Introduction

Abstract

The United States could be called “the reactive welfare state.” It does not take a preventive and noncoercive approach toward its members; rather it is reactive and largely coercive taking a “back-end” approach that responds to the destructive consequences of the relative neglect of the “front-end” approach and that is necessitated by such neglect.¹ The nation takes a preventive public health approach in ensuring that the population avoid diseases by drinking clean water and having adequate sanitation, yet it does not take a preventive approach in caring for people’s health. Rather than enacting universal health insurance, the nation ignores the health needs of millions of its citizens. Illnesses that could have been prevented get worse, forcing people to seek expensive emergency or long-term care. The nation neither puts many resources into insuring that people are not poor nor insuring the physical and emotional health of children raised in poverty. It tries to patch up the consequences of poverty by taking children away from their parents rather than providing the resources to help families care for their children, putting homeless people in shelters rather than providing public and affordable housing and, finally, when all other systems have failed, building one of the largest prison systems in the world, with few resources for rehabilitation (as described in Marguerite Rosenthal’s chapter on prisons).