Magazine article Policy & Practice

The Role Government in the 21st Century

Magazine article Policy & Practice

The Role Government in the 21st Century

Article excerpt

No one has a crystal ball that we can use to see how much things are going to change between now and the year 2100. It is probably safe to say, however, that some things are going to change a lot while others, not so much

The role of government in the 21st century falls into the category of things that are going to have to change. The U.S. Constitution gives Congress the authority to provide for the general welfare of the nation. In order to fulfill that responsibility a complex scheme of programs has been enacted-a big part of which we call human services. This system helps millions of people find employment, live in a safe home, obtain food, and ensures the safety of children in their own homes, or in day care, to name only a small part of what the government funds.

As the human service system has evolved over the decades it developed silos where more attention was given to how funds were spent rather than whether those funds were having their intended impact. As the nation struggles with an increase in demand for services and limited federal and state budgets, it is obvious that the status quo is unsustainable; things are going to have to change. That is why our members are calling for a transformation in the delivery of human services to create an integrated, outcomes-focused and client-centric system. Our Pathways initiative is designed to focus on achieving outcomes in the critical areas of gainful employment to achieve independence; stronger and healthier families, adults, and communities; and to sustain the well-being of children. Full implementation of Pathways will require giving states more flexibility, coupled with accountability for outcomes that matter, and changing funding streams to produce a more efficient delivery system.

Change is always difficult. It is easier to focus on short-term solutions than to deal with the larger, more complex issues necessary to achieve true transformation. Regardless of how the current system of delivering human services is entrenched, there are forces at work that will require a new paradigm. New ideas are too often analyzed and debated until the only alternatives available are undesirable. To avoid falling into the trap of believing what worked yesterday will be sufficient to meet tomorrow's needs, a clear understanding of the forces at work that are undermining the current system is necessary.

There are several highly intertwined issues that are inescapable. America is getting older, a lot older. The United States is in the midst of a major demographic shift. The definition of a Baby Boomer is someone born in the United States between 1946 and 1964. That means that starting in 2011, the first baby boomers turned 65. For the next 20 years, on average, 10,000 boomers will retire every day.1 Instead of paying into Social Security and Medicare, they will be collecting benefits from these two retirement programs. On top of that, as they retire they leave their peak earning years and significantly reduce the income tax they have to pay. This kind of a demographic shift has policy consequences with serious repercussions for U.S. public health and human service programs. The demands for government services for an older population will be unprecedented.

Driven only partly by an aging population, the cost to the federal government of providing health care continues to increase. Expenditures for health care continue to be one of the fastest growing components of the federal budget.2 The Congressional Budget Office predicts that "if current laws remained in place, spending on the major federal health care programs alone would grow from more than 5 percent of GDP today to almost 10 percent in 2037 and would continue to increase thereafter."3

People need more medical care the older they get, so as the percentage of population over 65 continues to grow, the total amount spent on health care will continue to grow regardless of any cost containment efforts that might be enacted. …

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