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Health, welfare, and the state — the dangers of forgetting history

Accepted version
Peer-reviewed

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Type

Article

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Authors

Szreter, S 
Kinmonth, AL 
Kriznik, NM 
Kelly, MP 

Abstract

Recent public policy in the UK has been dominated by a discourse which asserts that public expenditure on universal health coverage and welfare is a burden on the productive economy and unaffordable in what has been deemed a time of austerity. There is a widely held assumption that universal welfare provision, as offered by most modern welfare states, is a luxury, only afforded since World War 2 by wealthier economies. According to this view, if the productive efficiency of the economy falters, then this luxury should be trimmed back aggressively. Reduction in universal welfare will relieve enterprise, capital, and so-called hard-working families from the burdens of taxation required to fund these unproductive public services and (by implication) those unproductive families—the poor. We argue from history that there should be an end to setting the goal of economic growth against that of welfare provision. A healthy and prospering society needs both. We suggest that they feed each other.

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Keywords

England, Government Programs, History, 17th Century, History, 18th Century, History, 19th Century, History, 20th Century, Humans, Political Systems, Public Health, Social Welfare

Journal Title

Lancet

Conference Name

Journal ISSN

0140-6736
1474-547X

Volume Title

388

Publisher

Elsevier
Sponsorship
Wellcome Trust (097899/Z/11/Z)
The paper arose from discussions in the St John’s College Reading Group on Health Inequalities in Cambridge (http://www.joh.cam.ac.uk/st-john’s-reading-group-health-inequalities), which was supported by the Annual Fund of the College.