All industrialized countries have developed broad public programs of social insurance, health care, and income support. The purpose of these programs is to protect people from the possibility of income loss due to old age, unemployment, disability, work-related injury, or death and to assure access to health care and to an adequate standard of living. The support systems of the agrarian era--the family, private charity, and local government--proved universally insufficient to meet the needs of persons living in a predominantly urban environment and subject to the vicissitudes of a national industrial economy.
Although the social security programs that have developed in various countries in response to industrialization are broadly comparable, they differ in important ways. It is not surprising that diverse historical, cultural, demographic, political, and economic characteristics of various countries have shaped social security programs that are far from uniform. A number of unique characteristics--including geographic size, ethnic diversity, and a tradition of self-reliance fostered by frontier opportunities-have helped to shape the development of social welfare legislation and institutions in the United States. Their influence may be seen in at least three important areas.
First, the development of social welfare programs in the United States has been strongly pragmatic and incremental. Proposals for change generally are formulated in response to specific problems rather than to a broad national agenda. Actual program experience and evidence of unmet needs or unintended effects subsequently lead to adjustments, extensions, or alternative approaches.
The origin Social Security Act did not include the full range of programs that had developed in some European countries; it was anticipated that additional programs of social insurance and income support would be instituted later. The provision of benefits for spouses and children legislated in 1939, and the enactment of assistance programs and insurance for the disabled during the 1950's are two examples of such anticipated extensions. Program developments in other areas followed more of a "problem solving" and incremental pattern. Thus, the Medicare and Medicaid programs were enacted in 1965 in response to the specific medical care needs of the elderly and the widely perceived inadequacy of "welfare medical care" under public assistance. Similarly, the introduction, in 1964, and subsequent extensive growth of the Food Stamp program was a response to evidence of the persistence of hunger and malnutrition among some population subgroups despite general affluence. And, the Supplemental Security Income (SSI) program introduced a national minimum income guarantee for the needy aged, blind, and disabled, effective in 1974, to counteract wide differences in benefit levels and eligibility standards applicable to these groups under the Federal-State assistance programs. The Low-Income Home Energy Assistance program incorporates another pragmatic response to demonstrated need caused by the rapid rise of home energy costs during the 1970's.
Both the Food Stamp and Low-Income Home Energy Assistance programs are available to individuals and families who are eligible for payments under the SSI or Aid to Families with Dependent Children (AFDC) programs and to those needy individuals and families who are not eligible for either program. In this way, a pragmatic compromise has led to limited aid for certain groups without complete deviation from a major feature of Federal and federally assisted income support-categorical eligibility.
A second characteristic of social policy development in the United States is its considerable degree of decentralization. One mechanism for this decentralization is the Federal system of government with its division of responsibility among the Federal, State, and local governments. Some programs are almost entirely Federal with respect to administration, financing, or both; others involve only the States (with or without the participation of local government); still others involve 1 three levels of government. …