Sustainable Social Policy: Fighting Poverty Without Poverty Programs



Universal versus Targeted Policies





    Whether we like it or not, some voters clearly prefer to punish the underclass rather than to help it. Many of those who make it on their own and "earn their own way" define themselves in self-conscious contrast to the poor. In their minds programs targeted to the poor take on all the negative stereotypes of the poor themselves. That may well be the reason why cross-national research on social expenditures finds that in democracies universal programs are more sustainable, even if more expensive, than policies targeted to the poor or other "marginal" social groups.

    Are we left, then, with a stand-off, in which advocates of universalism and advocates of targeting each explain cogently why the other's solutions are likely to be unsuccessful or unattainable? So far as speculative arguments are concerned, there certainly is a stand-off. Yet I think we can draw two conclusions from the history of social provision in the United States. First, targeted antipoverty efforts have generally been inadequately funded, demeaning to the poor, and politically unsustainable. Second, some kinds of (relatively) universal social policy have succeeded politically. And within the framework of universal programs, less privileged people have received extra benefits without stigma. I call this pattern "targeting within universalism" and suggest it could become the basis for a revitalized strategy against poverty.

    The Travails of Targeting
    Without plunging into a detailed discussion of all governmental approaches to poverty in U.S. history, we can look quickly at some of the most important initiatives. In each case -- poorhouses in the nineteenth century, mothers' pensions in the early twentieth century, and the War on Poverty and subsequent reforms of the late 1960s and early 1970s -- the high hopes of reformers soon collided with the rock-hard realities of politics.

    The Rise and Fall of the Poorhouse. Nineteenth-century debates about antipoverty policy often concerned a choice between "indoor relief" in poorhouses and "outdoor relief," that is, assistance to the poor living outside institutional walls. Reformers before the Civil War often preferred indoor relief because of its presumed potential to reduce costs and improve the behavior of the poor. Like the mental asylum, the poorhouse was an institution aimed at reforming the habits and morals of defective people as well as preventing such abuses as the shunting of paupers from town to town. Adults would be put to character-building work and children sent to school. Fueled by these hopes, reformers peppered almshouses across most of the settled United States, except the rural South.

    By the 1850s, however, poorhouses were clearly not working as intended. As Michael Katz puts it in his recent history of poverty policy, In the Shadow of the Poor House, a "preoccupation with order, routine, and [low] cost replaced the founders' concern with the transformation of character and social reform." In practice it turned out to cost more to maintain people in institutions than in homes, and most poorhouses were never adequately funded in the first place. They failed to help needy inmates and quickly became prey to corrupt managers who made special deals with merchants and doctors. Appropriate work was often not devised for able-bodied paupers, and the old, insane, and children were simply shut up and often preyed upon by others. Furthermore, poorhouses did not always "discipline" poor people, who sometimes learned to come and go as they wished in response to the ebb and flow of outside opportunities.

    Before long, poorhouses lost broad support, and further movements were launched to abolish all forms of outdoor and indoor public assistance for the able-bodied and to create more specialized institutions for subgroups such as orphans and the insane. Surviving poorhouses served mainly as miserable, negative warnings to working people to avoid dependency at all costs. By the turn of the century, poorhouses were principally old-age homes for those unlucky enough to lack resources and family ties. Meanwhile, destitution and dependency proliferated along with industrialism.

    Pensions for Mothers. Mothers' pension laws swept across forty states between 1911 and 1920 and were enacted by four more before 1931. These laws allowed localities to give benefits to widowed mothers, and sometimes other caretakers, who had charge of dependent children. Federations of elite and middle-class married women were the impetus behind mothers' pensions. The National Congress of Mothers, the General Federation of Women's Clubs, and the Women's Christian Temperance Union argued that impoverished widowed mothers should not have to accept low-wage labor to survive, nor should they be forced to give up their children to custodial institutions. Above all, they should not be stigmatized as paupers. Instead, the women's associations argued, all mothers should be honored for their child-nurturing service and adequately supported by government, like disabled veteran soldiers, when their ordinary sources of support -- breadwinner husbands -- were not available.

    Despite the generous intentions and broad popular support behind mothers' pensions, they evolved into one of the most socially demeaning and poorly funded public welfare programs. Mothers' pensions were implemented only in some predominantly urban, local jurisdictions, leaving many widowed mothers, including most nonwhites, unable even to apply for benefits. Where established, the local programs were starved for funds by communities reluctant to spend taxpayers' money on the poor. With meager benefits, many clients could not avoid working for wages or taking in (male) boarders, even though doing so opened them to charges of child neglect and immorality. Social workers, whose organizations had originally opposed mothers' pensions, became local administrators and caseworkers after the laws passed. Hypersensitive to possible accusations of political corruption and lacking sufficient resources to help all needy applicants, the social workers applied eligibility rules and carried out "proper home" investigations with a vengeance.


    When mothers' pensions were federalized as Aid to Dependent Children (ADC) under the Social Security Act of 1935, benefit levels and administrative procedures remained decentralized and the tradition of low funding continued. At first, the federal government offered only one-third matching funds to the states. The 1939 Amendments to the Social Security Act increased the federal proportion to one half, but also removed from ADC the very "worthy widows" who had originally embodied reformers' hopes to make this an honorable form of social provision. Henceforth, surviving dependents of contributing wage-workers were to be covered by Social Security's Old Age and Survivors Insurance, leaving poorer caretakers of children, increasingly women without conventional family histories, as the residual clients to be helped by ADC (later renamed Aid to Families with Dependent Children, or AFDC). Nationwide citizen support never emerged for this program as it did for Social Security. Benefits remained stingy and geographically uneven, and surveillance by social workers became even more intrusive once blacks and unmarried mothers became the program's major beneficiaries. Directly contradicting the original sponsors' plans, mothers' pensions evolved into the core program of what today is pejoratively known as "welfare."

    The Limits of the War on Poverty. Antipoverty efforts reached unprecedented visibility and scale between the early 1960s and middle 1970s. Though the elderly gained more from the social policy changes of this era, the non-elderly poor were the more visible concern, especially of the widely trumpeted War on Poverty. As before in American history, antipoverty reformers dreamed of educating the poor to take advantage of economic opportunities, especially by reforming juvenile delinquents, giving children a "head start," improving the schools, and offering job training to adults. The Great Society also sought to improve access to medical care for both the poor and the elderly. Under President Nixon, income transfers to the poor also grew significantly. Between 1969 and 1974, aid targeted to the poor almost tripled, much of it channeled through programs such as Food Stamps, Medicaid, and housing subsidies. Throughout this period, too, Aid to Families with Dependent Children expanded, as states eased eligibility rules in response to changing federal regulations and incentives.

    Our evaluation of the era's initiatives against poverty must be mixed. Many people certainly were helped. Elderly Americans, including the impecunious elderly, benefited enormously from the enactment of Medicare, increases in Social Security, and the nationalization of need-based, old-age assistance with the adoption of the Supplemental Security Income (SSI) program in 1974. Community action projects launched many local black activists into political careers. Many poor women and their families, often from minority groups, were newly sustained by the expanded programs of this period. Overall, according to John Schwarz's estimates in his study America's Hidden Success, economic expansion between 1965 and 1972 lifted out of poverty only about one-tenth of the 21.3 percent of Americans who were below the poverty line in 1965. Government programs, on the other hand, lifted above the poverty line more than half of the remaining number.

    Yet both the services and income transfers of the period failed to reduce poverty rates greatly among Americans under age 65. And the programs certainly failed to reverse such worrisome trends as the rise in out-of-wedlock births and mother-only family units. Antipoverty warriors can argue that nowhere near enough was ever done or spent to make either services or transfers sufficient to end poverty or to reduce pathologies among the severely disadvantaged.

    But that rejoinder only brings us to the more fundamental difficulty. The antipoverty services and increased expenditures on the non-elderly poor of the 1960s and early 1970s very soon generated a political backlash that blocked their further extension. The Community Action Program helped to mobilize poor people, especially blacks, but these efforts were quickly de-emphasized by President Johnson in response to angry local Democratic leaders. President Nixon had no interest in enlarging the flow of federal money to groups and local governments hostile to his administration. Surviving social service programs were also highly vulnerable to charges of corruption in unfavorable political climates.

    Even the broader income transfers emphasized during the later Johnson and Nixon years ended up backfiring politically against lower-income Americans, blacks, and the Democratic Party. In due course they fell victim to Jimmy Carter's retrenchments, intense conservative intellectual and political attacks, and the cuts of the Reagan era. During the 1970s public opinion polls recorded decreasing levels of support for government efforts to aid minorities and for public social spending. Support declined especially for stigmatized service programs popularly identified with poor blacks. Electorally, blacks in general remained staunchly Democratic and in favor of strengthened governmental social programs. But union members, white urban ethnics, and white Southerners moved away from the Democratic Party, especially in presidential elections. The perceived Democratic Party position on racial and welfare issues contributed to these defections.

    This political situation was rooted in a split between people who benefited most from policy changes and people who saw themselves as burdened with higher taxes. Surely many working- and middleclass families have elderly parents or grandparents who gained from Medicare and increases in Social Security, but higher "welfare" transfers to the poor produced no gain for them. Meanwhile, these working- and middle-class families faced rising tax burdens from government at all levels. Little wonder, then, that many found appealing Ronald Reagan's tax cuts and his generalized attacks on government's social role. Although Reagan's efforts were not as successful as often supposed, the political and intellectual discourse of the 1980s has scarcely reversed the wide hostility toward "big government" and "throwing money" at poor people. Redistributive benefits or targeted services for the poor alone are highly unlikely to regain favor at this point. We still live amidst the political backlash against the War on Poverty and the Great Society.

    Universal Programs that Reach the Poor
    While targeted programs generate forces that undo their aims, social policies that deliver benefits across classes and races generate broad, cross-class political coalitions that sustain and protect the policies. What is more, universalistic programs have sustained moral imageries that allow the programs to redistribute income and deliver special services to disadvantaged Americans without risking public disaffection and political backlash. For much of American history, universal, locally supported public education has helped poor as well as more privileged children. Here I focus on federal social policies.

    Civil War Benefits: Aid for a Worthy Generation. Benefits to Civil War veterans are not often considered in histories of public social provision in the United States. But between the 1870s and early 1900s, veterans' pensions, disability, and survivors' benefits evolved into a massive, de facto system of public support for an aging generation of Northern men who could demonstrate even minimal service in the Union armies. Unrestricted by any means test, Civil War pensions absorbed from one-fifth to one-third of the federal budget between the 1880s and the 1910s. By 1910 approximately 29 percent of American men over age 65 (along with approximately 8 percent of elderly women and various other younger women, children, and other dependents of deceased men) were receiving benefits that were remarkably generous by contemporary international standards. While German old-age pensions were averaging only about 18 percent of annual earnings, U.S. military pensions in 1910 averaged about 30 percent.

    To be sure, ethnic and class differences showed up in the distribution of benefits. Civil War pensions went to native-born Northerners and to northern and central Europeans who had come to the North prior to the 1860s. By the late nineteenth century, the Union veterans were disproportionately likely to include farmers, skilled workers, and members of the middle class. Left out of the pension system were Southern whites and most Southern blacks as well as most immigrants from southern and central Europe, who came to America after the Civil War and were then disproportionately low-skilled urban workers. Nevertheless, black veterans and their survivors did qualify for full benefits, and the number eligible was significant because more than 186,000 blacks had served in the Union armies. Even among whites, veterans' pensions helped many who were economically disadvantaged as well as those who had done well during their working lives but then became impoverished in old age.

    Within the overall system of Civil War benefits, moreover, special aid beyond the federal pensions was available to the neediest veterans and their dependents. Some states, such as Massachusetts, offered generous public assistance to needy veterans in their own homes. Starting in 1888, the federal government offered subsidies for state-run veterans' homes. By 1910,31,830 Union veterans, or about five percent of those still living, were being housed in veterans' old-age homes across the country. These men had typically been skilled workers; few were middle-class.

    Conceived as a repayment for service to the nation and in explicit opposition to poor relief, these veterans' benefits were unequivocally honorable. Broad political coalitions agitated for benefit increases. Though the Republican Party generally led these campaigns, they also gained support from many Northern Democrats, who could not afford to let Republicans outbid them for votes. And since Civil War benefits were a badge of honor rather than disgrace, it was easy for individual recipients to accept public assistance, or a place in an old-age home, during what was supposedly the preeminent era of "rugged individualism."

    "An old soldier," Commissioner of Pensions Green B. Raum explained in 1891, "can receive a pension as a recognition of honorable service with a feeling of pride, while he would turn his back with shame upon an offer of charity." So popular were Civil War benefits that they eventually reached over 90 percent of surviving veterans. Despite vociferous elite attacks against the "political corruption" that pension expenditures supposedly expressed, the benefits did not recede until the generation of men who received them died out.

    Health Education Services for Mothers and Babies. During the early twentieth century, many programs to help mothers and children were enacted in America. While mothers' pensions were targeted on the poor alone, others were universal efforts, including the federal Children's Bureau established in 1912 and the Sheppard-Towner program enacted in 1921 to provide health education to pregnant women and new mothers throughout the United States.

    With a mandate to look into "all matters pertaining to the welfare of children and child life among all classes of our people," the chief of the Children's Bureau, Julia Lathrop, astutely mobilized women's associations and reformers on behalf of improved maternal and child health. Even though her aim was to reach out to underprivileged mothers, especially in remote, rural areas, Lathrop deliberately decided against a narrowly targeted program and insisted her efforts had nothing to do with charity. If the services were not open to all, Lathrop felt, they would degenerate into stigmatized poor relief.

    After the passage of Sheppard-Towner, the Children's Bureau was able to reach a broad cross-section of American mothers, just as it had in its earlier programs. By 1929, according to a study by Molly Ladd-Taylor, the bureau could claim that its childrearing information had benefited half of the babies born in the United States. The bureau had coordinated efforts that distributed "over twenty-two million pieces of literature, conducted 183,252 health conferences, established 2,978 prenatal centers, and visited over three million homes." Ladd-Taylor notes, "Women from every geographic region, social class, and educational background wrote to the Bureau as many as 125,000 letters a year." Yet while the bureau was reaching so wide a population, it was also effectively targeting less educated, white and non-white mothers in rural areas for special help through Sheppard-Towner-sponsored clinics, conferences, and consultations with public health nurses. While allowing great state-to-state variation in program design, the bureau prodded all states to improve official birth statistics and to channel resources toward places where infant and maternal mortality rates were highest.

    Politically, however, the Sheppard-Towner program was not an unequivocal success. As the 1920s ended, Congress refused to make the program permanent. Sheppard -Towner's chief opponents, private physicians, wanted to take over pre- and post-natal health counseling themselves, and their local associations affiliated with the American Medical Association were able to kill the program through congressional maneuvers. Sheppard-Towner, however, never experienced a democratic political backlash. It remained broadly popular with American women, and most of the elite and middle-class women's associations that had backed the original law in 1921 continued to lobby Congress on behalf of its extension throughout the decade. Many states continued Sheppard-Towner programs after the federal matching funds disappeared, and a few years later the federal program itself was revived in a new form under the Social Security Act of 1935.

    Sheppard-Towner itself was politically vulnerable because the 1921 legislation had not established any entitlement to benefits; as a discretionary program, it was subject to the annual appropriations process. The broad political support that follows from a universalistic program structure is clearly not the only factor affecting the survival of social policies. Entitlement status has also been important in ensuring the longevity of social policies. The most successful measures, such as Civil War pensions and Social Security, have, in fact, been those that ensured entitlements to cross-class categories of beneficiaries.

    Economic Security for the Elderly. Over the past half century, the national, contributory social insurance programs chartered by the Social Security Act of 1935 have evolved into a broad and, by international standards, generous set of income supports and medical services for retired American workers and their dependents. How Social Security particularly aids poorer elderly people within the framework of its universal benefits offers us a powerful lesson about the wisdom of targeting within universalism.

    Social Security was far from an antipoverty policy in its early years. For the first three decades, its originators and early administrators concentrated on building mainstream support, expanding the program's scope, and working out effective relationships with congressional committees. They sought to rein in public assistance to the elderly poor and to deflect conservative and populist demands for non-contributory need-based benefits or universal flat-rate pensions. They astutely propagated a public imagery that portrayed Social Security as a system of individual "accounts" that received "contributions" as workers built up "earned" benefits for themselves and their families.

    Despite the imagery, of course, early beneficiaries got back much more than they put in. They reaped windfalls because they had not paid taxes for many years before receiving benefits and because payroll tax increases were repeatedly deferred in the early years while benefits were increased.

    As Civil War pensions had once been contrasted to charity and poor relief, so Social Security was morally defined in symbolic contrast to public assistance. Step by step, new categories of beneficiaries and taxpayers were brought into the contributory insurance system, until it encompassed more than 90 percent of the labor force in the early 1970s. New benefits were added, partially filling the programmatic vacuum left by the absence of national health insurance in America. The original Old Age Insurance (OAI) program of 1935 became Old Age and Survivors Insurance (OASI) in 1939, and eventually Old Age, Survivors and Disability Insurance (OASDI) in 1956. Congress added Medicare in 1965.

    Social Security has always favored, not the neediest Americans, but the stably employed and the middle class. The system pegs pensions to earnings received during an employee's working years. As is well known, payroll taxes are regressive because they are set at a flat rate up to an income ceiling.

    Nevertheless, from the start Social Security gave retirement benefits to lower-income workers that, in proportion to their past wages, were relatively higher than those received by higher-wage retirees. More important, once Social Security was fully established, its administrators sought increased benefits for everyone and relatively better benefits for the less privileged, to bring Social Security pensions closer to a sufficient retirement income.

    Taking advantage of windows of political opportunity during the 1960s and early 1970s, Social Security's promoters gained presidential and congressional backing for major jumps in services and benefits for all of the elderly. They followed a strategy that Hugh Heclo describes as "helping the poor by not talking about them." Amidst the fuss about the War on Poverty, prior plans for Medicare were brought to fruition. Social Security administrators then began to work for higher retirement benefits, and in 1969, 1971, and 1972 increases adopted by Congress and approved by President Nixon far outpaced growth in the cost of living. At that time, Republicans could not afford politically to propose less for the elderly than the Democrats were proposing. In 1972 they pressed for indexing benefits to the consumer price index, unwittingly tying benefits to prices rather than wages just prior to a period when prices were to rise faster than wages. "Replacement rates in 1975," Martha Derthick explains, referring to the ratio of Social Security benefits to wages, "were approximately 67 percent for a married man earning average wages and 92 percent for a married man earning the federal minimum wage -- up from 50 percent and 67 percent, respectively, a decade earlier, on the eve of the drive for expansion." So while benefits increased for everyone, they jumped even more for poorer beneficiaries, and Social Security became by far modem America's most effective program for lifting people out of poverty.

    In general, social insurance does much more than means-tested income transfers to raise American families from below to above the officially defined poverty line. Social Security is the most effective poverty-reducing program even for non-elderly families, who receive disability, unemployment, and survivors' benefits. But there is no question that the elderly benefit most of all. Social Security pensions and Medicare were chiefly responsible for cutting poverty among the elderly, as officially measured, from 35 percent in 1959 to 14 percent by 1983, while the rate for other Americans fell only from 22 to 15 percent.

    The gains achieved for Social Security programs during the 1960s and early 1970s proved durable even in the face of the Reagan administration's retrenchments. While public support for "welfare" declined sharply during the 1970s, 95 percent or more of people polled continued to agree that "the government spends too little or about the right amount on the elderly." When the first Reagan administration discussed cuts in Social Security, it faced an immediate public uproar and soon backed down (except that it continued for a time to use administrative regulations to cut people from the disability rolls). Even though targeted public assistance programs for low-income people accounted for less than 18 percent of federal social spending, they took the brunt of the first Reagan administration's cuts. Impoverished mothers and children suffered, but the elderly on Social Security, including many who would otherwise have been poor, preserved their improved economic standing. And so they have to this day. Even in a generally conservative period, Social Security continues to be protected by its cross-class constituency and to be championed by congressional representatives of all partisan and ideological stripes.

    Current Possibilities
    The message of history is clear. Those who want to help the poor should not try to devise new programs finely targeted to low-income people or the "underclass." They should forget about reforming means-tested public assistance programs like AFDC. Rather, they should aim at bypassing and ultimately displacing "welfare" with new policies that address the needs of the less privileged in the context of programs that also serve middle-class and stable working-class citizens. Newly devised policies must speak with a consistent moral voice to all Americans, whether as recipients or as taxpayers, reinforcing rather than undermining fundamental values such as rewards for work, opportunities for individual betterment, and responsibility for the care of children and other vulnerable people.

    Establishing politically sustainable principles for social provision is more important than securing major new budgetary commitments up front. Even if new measures start small and give significant proportions of their benefits to families who seem less needy than the most desperately poor, advocates for the poor should realize that, before long, such measures could create new symbolic and political space for more targeted efforts on behalf of disadvantaged people. In contrast, measures that start out small and are narrowly focused on the poor may soon lose political support or never get the resources to reach more than a fraction of the needy people they are supposed to help.

    To supplement Social Security programs for the aged, the United States could develop a Family Security program for all of its working-aged citizens and children. This program would express and reinforce shared American values of work and family responsibility. I have in mind the following new policies, which would at least partially replace AFDC, unemployment insurance, and Medicaid:

  • child support assurance for all single-custodial parents;
  • parental leaves and child-care assistance for all working families;
  • job training and relocation assistance for displaced workers and new labor market entrants; and
  • universal health benefits.

    All of the elements in this program have separately received discussion elsewhere. Together, however, they form the basis for a coherent strategy for a new generation of sustainable social policy.

    Child support assurance, first outlined by Irwin Garfinkel and Elizabeth Uhr, would establish nationwide guidelines requiring all absent parents (most of whom are fathers) to pay fixed proportions of their wages as child support. In turn, the program would provide some income support to all custodial parents, most of whom are mothers. As a substitute for the current haphazard system of judicially awarded child support, payments would be more or less automatically fixed and collected through wage withholding, exactly as income and payroll taxes are now. The government would send checks to custodial parents in amounts nearly equal to collections from absent parents, except in cases where support payments could not be collected or fell below a minimum benefit needed to raise children. In that case, the custodial parent would get the minimum.

    A child support assurance program along these lines would express the nation's interest in helping single parents raise the approximately half of America's children who are now growing up in such families. The problems of single-parent families now cross class and racial lines, since about half of marriages today end in divorce and only about half of divorced mothers actually receive child support. (Separated and never-married mothers fare even worse.) Because the same program would process child support payments for women of all income levels, participation would not be stigmatizing. At the same time, an adequate minimum benefit could do much for the most needy. Child support, unlike welfare payments, would remain after the needy mother went to work. All custodial parents would, therefore, be free to earn as much as they could. If a mother received the minimum benefit because the father of her child was contributing nothing, she would have her benefit trimmed back only gradually as her earnings increased. She would have an incentive to work to make a better life for her children and herself.


    Parental leave and child care assistance respond to the broad need of American families struggling to balance jobs and parental responsibilities. Across social classes, more married women, including mothers of young children, are working outside the home. Yet current policies in the United States do little by international standards to buffer families from the extra stresses of childbirth or adoption, or to help families find and finance adequate child care while both parents work. Paid parental leaves for families of newborns or new adoptees should be one of our long-run objectives. Legally mandated unpaid leaves, including guaranteed reinstatement afterwards, could serve as a first step in that direction. We should also seek to direct more assistance than we do now for child care expenses through refundable tax credits.

    Help to parents raising children is one leg of an overall Family Security Program. The other leg must be assistance in securing jobs to make it easier for two-parent families to form and for parents to support their children. Such aid is consonant with American values because adults would be self-supporting, not put on a permanent public dole. As William Wilson and his collaborators have argued, grim job prospects for unskilled young black males are directly linked to the failure of poor men and women to marry, especially in economically depressed and socially disrupted inner cities. At the same time, the present welfare system traps many single mothers into a stark choice between low-paid, unskilled work and welfare benefits available only if the mother does not work (a situation that may encourage her to have more children). The existing welfare system rarely helps single mothers to gain new employment skills. Nor does it urge and help them to relocate, if necessary, to take advantage of decent jobs and housing in new locations.


    A new program of labor market assistance would correct these failures. It would provide help and incentives to low-income ' unskilled women and men within the same non-stigmatizing program that offers aid to more advantaged people who lose their jobs and cannot easily find similar ones. The labor market program would identify jobs and regions in need of new workers. It would provide transitional unemployment benefits and perhaps housing subsidies to help workers and their families relocate geographically, if necessary Most important, the program could train or retrain people for jobs.

    Some analysts believe that a new labor market program should also guarantee public jobs at the minimum wage as a last resort. But in that case, this new effort might get stereotyped as a "make-work~' program. An emphasis on training and relocation, on the other hand, would make public labor market policies more appealing. If existing labor markets cannot generate enough employment, other policies, such as infrastructure development, should be used to create new jobs. Furthermore, the institution of a higher Earned Income Tax Credit (EITC) to subsidize the incomes of low-wage workers might indirectly serve to make more self-supporting jobs available to newly trained workers. Although this is a targeted measure, it qualifies as targeting within universalism because it channels subsidies through the income tax system.

    Finally, more universally available health benefits are essential. The present patchwork system of health insurance discourages labor mobility and job redefinitions within industries and workplaces because medical coverage for many workers and their dependents is tied to particular jobs and firms. The present system provides Medicaid coverage to AFDC recipients and some other categories of poor people, but it leaves uncovered many working people, especially low-wage workers. This situation discourages welfare recipients from moving off welfare and arouses taxpayer resistance to improved public health provision. The present uneven system should be replaced either with Canadian-style universal health insurance or with publicly mandated private insurance. The example of other countries indicates that such systems can, in fact, hold down national health expenditures to levels lower than in the United States.

    A universalistic Family Security Program would require new budgetary commitments from the federal government -- but isn't this impossible in the present political climate? Before concluding that Family Security is pie-in-the-sky, we should realize that some of the policies discussed here would generate new revenues and save taxpayers' money as well as spend it. Child support assurance would be accompanied by wage withholding from absent parents, and the minimum benefit would allow us to phase out much of what we now call "welfare." The system of job training and relocation assistance would replace today's unemployment insurance. What is more, the new child support and labor market policies would encourage people to enter the paid work force and perform more efficiently in it, generating new tax revenues.

    To be sure, child care assistance would require significant new funding, and health benefits well might, depending on whether more comprehensive reforms were introduced at the same time. Still the history of Social Security demonstrates that American citizens will accept taxes that they perceive as "contributions" toward public programs yielding benefits to their own families, not just for others. Americans are also willing to pay for social programs that are morally worthy and economically productive. Perhaps the introduction of new programs could be accompanied by a Family Security payroll tax, collected up to a higher wage base than are Social Security taxes to avoid their worst regressive features. In any event, new universalistic programs and new sources of revenue -- to be collected from virtually the entire population, not just subgroups as with the unsuccessful catastrophic illness surcharge -- should be discussed in close connection with one another.

    Can the new Family Security Program I have outlined really help the American poor? Wouldn't this set of policies principally benefit the middle and working classes, along with the most privileged and least troubled of the poor? Initially, that might happen. But we should not hesitate to attack the pathologies of poor communities by doing the most, soonest, to help adults who are willing to work and care responsibly for their children. Once genuinely new and non-stigmatizing incentives, social supports, and job opportunities were in place, the example of hardworking people taking advantage of new programs and forging better lives for themselves might spread. Less privileged families and communities would have more hope and avenues for betterment through individual efforts augmented by non-stigmatizing public aid. Some people would take longer to get the message than others, but over time most would. By publicly supporting work and family responsibility, universalistic social policies would facilitate the moral reintegration of poor people into the mainstream of national life.

    Like Social Security, new Family Security policies could stimulate broad political alliances reinforcing the programs and willing to accept extra efforts for less privileged citizens as part of the overall package. With their own values and needs recognized, larger numbers of middle-class Americans might be prepared to go the extra mile for the needy, including the truly disadvantaged blacks of our most desolate urban ghettos. The barely privileged would not have to help the poor with no benefit to themselves, and the more privileged would see that support was consonant with national values. Past experience teaches us that targeting the poor alone fails; targeting within universal programs, however, can be both effective and politically sustainable.

    A different version of this article with full references is forthcoming in The Urban Underclass, edited by Paul E. Peterson and Christopher Jencks. This paper was originally commissioned for the Conference on the Truly Disadvantaged, held October 19-21 1989, in Evanston, Illinois, co-sponsored by the Committee for Research on the Urban Underclass of the Social Science Research Council and the Center for Urban Affairs and Policy Research of Northwestern University.

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