The politics of bad policy: Why don’t governments pick win-wins?

Abstract

Abstract Background Why, fundamentally, are the politics and public opinion of ageing and health so badly mis-aligned with facts about the costs of ageing societies? The literature has for decades characteristically divided between an old politics of expansion and the post-1990s new politics of recalibration and austerity. The problem for understanding the politcs of health and ageint is that a mix is also plausible: recalibration with an element of expansion in long term care. This mix then leads to a further thought: When do governments expand mature welfare states to deal with risks not covered in traditional male-wage-earner welfare programs? Methods A narrative review was conducted on the thin literature available attempting to answer the question as to why governments are not picking win-wins (e.g. keep people healthy so they can actually retire at their formal retirement ages, or ensure informal care is valued). Results There were a handful of hypotheses identified in the review, including: the “old politics” of welfare expansion where “credit claiming” is used for highly popular initiatives, the “new politics of the welfare state” also known as the “blame avoidance thesis” where politicians will attempt to avoid blame by making cuts less transparent, “blame buffering” and the “median voter theory” as well as “negative policy feedback”. Conclusions Mature welfare states are not expanding. In fact, the theories on the politics of ageing are focused on how welfare states are retrenching or reforming, as they call it. Blame avoidance and blame buffering are the most common explanations for decisions, often counterproductive ones, about how to recalibrate welfare states in the face of ageing.