as would, hopefully, some of the need for it compared to the capitalist present). So affordable levels of provision may look more like the limited safety-nets of the liberal and conservative regimes. In fact, the state in a small farm future might function more like some of the earliest states, primarily as a risk-pooling mechanism in times of dearth. I’d argue that a universalist public sphere or sense of shared community in which all people are valued equally as individuals and not differentially according to statuses (men or women, rich or poor, immigrant or indigene) is worth trying to preserve from the modernist social-democratic regimen, even if in practice it’s manifested locally in a mixed commons/private property regime with limited fiscal capacities which would push it toward more direct forms of support. This potentially cuts against the private power of families, households or communities to determine their own self-organizing circuits of welfare.

But a universal sense of shared community needn’t be the same as a pervasive regimen of disciplinary state power that determines minutely what is, so to speak, politically ‘correct’ – as is the case with the conservative regimes Esping-Andersen describes and their emphasis on particular kinds of family structure with gendered and sexual norms. Instead, the bounds of state universalism would be up for debate politically – as in the idea of the public sphere discussed earlier. What matters most is who’s able to participate in that debate. In a small farm future, the primary unit of welfare would most likely be the family – just as it still is in today, despite a long history of state centralization and pervasive political/feminist criticism – but ‘the family’ would hopefully be a contested idea, rather than a touchstone of traditional (male) authority.

I’d like to think that a small farm society constructed in this way wouldn’t feel the need for punitive forms of welfare. In a farming society of small proprietors the incentives to pull your weight are strong, and people who are unable to do so through illness, injury or more hidden injuries of the soul would inspire empathy of the ‘there but for grace of God go I’ variety more than censure. I’d like to think, too, that in such a small farm future we could carry with us something of Amartya Sen’s conception of ‘capabilities’[xi]. A fair society isn’t one that simply arranges for equality of access to service provision – so many years of schooling for all, so many doctors per capita population and so on – because for cascading reasons people have differential capabilities in turning that access into wellbeing. I think small farm societies can do a better job of equipping almost all their members with the capability to prosper in their own terms than modern capitalist ones, though they generally have less money at their command for doing so. What they have instead is land, and also – if they present their best face and find ways to avoid the narrow circle of status battles we examined earlier in F.G. Bailey’s ‘tragedy of approved mediocrity’ – empathy, labor and directed skill.

One way to mobilize these qualities in a money-poor, labor-rich small farm future is through (compulsory) civic service, with which various countries have experimented. In Western Europe, it often figured as an alternative to military conscription primarily for young adults in countries aiming to build national and civic identities as a bulwark against perceived Cold War threats from the communist east. With the end of the Cold War and the rise of neoliberalism its impetus has faded, but green thinkers have revived the idea in the form of ‘compulsory civic sustainability service’[xii]. I commend the idea for its ability to extend some of the benefits identified in columns 1 and 3 of Table 3.3 and limit the drawbacks in columns 2 and 4. In particular, I’d make the following points:

• Civic service is sometimes criticized as a cheap source of labor that decommodifies the market for welfare jobs, but since I’ve argued in this book that there’s a need for decommodification in the richer countries to build sustainable societies this argument loses its bite. Civic service provides a means for getting work done efficiently according to a society’s collective goals – in a small farm society, this would most likely be in agriculture and in human service.

• The surplus available for training highly-skilled experts would be limited in small farm societies, so the skills of such experts would be at a premium. Assistance from civic servitors would help extend expert reach. At the same time, it would demystify expert knowledge and hold experts to stronger public account – as for example if police officers were assisted in their duties by civilian servitors drawn from the communities they policed.

• Frontline exposure of all members of society to welfare recipients would bring people into contact with each other at a human level. This would destigmatize both the recipients and the workers performing low-skill welfare work, because everybody would have a hand in doing it.

• Civic service would counter the fragmentary tendencies of societies built around semi-autonomous farm households and help build wider social solidarity. Servitors would return to their families or households with wider knowledges of how other people behave, helping to check dysfunctional relationships within the farm household.

• Civic service would give people frontline experience of working in the underbelly of the human economy – delivering public goods, mitigating public bads. This would give them a more personal and granular sense of what membership in a political community means, and a strong experiential basis from which to articulate their own politics.

On the face of it, my arguments for welfare through access to inalienable private property rights in farmland and to civic service diverge from the case for universal basic income (UBI) which has been slowly building in recent years in the face of the many failures of existing welfare capitalism[xiii]. I won’t delve into UBI here, but my proposals are similar to the more ‘social democratic’ forms of it inasmuch as they emphasize using scarce resources as efficiently as possible to enable people to generate their own wellbeing within the structures of a wider society that recognizes individuals won’t always succeed in doing so alone, and therefore mobilize further resources to assist them. The difference is that small farm societies have difficulties generating large reserves of symbolic capital like money, so they have to provide welfare benefits mostly in kind rather than in cash.

In view of that limitation, it’s unlikely that expensive, high-tech welfare such as healthcare of the kind we’re used to in the rich countries will be widely sustainable in the future. Social equality, clean air and water, wholesome food, sound hygiene, good primary healthcare and basic secondary care may be as good as it gets. But in fact those things get us a long way – probably further than we currently are, since the ‘average’ global person lacks most of those things, creating a large additional burden of ill health[xiv]. I’m sure that when my time comes I’ll crave access to all the marvels in the book of modern medicine, but I’m equally sure that this isn’t the future that’s in store for humanity as a whole and it’s vain to pretend otherwise. It may be better to invest in dignified palliative care and a realistic philosophy for life’s end.

With social services and social security, the first and second port of call across the life-course will be kinship or friendship – the farm family (kinship) or the farm household and wider community (friendship). Again, the capabilities instilled through civic service, civic education and a farm upbringing are a fine prophylaxis against many troubles but not, of course, a foolproof one. In this section, I’ve tried to construe possibilities for a plurality of wider interventions into this household core – from the local community, civic servitors, charitable patrons, professional experts and from the centralized state – while being aware of their respective drawbacks. In a small farm future, affordable social services would most like tend toward the residual or ‘safety-net’ end of the spectrum, but hopefully not with discriminatory or disciplinary intent.

Likewise with policing. The kind that delivers public safety and the rule of law rather than the questionable self-welfare of the gun-toting householder or local vigilantism is a prime example of civic efficiency (Table 3.3, #4) and rational fairness (#14). Current policing delivers that for some (especially the white and wealthy), but for others it involves too much surveillance, discrimination, unresponsiveness and abuse (#12, #17). Police officers, like human service operatives, are ‘street level bureaucrats’ whose capacities and delegated decisions instantiate the state in our everyday lives[xv]. Ultimately, then, with policing and with all other areas of welfare, questions of how we would take care of each other, or fail to do so, in a small farm future devolve to how the state would interact with wider society and its different elements.

[i] See https://ourworldindata.org/government-spending.

[ii] E.g. Armstrong 2017; Ryan 1988.

[iii] Ryan 1988.

[iv] Laslett 2000.

[v] Fraser 2013; Linklater 2014, 89.

[vi] Vitale 2018.

[vii] Hart 1971.

[viii] Illich 2005.

[ix] Varvarousis and Kallis 2017.

[x] Esping-Andersen 1989.

[xi] Sen 2006.

[xii] Barry 2012; Smith 2004.

[xiii] Standing 2017.

[xiv] E.g. Marmot 2015.

[xv] Lipsky 2010.