Caveats: I am without computer, so I am blogging from my iPad. For some reason, it is not putting in links. There is abundant evidence that MoW delivers positive health outcomes. Just Google. Also pardon the cray typos.
The Trump budget documented the news cycle last week. I don’t know what I saw more of, really: the outrage at cutting programs for the most socially vulnerable, or the frankly disheartening way that Trump & Co have appropriated the language of evidence-based public policy to twist to their own ideological ends. Beware, always, somebody who says “actually, teh facts are.” There are empirical findings, but the interpretation of those findings are subjective. Unfortunately, we have apparently swallowed so much of the po-mo line that we no longer focus on interpretation, but instead allow ourselves terms like “alternative facts.”
In the case of Meals on Wheels, budget director Mulvaney says we just don’t see any results from the program–and thus the appropriation of policy analysis lingo, in the bean countiest way possible, is invoked to condemn a program that “sounds good but doesn’t deliver.” (The program does deliver on multiple fronts, btw). Left unsaid are the many, many different things that count as policy outcomes.
What is, in the language of efficiency, the point of feeding elderly people, after all? They are not returning to the workforce; they are not going to be economically productive. After all, a dollar spent on them might be be better spent on something else. Thus within that strict paradigm, the only way the program makes sense is if it saves money on health interventions. To be effective, feeding elderly people should reduce their health care costs. If it is does not, then…? So what if fewer hips get broken if they simply die of something else? Something potentially costlier to the rest of us?
And thus there is the killing language of policy analysis when it is turned on social programs. Left aside are the material and yet intangible realities: isolation among the elderly kills (we have good evidence of this) and isolation is also terribly, terribly painful, as is hunger. If we have it within our means to stop suffering, do we not have a duty to alleviate it, regardless of the perceived benefits to us of so doing?
But I don’t want to stray too far from my point about outcome analysis with social programs. If you get too instrumental with any of this stuff, the purpose and benefits of social programming can evaporate under the scrutinizing eye. Feeding hungry people? Since when was that a rationale that fit into a cost-benefit analysis? So the benefits associationed with feeding hungry people becomes operationalized and monetized, and quelle suprise…like quicksilver, the benefits measured in this “secondary benefits” approach become harder to grasp. Ditto with hungry children. We can’t just feed them because they are hungry. We have to feed them to improve their school performance, and if, on aggregate, average school performance improvements do not materialize, well, that program doesn’t “work.”
Note that this language of accountability around outcomes never crops up around the military or tax cuts. Did we win the war on terror? What was the cost-benefit ratio there? We certainly seem to have made a dent in al Qaeda, but we are still there in Afghanistan, and “democratizing Iraq” does not seem to have brought stability to the region. But that’s security! The sky is the limit! There is no price too high. And yet, if we subjected the military to the same outcomes accountability routinely applied to social programs, could we ever justify the expenditures?
This is how power turns the wheels with policy analysis. It is not a question of “alternative facts.” It is a question of what facts and measures matter enough to be exempt from accountability for outcomes and which ones for which accountability will become a weapon used to snuff programs with which power has an ideological beef.
Note also Mulvaney’s tax rhethoric. We can’t ask “steel workers” or “single mothers” to pay. Perhaps not, But what about billionaires? Oh, now, that’s just crazy.