Introduction

This chapter addresses two different, but related topics. The first is whether the US election of 2004 represents a serious mandate for social policy change. The second analyses two of the most important social policy proposals that the Bush Administration decided to promote vigorously. Fundamental change in social insurance pensions, not prominent in the election, is now the most newsworthy source of social policy debate: proposals for individual risk-bearing retirement accounts that are misleadingly termed ‘privatisation’. Medicare, the health insurance programme for America's older and disabled people, was prominent in 2003-04, and remains so today. The relevant Medicare politics in 2005 are about the implementation of the fundamental and highly controversial ‘reform’ legislation enacted late in 2003. In both instances, the Bush Administration has used the language of imminent crisis to bolster policy reforms that in fact undermine rather than support America's two most important social programmes. This bold assertion, the core of this chapter, will require (and be given) extended argument and documentation.

In addressing these topics, one must also raise the question of whether – or in what ways – American reform programmes and proposals are relevant to European social policy discussions generally or those in the UK particularly. In connection with that issue, I will take up one strikingly conventional framing of contemporary US social policy. That is the view that a new century – the 21st – presents new challenges to social policy, throwing up such new risks that a reconceptualisation of the welfare state is warranted. The chapter closes with a largely sceptical response to that formulation.

Drawing lessons from the experience of other countries is never easy in any case (de Gier et al, 2004). This is especially problematic for Europeans when the topic is social welfare policy and the country compared is the US. For decades now, the pattern of media coverage and academic commentary has been imbalanced. The US media – television coverage, radio broadcasts, newspaper reports and magazine stories – flow northward and eastward vastly more frequently than do southward flows from Canada or westward flows from the UK or continental Europe. The result is utterly asymmetrical, with others receiving much more information (accurate or not) about the US than Americans receive about European or Canadian social policy.