Political and Economic Change and Development
The National Health Service and Social Welfare in Advanced Democracies
A hallmark of advanced democracies is the existence of robust social welfare programs, which typically include aid to the poor, health care provision, and unemployment insurance. A primary example of such a system is the United Kingdom’s National Health Service, commonly referred to as the NHS, which was established following the conclusion of World War II. The NHS is structured so that the majority of its revenue is provided directly by the government. Under this system, patients do not receive bills or pay deductibles, as the service is provided regardless of an individual's ability to pay. An evaluation conducted in ranked the NHS as the best health care system in the world. Its cultural significance was further highlighted when it was celebrated during the opening ceremony of the London Olympics. Despite these accolades, the system faces criticisms, most notably regarding long wait times for elective surgeries and relatively low pay for health care professionals.
Section 12.1: Economic Policies and Industrialization Models
Economic policies are often categorized by their level of protectionism or liberalization. Import substitution industrialization, or ISI, represents a protectionist economic strategy designed to shelter domestic industry from international competition and reduce foreign influence on specific sectors of the economy. These policies involve the enactment of high tariffs and the provision of government incentives to encourage the growth of domestic manufacturing. In contrast, neoliberalism is an economic ideology that favors policies supporting the free market and the reduction of trade barriers. Neoliberal policies frequently include the reduction or elimination of tariffs, the privatization of nationalized industries, the reduction of subsidies to businesses, consumers, and workers, the deregulation of various industries, and the active encouragement of foreign direct investment.
Structural Adjustment and Austerity Measures
Countries seeking financial assistance from international lenders, such as the International Monetary Fund (IMF), are often required to implement structural adjustment policies. These requirements include the privatization of state-owned companies, the reduction of tariffs, and the removal of subsidies for domestic industries. Combined with these are austerity measures, which involve significant cuts to social services. These cuts may impact programs designed to assist women, children, the elderly, and the impoverished, with the primary goal of reducing government debt. Critics of these neoliberal and structural adjustment policies argue that they prioritize quick growth over long-term development and undermine the development of human capital. Human capital refers to the education, skills, training, and other positive attributes that individuals contribute to the economy. Furthermore, critics suggest these policies hurt vulnerable populations, lead to environmental damage and urban sprawl, and increase income inequality, which often activates social movements opposed to such shifts.
Section 12.2: Gender Equity and Social Policy Trends
Worldwide, including within the six course countries, the role of women in politics and government has increased, although women remain generally underrepresented. Mexico serves as a notable example of institutional change, as it requires political parties to run female candidates. While the education gap between genders has narrowed, a gap in workforce participation persists. Generally, democracies are more effective at protecting women’s rights, though issues such as abortion access remain controversial and pressures for better access to childcare are growing. According to data from the Gender Inequality Index provided by the U.N. Development Programme, levels of inequality vary significantly: the United Kingdom, Mexico, and China show different levels of progress, while Russia, Iran, and Nigeria face distinct challenges.
Categorization of Social Welfare and Health Care Systems
Social welfare policies aim to reduce poverty and provide services like retirement security and healthcare. These are divided into means-tested and non-means-tested programs. Means-tested programs are restricted to individuals below a specific income level and include food subsidies or cash payments for housing assistance. A sub-category is the conditional cash transfer program, such as Mexico’s Prospera, which provided cash assistance specifically to poor families who ensured their children remained in school. Non-means-tested programs, such as public education and social insurance for retirement, are available to citizens at all income levels. Regarding health care, there are three primary systems: the National Health System (NHS), which is government-financed; the National Health Insurance (NHI) system, where citizens purchase insurance but the government regulates costs and limits premiums; and Market-based systems, where insurance is typically obtained through employment and universal coverage is not guaranteed. In Mexico, the percentage of the population without access to health services has seen a downward trend from in to in , with a low of recorded in .
Section 12.3: Globalization, Industrialization, and the Environment
Globalization has shifted many countries from agricultural to industrial economies. While this transition generally raises income levels, it can lead to a "race to the bottom" regarding labor and environmental standards. Environmental concerns are now classified as "third-generation" problems because they impact the entire planet, such as deforestation and climate change. Most energy production results in carbon emissions, making the development of renewable energy vital. China has emerged as a global leader in this sector by investing billions in renewable sources, monitoring air quality, and shutting down individual polluters. Most countries have now enacted policies specifically to address air pollution.
Nationalized Resources and the Resource Curse
Several countries, including Mexico, Russia, Nigeria, China, and Iran, have nationalized their natural resources to increase state sovereignty and create a revenue stream for social programs, infrastructure, and "rainy day" funds. However, subsidizing fuel costs can strain national budgets. Conversely, private ownership is associated with increased efficiency and modernization but may weaken state sovereignty and increase the wealth gap. A rentier state is defined as a state that relies heavily on the export of oil or the leasing of resources to foreign entities for government revenue. Rentier states, such as Russia, Nigeria, and Iran, often face more opportunities for corruption and conflict over revenue distribution. The "resource curse" occurs when an abundance of natural resources limits economic diversification, makes revenue dependent on volatile world markets, and decreases government responsiveness to citizens. Countries suffering from this curse are often more authoritarian and prone to economic recession if they spend anticipated future revenues prematurely.