by Daniel Béland and Alex Waddan
Canada and the United States are often described as liberal welfare regimes. They rely more extensively on social assistance-style programs and tax-subsidized private benefits and services than is the case in social democratic or corporatist welfare states. Yet, a closer look at these two countries illuminates key differences in areas such as health care, old-age pensions, family benefits and poverty alleviation.
Our new special issue of the Journal of Comparative and International Social Policy highlights recent social policy developments in Canada and the United States in ways that further illustrate the broad similarities, but also the key cross-national differences in policy design and real-world consequences.
Expansion in healthcare and pensions
This special issue is especially timely because it explores how, over the last decade, both Canada and the United States have seen major debates over social policy reform, which perhaps counter-intuitively, have focused at least as much on expansion as on austerity. The expansionary moves in the years since the Great Recession contrast to the situation witnessed in European countries as different as Greece and the United Kingdom, where the emphasis has been more one-dimensionally concentrated on social policy retrenchment. Yet, in the United States, the symbol of this expansionary push in the immediate aftermath of the Great Recession and during the Obama presidency (2009–2017) was the enactment in 2010 of the Affordable Care Act (ACA). This was a particularly bold move as the new administration was also dealing with an economic downturn on a scale not seen in the post-war era. This major piece of legislation has many moving parts that have not all been smoothly implemented, but it has still led to a major decline in the percentage of Americans living without health insurance. To the north, in Canada, perhaps the most significant example of social policy expansion during the last decade was the decision to increase the retirement benefits available through the Canada Pension Plan and the Québec Pension Plan, two highly coordinated earnings-related public pension programs that are at the core of the country’s old-age security system.
Yet, as Carolyn Hughes Tuohy, in her examination of health care in Canada and the United States, and Daniel Béland and Kent Weaver, in their study of pension reform in Canada, illustrate, these expansionary reforms have triggered much contentious debate both at federal and sub-national levels. For example, despite gaining some traction amongst the left of the Democratic Party, single-payer health care remains a political taboo in the political center in the United States. Hence, the country’s health care system remains heavily dependent on people accessing care through private health insurance, be that insurance provided as a reward of employment or purchased on an individual basis. Furthermore, even though the implementation of the ACA led to a reduction of the number of uninsured in the United States, many millions remain without insurance and many more in private health insurance plans that require individuals to bear significant ‘out-of-pocket’ co-payments or large deductible payments (excess payments). These factors suggest that large numbers of Americans will remain economically vulnerable should they have health problems.
In contrast, Canada’s ‘single payer’ system sees the government as the primary funder of health care services. Over time, this policy difference has become an important feature of Canadian national identity — a means by which it marks its distinctiveness from its economically dominant neighbour. This contrast seems likely to remain in place for some time to come.
Contradicting policies regarding women, motherhood and work
Another area of policy action has been in the crucial domain of gender equality. Yet even if governments have tried to move towards more gender-neutral frames, policy developments have remained rooted in gendered assumptions about vulnerability, employability, and disability. In both countries, policymakers have struggled to accommodate the increased anticipation that mothers will join the labour force within the framework built upon a ‘male-breadwinner’ family unit. In their exploration of this topic in the United States, Marie Laperrière, Ann Orloff, and Jane Pryma show how quite different policy logics can simultaneously be in process. For example, as mothers have become equally subject to the demands of commodification, policy proposals have taken supportive forms through ideas such as paid parental leave, but also coercive ones through measures such as work requirements.
In Canada, similar policy contradictions are also apparent. Susan Prentice and Linda White demonstrate that the expectations placed on mothers to enter the workforce have not been matched by social supports to enable that outcome. In both countries, the decentralization of much policymaking in this area has made for inconsistency.
Efforts at reducing poverty
Finally, there has been a growing public discussion of the consequences of rising economic inequality. But, in the aftermath of the Great Recession, it is also important to look at the narrower question of policy measures to reduce, or at least contain, the numbers of people living in poverty.
How did the Obama administration fare in this regard in the United States? In his examination of this question, Alex Waddan finds that while administration efforts did limit the impact of the Great Recession on poverty rates, this was achieved mostly by expanding existing programs rather than through bold innovation. Hence, whatever the advantages of the administration’s approach in political terms, the decision to tackle poverty through ‘stealth-like’ measures meant that there was no possibility of reviving the grand ambitions of the ‘War on Poverty’. Yet, the expansion of the Medicaid program, as part of the Affordable Care Act, was a more important change to the ideas underpinning the program than is often understood.
As it was initially written, the ACA effectively required states to expand their Medicaid programs to cover everyone with an income below 138 percent of the federal poverty level. This measure was not heralded as a direct anti-poverty policy and its impact was reduced by a 2012 Supreme Court decision that gave states an option not to join the expansion. Yet, it intended that states could no longer impose ‘morality based’ conditions on Medicaid eligibility beyond a means test. As for February 13, 2019, 36 states plus Washington DC had expanded their programs, but 14 states, including Florida, Georgia and Texas had not done so.
In Canada, policy development also needs to be studied at the provincial level where poverty reduction strategies (PRS) have been tested. In his study, Charles Plante finds that poverty rates mostly fell before the implementation of these strategies, but there is still some cause for optimism in the use of PRS as they change institutional relationships and future expectations while drawing more public attention to the issue of poverty alleviation. They also offer opportunities for policy learning about what may actually work in the future.
Resurgent racism in education policy
In the United States, more explicitly than in Canada, race remains core to policy development, with disturbing evidence that there has been some reversal of social progress in terms of racial integration in schools. Richard Johnson and Desmond King suggest that, while some states have continued efforts to further integrate schools, there have been racist moves to reverse desegregation efforts in some Republican-controlled states. Using language apparently responsive to local concerns, such as ‘neighbourhood schools’, which is a coded call for racially homogenous rather than diverse school communities, Republican political actors have moved to encourage school district secession, effectively resulting in school re-segregation. The consequences of this are negative across the board, with evidence showing that African American children who attend integrated schools are likely to have better educational outcomes, while white children who attend heterogeneous schools fare equally as well as white children in predominantly white schools.
The evidence from our special issue suggests that Canada and the United States remain unidentical twins, facing similar socio-economic challenges but frequently mobilizing different policy instruments to address them. Simultaneously, these two cases suggest that social policy expansion remains on the agenda despite ongoing economic and political pressures towards fiscal austerity. This is, in part, why they remain fascinating cases for the comparative study of social policy reform in a rapidly changing world.
Daniel Béland is Director of the McGill Institute for the Study of Canada (MISC) and Professor of Political Science at McGill University (Montreal, Canada). You can follow him on Twitter @danielbeland and consult his website to find more about his social policy research and publications.
Alex Waddan is an Associate Professor in Politics in the School of History, Politics and International Relations at the University of Leicester. You can look at his website to find out more about his research and publications.
This blog is based on the contents of a special issue of the Journal of Comparative and International Social Policy co-edited by Daniel Béland and Alex Waddan.