Social Security 25 Years Hence
WILBUR J. COHEN
After more than 25 years of continuous involvement with social security from the vantage points of several positions, Dr. Cohen expresses here a buoyant optimism about what can and should be accomplished in the next 25 years. Having been a member of Dr. Witte's staff in the days of drafting the 1935 Social Security Act, he closes this article with the wish to be "alive in 1985 to see these dreams become real."
In 1985, the social security program will be 50 years of age! It should reflect 50 years of varied experience. It should then be the kind of program which has been tested under a variety of circumstances and has been modified to meet the changing needs of an energetic people and a dynamic society. The social security program of 1985 probably will look very different from that of 1960. The program 25 years hence probably will be even more different from that of today than today's program is different from that of 1935.
While we have made notable progress in our social security program in the past 25 years, there is ample justification for believing we must--and can--accelerate the rate of improvement in the program in the future. Our population will increase tremendously in the years ahead. The number of children and the aged will be much larger than today. Medical costs probably will have risen much faster than the general price level. There will be new and remarkable medical and scientific discoveries. The educational level and aspirations of the population will have moved upward steadily and will be still ascending. More women will be at paid work. There will be a wider range of job opportunities and less discrimination. More older people will be able to continue work in relation to their physical and mental abilities and their own needs. There will be better housing, nutrition and health standards. Our gross national product should have more than trebled (measured in present day prices). Family incomes will be substantially larger than today. More persons will be on a salary basis with a "guaranteed annual wage." There will be a smaller proportion of individuals and families with substandard incomes. Thus, we should and will be able to afford a much improved level of living for everyone, thereby convincingly demonstrating the superiority of our institutions over any totalitarian form of society. Our social security program undoubtedly will reflect these and other striking economic and social developments which will take place during these next momentous 25 years.
As we try to visualize the form of social security in the coming 25 years, the thought which comes to mind is that the "first 25 years are the hardest." During this first period, consent had to be obtained to the basic idea, public understanding had to be achieved of the concept and its objectives, the reluctant acceptance had to be won from those persons and groups who oppose or are resistant to any change whatsoever. These were only attained with great effort. During this first 25 year period, many difficult administrative problems were successfully solved. With these accomplishments now achieved, we should be able to move ahead to close existing gaps and meet new needs as they arise.
That is not to say that there will not be equally large problems to face in the future if social security is to be kept up to date to reflect changes in attitudes and experience. In the decade of the '50's major improvements were made in the OASDI program. Unfortunately, the improvements in unemployment insurance and public assistance to date have been much less fundamental. Both our unemployment insurance and public assistance programs need major improvements in the immediate years ahead. Hopefully, as we are able to reduce the volume of long duration unemployment and dependency, we should have to rely less in the long-run on unemployment insurance and public assistance as built-in stabilizers for our economy. But, if that is so, we ought to make these programs a much more effective instrument for the people who do need them. We should be able to do so with less relative cost to the economy than it was thought possible when these programs were originated under the depression psychology of 1935.
Bound as we are to a great extent by the experience of the past and the compelling needs of the present, it is difficult to visualize today how our social security program might look 25 years from now. I expect it will look very different because our economy and our world will be vastly different. Yet I feel reasonably sure that any changes will evolve out of experiences as we go along--a pragmatic step-by-step evolution which will be in keeping with other deep and abiding aspirations we cherish. I believe our children and our grandchildren will improve upon what we have built and evolved over the past 25 years.
Some of the features of our public and private social security programs and our economy in 1985 which it seems to me possibly may be operative then are the following:
1. We will have achieved the goal that no aged retired person or any sick or disabled person, or any family where the breadwinner has died or is unemployed, will be in want, irrespective of residence, age, or any other condition.
2. Medical services will be available to all persons without regard to their financial ability to pay for them at the time they need the medical service. There will be a higher quality of medical care than today. The hospital will be a more important center of medical care. Group practice will be more prevalent. By 1985, the American Medical Association will have dropped its opposition to the changes in the methods of financing and organizing medical care which it opposes today. The AMA will be praising the then existing arrangements as part and parcel of the American way of life and the tried and tested result of experience and the sound judgment of the statesmen in the Congress who had vision and foresight.
3. The need for recourse to public assistance on a needs test basis will be reduced to an absolute minimum. Today about four percent of the population is receiving public assistance. If we improve all of our private and public health, education, insurance, and economic programs to their maximum extent, the number receiving public assistance in 1985 should not exceed one-half of one percent of the population.
4. All programs will have built into them a service philosophy which emphasizes the maintenance and preservation of family life and social rehabilitation. Sick and disabled persons will have available to then at an early stage all the rehabilitation services needed. These will not be limited to vocational potentialities but also will stress the individual's potentialities for independent living. Service to the applicant or recipient and his family will be the central theme of good administration. Full utilization of a wide range of public and private community resources will be encouraged.
5. These community resources will be staffed with competent personnel dedicated to developing the capacities and creativeness of the individual to the maximum extent. We will have developed a broad program of training in which welfare and social security agencies will be cooperating with centers of higher education in producing qualified personnel competent in giving services, organizing community resources, and changing social policies to meet social needs. There will be a greater degree of sympathetic cooperation from the medical profession and the insurance industry which by that time will come to recognize that social security is not a threat to them.
6. The concept of adequacy in the benefit structure of the various programs will not be based on minimal standards such as is implied by a "basic floor of protection," as at present but will emphasize a standard of health and decency closer to the standard of the productive population. Today, our levels of social insurance and assistance payments are based on a marked spread between the level of living of the beneficiary and that of the person working full-time. As our economy expands and the gross national product increases we should be able to raise the level of benefits for our dependent groups without discouraging the initiative, thrift, and responsibility of the productive groups.
7. At the same time, I believe private insurance, home ownership, and other forms of savings will have increased dramatically. There will be new forms of private insurance and ways to save. There will be increased incentives and encouragement for self-development, imagination, productive achievement, and creative enterprise. There will be more leisure time for art, music, literature, and other forms of individualistic self-expression. There will be more extensive and challenging opportunities to earn and save money, new and more products and services to buy and enjoy, and many new public and private resources dedicated to serve the consumer, the family, the sick and disabled, the unemployed, or retired person.
As we move forward in the'60's toward the goal of a more effective program, we must remind ourselves that we face a much different task today in charting our future course for social security than Edwin E. Witte, Arthur J. Altmeyer, Frances Perkins and others had in 1935. Then they had the advantage of a relatively clean slate and the availability of talented and highly motivated personnel but with the great disadvantage that many problems of administration had to be solved. We have gained "know-how" in administration. We have gained a reasonable degree of competence in our financial, actuarial and economic planning of the programs. We have a going concern. We are beginning to emphasize prevention, rehabilitation and quality of service.
But today we have a pluralistic, piecemeal, categorized system with many specialized interests; a jigsaw puzzle of many parts, with more diverse arrangements than we had in 1935. And, with each passing year, it may become more difficult to make basic changes in the structure as institutionalization and rigidities take hold, and as the opposition to specific social security improvements becomes more determined from powerfully organized groups.
For these reasons, we must institute a bold program of research to find the causes of dependency and we must inaugurate a vigorous program of social action to eradicate these causes of dependency from our land. We must seek out new and better methods of accomplishing our goals. We must experiment with new arrangements. We must be willing to re-examine our existing programs. And we must be willing to engage in "controversy" with those opposing improvements in the program so that we can discover the most effective ways of advancing the well-being of the entire community.
In looking ahead, I see all our health, education, and welfare programs--private and public--increasingly "affected with a public interest." I see the American Public Welfare Association continuing and expanding its leadership role in the public welfare field. I see our nation recognizing expenditures for these purposes as an "investment" instead of as a "burden." Just as private insurance is an investment in human welfare, social insurance and social welfare programs are likewise an investment in the nation's future. I see a growing realization that government has a valid and responsible role to play in assuring that the public interest is superior to any private interest. I see a decline in the attitude and propaganda that the federal government (and the Congress) is a "foreign" and distant power. I believe our representatives in Washington will demonstrate an effective and intelligent response to meeting human needs and will show our local and state representatives that leadership and statesmanship can be combined with representative democracy. I believe our economic and political system will respond to these changes and still retain essential freedoms and incentives for the individual.
There will be some who will believe these are unwarranted hopes. There are some lawyers and actuaries who call any such ideals or speculative plans for the future an "arrogant" assumption. They are men of little faith. Essentially, a belief in the dignity, integrity and growth of man and the growth of our economy is a belief in the expansible potentialities of the human spirit. I am optimistic for America and for our future. I feel I have had better opportunities than my parents. I believe my children can have even better opportunities than I have had. I believe that what some people think is impossible today can be achieved tomorrow. I hope I am alive in 1985 to see these dreams become real.