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Once again we see no indication that public insurance generosity has had a damaging effect

Note also that the employment rate increased in nearly all of the countries during this period. On average, it rose by nine percentage points between 1979 and 2013. That’s not what we would expect to see if generous public insurance programs were inducing large numbers of able adults to withdraw from the labor market

What we see in the chart is that countries with more generous public insurance programs tend to have less material deprivation.

With globalization, the advance of computers and robots, increased pressure from shareholders for short-run profit maximization, union weakening, and other shifts, wages have been under pressure. Couple this with the fact that many people at the low end of the income ladder have labor market disadvantages — disability, family constraint, geographic vulnerability to structural unemployment — and we have a recipe for stagnation in the market incomes of the poor.

here’s a good reason for these shifts: government provision offers economies of scale and scope, which reduces the cost of a good or service and thereby makes it available to many people who couldn’t or wouldn’t get it on their own.

Government provides more insurance now than it used to. All of us, not just some, are dependent on it. And life for almost everyone is better because of it

hese expenditures are encouraged by government tax advantages.22 But they do little to help people on the bottom of the ladder, who often work for employers that don’t provide retirement or health benefits.

To make them more affordable, the government claws back some of the benefit by taxing it as though it were regular income. All countries do this, including the United States, but the Nordic countries do it more extensively. Does that hurt their poor? Not much. The tax rates increase with household income, so much of the tax clawback hits middle- and upper-income households.

Another difference is that public services such as schooling, childcare, medical care, housing, and transportation are more plentiful and of better quality for the poor in the Nordic countries. Public services reduce deprivation and free up income to be spent on other needs. It’s difficult to measure the impact of services on living standards, but one indirect way is to look at indicators of material deprivation,

Targeted transfers are directed (sometimes disproportionately, sometimes exclusively) to those with low incomes and assets, whereas universal transfers are provided to most or all citizens.

Targeted programs are more efficient at reducing poverty; each dollar or euro or kroner transferred is more likely to go to the least well-off. Increased targeting therefore could be an effective way to maintain or enhance public insurance in the face of diminished resources.

“the more we target benefits to the poor … the less likely we are to reduce poverty and inequality.”

Korpi and Palme found that the pattern across eleven affluent nations supported the hypothesis that greater use of targeting in transfers yields less redistribution

The hypothesis that targeting in social policy reduces political support and thereby lessens redistributive effort is a sensible one. Yet the experience of the rich countries in recent decades suggests reason to question it. Targeting has drawbacks relative to universalism: more stigma for recipients, lower take-up rates, and possibly less social trust.44 But targeting is less expensive. As pressures to contain government expenditures mount, policy makers may therefore turn to greater use of targeting. That may not be a bad thing.

Public insurance programs boost the incomes of the least well-off and improve their material well-being. If such programs are too generous, this benefit could be offset by reduced employment or economic growth, but the comparative evidence suggests that the world’s rich nations haven’t reached or exceeded the tipping point.

Spending lots of money on social protection is not in and of itself helpful to the poor. Total social expenditures in the United States are greater than in Denmark and Sweden, because the US has a large private welfare state. But relatively little of America’s private social spending reaches the poor.

Public services are an important antipoverty tool. Their benefit doesn’t show up in income data, but they appear to play a key role in reducing material hardship. Services expand the sphere of consumption for which the cost is zero or minimal. And they help to boost the earnings and capabilities of the poor by enhancing human capital, assisting with job search and placement, and facilitating work-family balance.

slash rates of premature death from mental disorders by a third by 2030.

By one analysis, which includes Western countries and developing regions like West Africa, depression, drug abuse and schizophrenia are on track to be the three leading causes of lost economic output by 2030.

Among the successes have been group therapy for rape victims in the Democratic Republic of Congo, family and individual counseling for survivors of torture in Myanmar, and talk therapy and medication for people with depression in rural India.

But without reliable support, follow-up and medical supplies — particularly psychiatric drugs when needed — interventions can quickly lose traction, no matter how well trained and devoted the workers are.

One moment, she was dozing off during a rest period; the next, she felt the presence of strange men coming after her. She screamed at them to stop. “My shouting didn’t stop the men; they kept coming for me,” she said. “So, what did I do? I ripped off my school uniform and ran.”

The medical staff had little training in how to handle a psychotic break: the hallucinations and delusions characteristic of schizophrenia. They sent her home, where the sensation of being hunted seeped back into her thoughts.

Sometimes, she ran out onto the open savanna to escape the demons pursuing her.

Family members took turns keeping watch and exhausted traditional methods of healing. Precious animals were sacrificed to drive away the spirits disturbing her. Healers administered herbal powders, and one applied a pale dye to her face and body in an effort to purge demons.

One is known as task sharing.

The second is community self-help.

The third is raising awareness

The evidence that a combination of these services can lead to lasting improvement for people with severe mental illnesses is thin, but a foundation is being laid.

“The key thing is that it’s not simply home-based care for people with schizophrenia,” Laura Asher, who is running the study, said by email. “It also involves awareness raising and community mobilization.”

the cost of these programs is minute compared with the cost of standard psychiatry

$8 per client per month on average, according to Peter Yaro, its executive director. In the United States, it costs $200 to $700 for a single appointment with a psychiatrist, depending on the provider, the type of care and the location.

In global cost-benefit terms, economists typically rate health care programs by the amount of disability they reduce per dollar. Historically, mental health interventions have scored poorly compared with efforts that save young lives, like neonatal care or treatment of diarrhea. A new analysis of mental health strategies in Ethiopia, for instance, found that treating schizophrenia with generic medications was about as cost-effective as treating heart disease with a combination of drugs, like aspirin and a statin — and much less cost-effective than treating depression or epilepsy. The findings, though preliminary, suggest that treating psychosis is relatively costly.

the studies do not take into account the effect of chronic psychosis on an entire family. “The person with psychosis becomes a full-time job for someone else in the family, and depending on how aggressive the person is, maybe more than one person,” said Dr. Simliwa Kolou Valentin Dassa, a psychiatrist in neighboring Togo

Dr. Aaron Shirley, a physician who has worked for better health care for blacks in Mississippi, said that the history of segregation and violence against blacks still informs the way people see one another, particularly in the South, making some whites reluctant to support programs that they believe benefit blacks. That is compounded by the country’s rapidly changing demographics, Dr. Geiger said, in which minorities will eventually become a majority, a pattern that has produced a profound cultural unease, particularly when it has collided with economic insecurity. Dr. Shirley said: “If you look at the history of Mississippi, politicians have used race to oppose minimum wage, Head Start, all these social programs. It’s a tactic that appeals to people who would rather suffer themselves than see a black person benefit.” Opponents of the expansion bristled at the suggestion that race had anything to do with their position. State Senator Giles Ward of Mississippi, a Republican, called the idea that race was a factor “preposterous,” and said that with the demographics of the South — large shares of poor people and, in particular, poor blacks — “you can argue pretty much any way you want.”

First, well-paying jobs disappeared, partly because of technology and globalization but also because of political pressure on unions and a general redistribution of power toward the wealthy and corporations.

Second, there was an explosion of drugs — oxycodone, meth, heroin, crack cocaine and fentanyl — aggravated by the reckless marketing of prescription painkillers by pharmaceutical companies.Third, the war on drugs sent fathers and mothers to jail, shattering families.

Both political parties embraced mass incarceration and the war on drugs, which was particularly devastating for black Americans, and ignored an education system that often consigned the poor — especially children of color — to failing schools. Since 1988, American schools have become increasingly segregated by race, and kids in poor districts perform on average four grade levels behind those in rich districts.

we should be able to agree on what doesn’t work: neglect and underinvestment in children.

Job training and retraining give people dignity as well as an economic lifeline. Such jobs programs are common in other countries.

The United States focused on money, providing extended unemployment benefits. Canada emphasized job retraining, rapidly steering workers into new jobs in fields like health care, and Canadian workers also did not have to worry about losing health insurance.

For instance, autoworkers were laid off during the 2008-9 economic crisis both in Detroit and across the Canadian border in nearby Windsor, Ontario.

Another successful strategy is investing not just in prisons but also in human capital to keep people out of prisons.

Women in Recovery has a recidivism rate after three years of only 4 percent, and consequently has saved Oklahoma $70 million in prison spending, according to the George Kaiser Family Foundation.

We need the government to step up and jump-start nationwide programs in early childhood education, job retraining, drug treatment and more.

Nicholas Kristof

ommitted over $2 billion to education in India

caters to some 200 million children

the program has brought nearly 20 million children into primary school

there are 93 girls for every 100 boys in primary school compared to just 90 in 2001

expand facilities and improve infrastructure, get children to school, and set up a system to assess learning

more than 95 percent of India’s children attend primary school, less than half of 16 year olds - just 44 percent – complete Class 10

more relevant skills

60 percent of secondary schools which are privately managed in India

Since 2000, the World Bank has committed over $2 billion to education in India

Having improved access, India is now seeking to upgrade the quality of education provided and improve levels of learning

expand access to upper primary education, increase retention of all students until completion of elementary education (Grade 8), and improve learning levels

Johns Hopkins University

He is today the Majid Khadduri professor in Middle East Studies and Director of the Middle East Studies Program

One notable contribution Ajami made in the September October 1993 issue of Foreign Affairs was a rebuttal to Samuel Huntington’s "The Clash of Civilizations?", regarding the state and future of international relations after the Cold War.

In his article “The Summoning”, Ajami criticises Huntington for ignoring the empirical complexities and state interests which drive conflicts in and between civilizations