Remember our discussion of statist individualism in Sweden, which we elaborated on more recently? Andrew Brown offers a look at contemporary Sweden that offers a kind of pox-on-both-their-houses — social democracy and neoliberalism — analysis. It’s actually a surprisingly sensitive and intelligent take, but I fear it draws the wrong conclusion:
The rather bigger scandal, or series of scandals, concerned old people’s homes run by Carema, a private company in Stockholm. Relatives and former workers have come forward with stories of dead old ladies left in front of the television; demented patients left to smear themselves with excrement and a management demand that incontinence pads be weighed to make sure they had not been changed until absolutely full.
This is what happens when the health service is part privatised, say critics. I’m not sure that things were idyllic under the old, wholly nationalised system. My then wife worked in an old people’s home north of Gothenburg and said it was run with brutal efficiency but so emotionally cold that she would rather be in hospital in England. Indeed, the big selling point when competition was introduced to some services in the 1990s was that the care homes would remain small, local businesses, with less bureaucracy than the old centralised model, often family run. But that’s not how a market works.
This passage is interesting, and it raises an important truth that is evoked in debates over for-profit higher education. When we use an impersonal process to deliver an outcome, the design of that process is essential. A poorly-designed formula will lead for-profit firms to exploit the formula “until it breaks.” Non-profits will also seek profits of a kind (in the form of featherbedding, etc.), but they’ll have weak incentives to meet demand. What we don’t have are small organizations that mimic families, i.e., that have deep and intimate knowledge of beneficiaries, moral authority, and an ability to use moral suasion (the fear of shame or disapproval) as effectively as crude coercion. This is why structures rooted in kin-based social networks are so much more robust and resilient than modern structures.
Taken together, these scandals show that both left and right are in trouble. The old Social Democratic model is completely broken, but the new, competitive model doesn’t work very well, either. In both cases, people don’t believe in society partly because they no longer have any reason to fear it.
The conformism of Sweden is something almost every visitor notices and complains about. But many foreigners suppose that it is imposed from above, on a duped or unwilling population. I don’t think that was ever true. The way it really worked was written in gothic script outside the German church in the old town of Stockholm: “Fürchtet Gott! Ehret den König!” – “Fear God and honour the king!”
Of course, very few people fear God in Sweden today. At some stage in the 20th century, God was replaced by the future. The future, which everyone was confident could be trusted, appeared to have the attributes of God, an inscrutable wisdom that could nonetheless be trusted, and was, in any case, authoritative. In the end, the future could talk to you with the crushing authority of God talking to Job.
Social control worked because everyone – including the governors – was seen to submit to the same authority. The Social Democrats established that this didn’t have to be God. The future would do just as well, if everyone believed in it. This submission to a common authority was what Swedes generally meant by “democracy”. It wasn’t an ideal of a system of voting, and it wasn’t even a commitment to a tyranny of the majority, though it could feel like that. It was a commitment to the belief that no one is above the law, and no one can escape the future, which blurred on one side into the traditional, vicious egalitarianism of small communities, and on the other side into a confidence that the future must be more democratic.
Social democracy spent decades smashing up the old authority structures, among them God and the traditional family, in order to take over their authority. From the 1980s onwards the neoliberals spent decades smashing up Social Democratic beliefs. And at the end of this process, the future has let both sides down. The idea of society as a place of mutual service has disappeared or at least attenuated to an ideal.
Both the socialist and the anti-socialist ideals have been traded in for individual fulfilment through magically enlightened self-interest. The Carema scandal shows where that leaves people when they are useless: lying in a bed full of their own shit, waiting until it’s profitable to the shareholders for someone to come and clean them up. The trouble is that it’s much easier to destroy structures of mutual obligation than it is to build them up again. This isn’t a uniquely Swedish problem. [Emphasis added]
Another way of looking at the dilemma Brown identifies, however, is that the essential break came when “social democracy spent decades smashing up the old authority structures, among them God and the traditional family.” Neoliberals might improve the workings of a rationalized bureaucratic system at the margins (or not); what it can’t do, perhaps, is re-knit the social fabric that social democracy tore apart.
Despite Brown’s somewhat grim characterization of modern Sweden, it is worth remembering that a far higher proportion of Swedish 15-year-olds — two-thirds, according to a somewhat dated Ellwood and Jencks analysis — live with both biological parents while only half of American 15-year-olds can say the same. The United States is a “fat tail” country, in which a significant swathe of our population has preserved kin-based social networks while a perhaps larger swathe has experienced a kind of atomization even more extreme than what we see in Sweden. Trying to build shared institutions for a country so diverse is a profound and not very well-understood challenge.
(Thanks to Tyler Cowen for the link!)