Democracy, Social Values, and Public Policy

Public policy

Health in International Perspective: Shorter Lives, Poorer Health. National Academies Press US ; Chapters 4 — 7 identified intriguing differences between the United States and other high-income countries that might plausibly contribute to the health gap:. Although each of these unfavorable patterns could be examined in isolation, the panel was struck by a recurring theme: This finding is true for the young and old and perhaps even for affluent and well-educated Americans.

Other rich nations outperform the United States not only on health status but also on protecting children from poverty, educating youth, and promoting social mobility. It is highly likely that the U. This pattern began decades ago. As long ago as the s and s, the United States began losing pace with other high-income countries in preventing premature death, infant mortality, and transportation-related fatalities; in alleviating income inequality and poverty; and in promoting education.

More research is needed to determine if there is a common underlying cause, but the panel did discuss possibilities, such as characteristics of life in America that create material interests in certain behaviors or business models. For example, those characteristics include the typically pressured work and child care schedules of the modern American family, the strong reliance on automobile transportation, and delays created by traffic congestion often leave little time for physical activity or shopping for nutritious meals.

Busy schedules create a market demand for convenient fast food restaurants. Certain character attributes of the quintessential American e. Might these same characteristics also be associated with risk-taking and potentially unhealthy behaviors? Few quantitative data exist to answer these questions or to assert that these characteristics actually occur more commonly among Americans than among people in other countries. Still, for a variety of social or historical reasons, these values have salience for a large segment of U.

The nature of the interaction between the free market economy and consumer preferences may also be somewhat distinctive in the United States. Manufacturers and other businesses cater to consumer demand for products and services that may not optimize health e. Another systemic explanation considered by the panel is whether there is something unique in how decisions are made in the United States, in contrast with other countries, which might produce different policy choices that affect health.

Not all of the problems identified in this report are affected by policy decisions—many relate to individual choices or perhaps the inherent nature of life in America—but decisions by government and the private sector may play a role in shaping many of the health determinants discussed throughout this report.

The relevance of public policy to health is perhaps most conspicuous in relation to recognized problems in the U. But the potential causes of the U. People are responsible for their individual behaviors, but individual life-styles are also influenced by the policies adopted by communities, states, and national leaders Brownell et al. Cigarette smoking, second-hand smoke inhalation, and societal norms about smoking are influenced by the price of cigarettes, bans on indoor smoking, and advertising regulations Brownson et al.

The obesogenic environment reflects decisions by the food industry and restaurants about the content and sizes of their offerings; business strategies about where to locate supermarket chains and fast food outlets; ballot decisions on parks, playgrounds, and pedestrian walkways; school board policies on high-calorie cafeteria menus and vending machine contracts; and the marketing of electronic devices to children Brownell and Warner, ; Institute of Medicine, , b , c , c ; Nestle, Public- and private-sector policies affect drinking and driving, binge drinking, prescription and illicit drug abuse, and the use of contaminated needles by injection drug users.

Policies can also influence access to contraceptives and firearms. Both the incidence and lethality of injuries are affected not only by personal choices, but also by decisions made by manufacturers, builders, lawmakers, and regulatory agencies that control product safety, road design, building codes, traffic congestion, law enforcement of safety regulations e. Policies also affect the social and economic conditions in which people live, and the quality of education—from preschool through college and professional schools Bambra et al. Political and economic institutions, which help drive the economic success of nations, are subject to a range of public policies Acemoglu and Robinson, Tax policy and decisions by employers, business leaders, government, and voters affect job growth, household income, social mobility, savings, and income inequality.

They determine the strength of safety net and assistance programs and the quality of the environment, from its physical characteristics e. The relevance of macroeconomic government policies on health was exhibited in a natural experiment when East and West Germany unified in — Policies that affect public health, education, and the economy are themselves shaped by the institutional arrangements in a society—the governmental and nongovernmental arrangements that organize social relations, rank people into social hierarchies, assign worth, structure employment and the labor market, and address working conditions Bambra and Beckfield, As illustrated in Table , some studies of what has been described as the political economy of health Muntaner et al.

These influences are multilayered and complex. Figure presents a model by Hurrelmann and colleagues , which illustrates the multitude of social and political factors that contribute to population health and, by extension, to cross-national differences in health. Findings of 73 Empirical Studies. A model of structural and political influences on population health. Most European welfare programs came into existence after World War II with the goal of providing more universal access to assistance Bambra and Beckfield, The social democratic model promotes social equality through wage compression, organized through strong collective bargaining by unions, and tax policies that direct resources to the social security system Bambra and Beckfield, As detailed in Part I of the report, the Scandinavian social democratic countries generally have higher health rankings than the United States, along with more favorable measures of social and economic well-being.

As a group, these social democratic countries report longer life expectancies, lower infant mortality rates, and better self-rated health than do liberal countries, including both the United States and the United Kingdom Bambra, , ; Chung and Muntaner, ; Coburn, ; Eikemo et al. Figure shows that this pattern has existed for decades Conley and Springer, Infant mortality rate for the United States and 30 other countries, classified by welfare regime type.

Infant mortality rates by welfare regime type, — Conley and Springer , Figure 3. Sociological research is beginning to suggest that the style of governance in a country may exert its own influence on health outcomes, independent of individual-level variables. Another study concluded that the model type predicted approximately 20 percent of the difference in infant mortality rates among countries and 10 percent of the difference in low birth weight Chung and Muntaner, However, the panel notes the limitations of current evidence on this topic, which relies heavily on cross-sectional associations.

Controlled trials to produce more definitive evidence would be untenable, and all studies on this subject must cope with a variety of methodological challenges, such as the potential endogeneity of the political and social environments, as well as issues relating to aggregate efficiency, intertemporal dynamics, and macroeconomic effects. Typologies for regimes, such as welfare states, can be blunt measures that require further refinement to properly differentiate policy nuances across and within countries and to track changes that affect countries over time.

For example, social democratic countries like Sweden had low infant mortality rates early in the 20th century Regidor et al. There is little question that the European welfare model is effective in redistributing income and reducing poverty. More universal and generous welfare systems achieve greater income equality than other systems through more generous income transfers through taxes and services Esping-Andersen and Myles, These entitlement benefits may buffer the health effects of material deprivation and thereby improve health outcomes but they may have other consequences that are not economically or politically viable in the United States.

Related characteristics of Scandinavian society, such as greater gender equality Stanistreet et al. Political empowerment of minority groups and women appears especially important to health Beckfield and Krieger, As noted in Chapter 7 , citizen engagement in the United States, such as voting in elections, is lower than in most other OECD countries e , and the United States has one of the lowest rates of female participation in the national legislature Congress Armingeon et al.

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People are responsible for their individual behaviors, but individual life-styles are also influenced by the policies adopted by communities, states, and national leaders Brownell et al. For example, mortality rates in Denmark approach those of the United States, and Finland has high mortality rates for some conditions. As a group, these social democratic countries report longer life expectancies, lower infant mortality rates, and better self-rated health than do liberal countries, including both the United States and the United Kingdom Bambra, , ; Chung and Muntaner, ; Coburn, ; Eikemo et al. Its conclusions included the following challenges to implementation of such policies:. As specific policy initiatives tend to be targeted to a specific population group in certain circumstances and for prescribed time-periods, they can neglect the wider context within which the social and other determinants are generated and re-generated. Retrieved from " https: The kinds of organizational forms that are cultivated by governments are important in determining how citizens come to acquire the skills and attitudes that enable them to play the roles demanded of them by the Partner State.

Scandinavian society is also known for having less income inequality than in the United States see Chapter 6 , a likely product of the welfare state. The Luxembourg Income Study provides evidence that social democratic policies have, over time, substantially reduced income inequality Alderson and Nielsen, The Scandinavian welfare programs universalism, generous wage replacement rates, extensive welfare services may also narrow income inequalities and provide low-income individuals with greater access to services Coburn, However, as discussed in Chapter 6 , it remains unclear whether income inequality itself, or the policies that affect income inequality, bear more on the U.

There is some evidence to suggest that aggregate spending on social programs is associated with better health. One study examined spending on health care and social services in 30 OECD countries and found that U. More importantly, the study found a significant association between social spending and life expectancy, infant mortality, and potential years of life lost Bradley et al. In a commentary about the U.

European tax systems are more progressive, child benefits are traditionally available for parents in many countries regardless of income, social programs are generally not restricted to the poor, employment protection is substantially higher, unemployment benefits are more generous, and labor standards for working parents are more extensive.

Authors of another study also noted that the United States ranks poorly on measures of full-time employment, public child care, union representation, and parental leave Pettit and Hook, see Table Many of these may be less acceptable in the United States because of related tax burdens and other implications. In seeking a systemic cause for the U.

We have suggested a potentially promising line of inquiry based upon differences in social policy contexts. However, the challenge is obviously to identify the particular social and labor policies that have a causal impact on health and that may contribute to cross-national health differences. For example, do the more generous parental leave policies in Europe contribute to their comparative health advantage? Have employment protection policies contributed to the better health of European workers compared with their U. The great variation in policy reform during the last 50 years across Europe and the United States provides us with a potentially fruitful set of natural experiments to consider.

Broadening the scope of our inquiry to include the social and policy context of nations might help to solve the puzzle of the U. Even the reduction in income inequality achieved by this form of capitalism probably results from the interaction and combination of multiple policies e. Nor is the social democratic model a panacea for public health.

Compared with Scandinavian countries, health gradients tend to be lower in Bismarkian countries e. As discussed in Box , a variety of explanations for the paradox have been proposed Bambra, ; Dahl et al. Explanations for the Scandinavian Welfare Paradox. One proposed explanation for the paradox of greater health inequalities in many Scandinavian welfare states is that lower social strata may have a higher relative concentration of individuals at increased more The United States can take little comfort in debates about why some European countries do better than others in reducing health gradients, because it is still the case that the United States and the United Kingdom generally fare worse than all of them—on both aggregate health status and the steepness of the health gradient Avendano et al.

As noted in Chapter 6 , at least one study has reported that the health gradient by education is steeper in the United States than in Western European countries Avendano et al. These cross-national comparisons certainly shed light on the U. Social, economic, and public health policies are often an expression of societal values, set against the backdrop of other exigencies e. Social rights were extended at minimal cost to the entire population in a social contract that sought to eliminate status privilege Bambra and Beckfield, On issues that pertain directly to the U.

The United States ranks poorly on a number of factors that could explain its health disadvantages. As detailed in Chapters 4 — These conditions reflect multiple factors, including history, governance models, societal values, and priorities that cannot be ignored in trying to understand the U.

For example, as discussed in Chapter 4 , the lack of universal health insurance coverage sets the United States apart from most high-income nations, but there are reasons this situation has existed for generations.

Public Policy for a Social Knowledge Economy

At the same time that countries in Europe were establishing universal access to health services, attempts to do so in the United States, beginning with the Truman administration in the s, met with political resistance, as it still does today Altman and Shachtman, ; Starr, The resistance has been shaped not only by interest groups, such as medical organizations and health insurance companies, but also by societal beliefs about the proper role of government and the private sector in health care Freeman and Marmor, Similarly, to make sense of why Americans are more likely to engage in certain unhealthy behaviors or injurious practices see Chapter 5 , the role of societal values in enacting or resisting countermeasures cannot be ignored.

Yet there is little empirical evidence to prove that values in the United States differ substantially from those in other high-income countries. The internal and external validity of the indicators and sampling techniques used in such surveys is less than ideal. However, the panel believes that the individual behaviors and policies of Americans in relation to public health and socioeconomic issues are, to at least some extent, influenced by prevailing values and priorities Goldberg, For example, five iconic American beliefs seem especially relevant: Individual Freedom Strong beliefs in individual freedom, as expressed in the Declaration of Independence and Bill of Rights, remain powerful drivers in modern America Fairchild et al.

Some personal freedoms carry special significance in the United States, such as the right to bear arms, a constitutional protection that does not exist in most other countries Glantz and Annas, Free Enterprise American society is committed to free-market capitalism and generally eschews restrictions on industries, especially when they impede economic activity or involve an expansion of governmental regulatory authorities.

Many aspects of the political process, including the campaign finance system in the United States, give large donors and special interests a degree of influence over the formulation of policy than may exist in other countries Mann and Ornstein, Whether regulations are meant to protect public health, assist vulnerable populations, or meet other needs, a popular refrain in the United States is that effective solutions for social and economic problems are best achieved through the free market and more directly by families and their communities see discussion on self-reliance, below.

It is also true that a vibrant and growing economy is good for public health and for the health of the population, that anything that impedes economic growth and flexibility can have detrimental population health effects, and that strategies to boost employment and raise levels of income and wealth can yield important health benefits. Self-Reliance In a nation founded by pioneers, many Americans believe in the responsibility of individuals, not the state, to solve personal problems: Thus, raising taxes for state-financed social or health programs is often unpopular with a large proportion of American voters.

In contrast, there is a consensus in many other high-income countries around shared responsibility, solidarity, and the principle that a certain standard of living is a right of citizenship Bambra and Beckfield, ; Esping-Andersen, ; this consensus that may not be as pervasive in the United States.

Role of Religion Although the separation of church and state is a core principle in the United States, the United States is less secular than most other high-income countries Taylor, ; World Values Survey Association, , and religious beliefs are often raised in public discourse. Sensitive public health policies, such as those related to contraception or adolescent sexuality, may not be as contentious in other countries Darroch et al.

At a service level, multi-stakeholder organizations representing different stakeholders and interests can negotiate contracts and services, co-ordinate organization and production, and support the social economy providers with cross sectoral training, logistics support, collective purchasing, financing, etc. Popular education programs to raise awareness and understanding of this new approach among communities are also key.

And, as outlined in more detail below, there is an urgent need for higher-level academic research, education, and professional training for both civil servants and social economy actors.

U.S. Health in International Perspective: Shorter Lives, Poorer Health.

Democracy, Social Values, and Public Policy [Milton M. Carrow] on donnsboatshop.com *FREE* shipping on qualifying offers. Transcending the widespread concerns. This book deals with a significant aspect of value debates, namely, the social values underlying public policies in a democracy. In the United States we have.

A review of public policy trends and instruments for supporting the social economy reveals a highly developed array of strategies developed by many countries. These integrated programs may be broadly organized along four mutually supportive axes:. In general, the role of government in administering these initiatives may be summarized as follows:. Many of these initiatives have proven successful in strengthening the capacity of social economy organizations to contribute to social wellbeing through the production of much-needed social services and the increase in training and employment that these services provide.

In particular, the use of co-operative models for the provision of social care has yielded not only an increase in the range and quality of services available to the public, but in jurisdictions like Italy and Quebec where public policy has supported their development, social co-ops have generated a high proportion of the new employment generated by the social economy. Within the broader commercial economy, social economy organizations like co-operatives have prospered when access to basic capital resources — owned and controlled by the social economy itself — has been bolstered by progressive tax policy, by enabling legislation, by education and professional development, and most of all, by the support of representative civil associations that can identify and address the collective needs of the sector.

Multi-stakeholder structures representing a broad range of social economy actors have been key in this regard. In summary, there is no question that a concerted use of public polices by government can have a decisive effect on the capacity of the social economy to play a much enhanced role in the provision of new goods and services, in generating new opportunities for training and employment, and in strengthening the productive capacities of key sectors through the use of co-operative and other collective systems. This is essential for the pursuit and institutionalization of those values that will, in the long term, be the foundation for a more socially just and equitable social order.

When the government of Ecuador introduced to the world its visionary constitution and its bold plan for reframing the direction of development according to the precepts of a social knowledge economy and Buen Vivir , it held open the possibility of a wholly new conception of governance and of the role of citizens in both defining and defending the common good. Drawing on both the theoretical and practical foundations of the Partner State as a model of governance, the paper argues that the proposed transition to an economy based on social knowledge and the realization of Buen Vivir requires a radical restructuring of the state apparatus toward a direction of increased empowerment and meaningful engagement of both civil society and economic agents in the small firm economy as prerequisites for this transition.

The idea of the social market is also advanced as a means of enlarging the scope of social economy activities throughout the economy and as a central aspect of a Partner State approach to empowering civil society. Just as the vision of a social knowledge economy and Buen Vivir represent a radical departure from neo-liberalism, so does the Partner State represent a departure from the state as the command and control apparatus from which economic and social development proceed.

The Partner state, in which active citizenship for the common good is a defining feature, is the political expression of a society in which knowledge, economics, and social policy are all in service to civic values and the common good. At a time when many are searching for viable alternatives to the traditional Welfare State on the one hand, and the emerging Corporate State on the other, the idea of the Partner State is a new formulation in which the state is both the guarantor of public welfare and the promoter of civic values.

Recovering the state and its role in planning, administrating, executing, distributing and redistributing has … been vital to guarantee and open up opportunities for participation by persons, communities, peoples and nationalities in order to formulate, implement, evaluate and oversee public policies and public services.

The question that needs to be answered however is: To achieve the kind of society envisaged by the National Plan, a fundamental reframing of the role of the state is necessary. Such a policy is also indispensible for the development of a society that is decent, which is to say, a society whose institutions do not humiliate its members. In its evolution, the idea of the Partner State proceeds directly from the principle that civil society is the source of political legitimacy in a democracy.

In this view, the state is in the service of civil society as a vehicle to advance and protect the common good. The Partner State is an enabling state. Its primary purpose is to maximize the capacity of civil society to create social value and to act as an equal partner in the formation and delivery of public policy for the common good. The enabling role of the state is not confined to the promotion of social value. It also entails the promotion of open access to the economy. It provides space for many models of entrepreneurship, including collective and commons-based forms of enterprise such as co-operatives and peer-to-peer networks, and the promotion of participatory politics.

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The Partner State enlarges the scope of personal autonomy and liberty while reinforcing the social bonds that build healthy communities and a vibrant civil society. Central to this process is the democratization of the state itself. Each of these sectors operates on a distinct set of economic principles and values. The private sector utilizes the principle of exchange equivalence price to create profit — its values are wealth accumulation and market efficiency; the public sector the state uses the economic principle of wealth redistribution to provide for public goods — its values are equity; the social economy utilizes the principles of reciprocity and mutuality to promote social aims — its values are social utility and human solidarity, whether they operate in the area of social goods and services or in the broader market economy.

In modern times, the regulatory role of the state has habitually swung from the promotion of either the private sector through support of the capitalist economy, or the redistributive function of government through state control of economic planning. The first submits the public and social economies to the requirements of capital; the second submits the capitalist and social economies to the needs of centralized state planning. Both models have come at unsustainably high economic and social costs. In theory and practice, the Partner state is the first state formation to do this.

Consistent with the values and operating logic of the social economy, the use of reciprocity and mutuality as central tenets of economic and social development transforms and re-orients the state toward civil society as the primary engine for the creation of social value for the common good. With social values, equity, and sustainability at the foundation of public policy the Partner State also re-orients the role of government toward the private economy and the operations of the public sector. The private and public sectors still retain essential functions in the national economy and in society.

The profit motive and private business continue to play a role. The difference is that in the Partner State the respective roles and powers of the commercial market and the public economy are counterbalanced by the primacy of the common good as the framework within which public policy is formulated and enacted. The institutions of civil society are thus central to the realization of this vision as is the development of public policies and practices that translate this vision into meaningful political participation from the level of local neighborhoods to the directing institutions of government itself.

How then, may such a model be made real? What are the policies and practices that are essential to its operation? Where are the examples that may serve as models? Before discussing how a Partner State would operate, we must first consider the economic, cultural, and structural differences that differentiate the state from the social economy. As outlined above, the state and the social economy are two very different types of economy. Its services are generally free and administered through a highly centralized system of hierarchical control. In a representative democracy, the operation of state services depends on a ladder of accountability that reaches from the front line worker up through the departmental hierarchy to a Minister who is then answerable to a representative Parliament, or directly to a head of state.

This is a system that is characterized by a high degree of control over functions and behaviours and which has a built-in bias against uncertainty, innovation, and individual initiative. Power is imposed and flows from top to bottom and the legitimate exercise of this power rests internally with the designated managers of the civil bureaucracy and the Ministers they report to, not to external stakeholders, except as mandated periodically, and very indirectly, through the broader electoral process.

The internal economy of this system is based on the negotiation of tax or debt-financed budgets that are bargained over by a small group of Ministers and senior civil servants. The main forms of control are over expenditures rather than outcomes or desires , and insofar as power is exercised through control over budgets it is a system that encourages expenditure up to the budget allocated. The social economy operates very differently. As Robin Murray remarks, [17] whether it involves social ventures selling into markets, or grant based organizations, or informal associations of households, the social economy is impelled by a strong element of enthusiasm and a sense of vocation.

It relies on the willing contribution of time, finance and ideas in pursuit of an idea or social mission. It is the quality of this idea and the capacity to communicate, inspire interest, mobilize resources, and realize the idea in practice that determines the relative magnetism of the venture.

It is this which acts as the discipline — similar in some ways to the discipline of the market — as against the disciplines of accountability in relation to budgets and political aims that characterize the state. The social economy is mission driven rather than cost controlled on the basis of budgets, as is the case with the state. The structures, labour contracts, aims, and culture of the two systems follow from the above.

And it is these differences that make effective partnering between state and civil society structurally difficult. The diagram below highlights some of the differences that need to be addressed for a partnership to function. Given these differences, it is easy to conclude that a working partnership — a new social contract in effect — is impossible between the state economy on the one hand and the social economy on the other. But this would be to ignore the fundamental commonality of purpose that is shared between the two systems. Both are concerned, and their legitimacy is derived, from a commitment to social as opposed to private goals.

In this very fundamental sense, they are extensions of the solidary principles that constitute the operations and aims of the broader civil society that sustains and validates both systems. In pursuit of these civil aims, the state offers stability and scale while the social economy generates creativity and social connection. All living things and all social systems, as with all matter, are a delicate balance of order and chaos. Order alone leads to entropy. Creativity alone leads to chaos. A state model based on public-civil partnership offers the potential of achieving a vitality and efficacy that each sector on its own is unable to achieve.

The art is to establish a division of labour that corresponds to the aims and dispositions of the two cultures.

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The state has the capacity to be a synthesizer and facilitator, to set the rules and provide a basic flow of core funds that allows a distributed system of social enterprises to flourish. It has the capacity to organize large projects, and at national scales.

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In its normative role, it has the mechanisms to reinforce behaviours that reflect a broader societal consensus. It represents the general interest, however mediated its mechanisms. The social economy on the other hand is a source of innovation, of distributed production, and in particular of relational production — something essential to the provision of human services. In a very real sense, the two domains manifest the requirements of collective versus personal citizenship and each is the necessary complement to the other.

A new social contract must be based on this fundamental framework. How then, might such a partnership work? How can the interface between these two admittedly contrasting economies be made more permeable and productive? The following discussion offers some directions.

THE ROLE OF PUBLIC- AND PRIVATE-SECTOR POLICIES

Chief among these are. Earlier, we also highlighted the economic, social, and quality of life benefits that are made possible by the democratization and decentralization of public goods and human services. Neither the privatization of social care, which instrumentalizes people for the generation of profit, nor the de-personalization of care by the state, which submits individuals to the impersonal requirements of bureaucracy, are capable of humanizing care or of responding adequately to the real needs of individuals and their communities.

The creation of civil bodies, operating at local and regional levels, and providing a mechanism whereby individuals may directly determine the nature of the care they receive, is one indispensible condition for the operation of a Partner State model with respect to the provision of social care. The other is a mechanism through which government and civil interests can collaborate on the design and delivery of human services, at local, regional, and national levels.

The use of subsidiarity is therefore a key principle of inclusive planning is central to the reform of public services as a defining characteristic of the Partner State. To this end, specific provisions that recognize and reinforce the role of social economy organizations in the development and delivery of social care to their communities are of paramount importance. Among the best examples of this approach to the decentralization and democratization of human services is to be found in Italy.

The co-design and delivery of social care services is supported through a system of subsidiarity that grants local authorities the power to identify service needs and to commission the provision of these services through accredited co-operative or other non-profit service groups. In this way, the progressive democratization of human services entails a new governance matrix that maximizes citizen participation in the design and delivery of human services at those levels closest to the actual provision of care. In addition to facilitating a partnership approach at the local level, the matrix must also allow for efficient planning and governance of human services at regional and national levels.

To this end, we propose the adoption of viable systems models VSM that maximize local decision-making and autonomy. Viable System Models enable scaling to higher orders of service delivery through the adoption of co-operative governance structures that engage both civil society and government in jointly controlled institutions at the provincial, regional, and local levels of governance.

The co-construction of public goods and services through an institutional framework that fosters public-civic partnerships is at the heart of the Partner State as envisioned here. To this end, the following are the kinds of policies that help to recast the role of the state from one of dominating control over the production of public goods and services, to that of promoting and enabling the civic production of goods and services as a form of protected commons.

Among the most significant achievements of the Ecuadorian state for the advancement of social protection is the use of the Bono de Desarrollo Humano BDH for the alleviation of poverty and the improvement of educational and health outcomes. The BDH has led to increased school retention rates, increased health care visits, and a reduction of people living below the poverty line from 49 percent in to 37 percent in Additionally, the ratio of income inequality in Ecuador has been declining steadily since They are founded on the theoretical underpinnings of Buen Vivir as a strategy that looks beyond the quantitative measurements of economic performance and establishes a new vision for economic inclusion, transparency and citizen participation.

These are essential theoretical and political foundations for the transition to a Partner State. Not only do such social income programs ensure a measure of social security and equity; they also establish the socio-economic basis for the emergence of an autonomous economic space for a true social market. But important as such programs are, if they remain under the exclusive control of state institutions they are not yet in a form where they could play a transformative role for the inception of a Partner State.

For this, a new mechanism for the shared management of these systems by government and individual citizen-users is required. How then, might the idea of social income be re-imagined for it to become a building block in such a transition? By social value we mean the creation of goods and services whose value is determined by their social utility and social benefit, not their exchange value as commodities in the market. A key area for implementing such a transition is in the use of social income to create a social market for the production and consumption of human services.

One avenue to explore is the creation of a universal social income that can be used to fuel the expansion of the social economy through the creation of a social market for human and social services. In the case of Ecuador, one approach is to provide an addition to the BDH in the form of a social voucher or social currency that may be exchanged for services that would be offered by social economy organizations that have been established for this purpose. Such a system could begin with a targeted social currency that provides support for human services such as home care, elder care, childcare, or services to persons with disabilities.

A social income should not be restricted to the poor. For purposes of cultivating new forms of social service, the provision of a social income should be designed to include also higher income strata and adjusted to income levels. This approach would also remove any stigma associated with the program. A social income for human services opens up a number of opportunities for increasing the capacity of the social economy to create the institutions that can deliver human services as a common good and also to establish an initial framework for a partnership between government and social economy organizations for jointly designing and producing these services.

A number of institutional resources would be required for this approach to succeed:. The democratization of the broader commercial economy is of fundamental importance to the evolution of a Partner State. But if an economy is truly to serve the common good, its driving values, its rewards and punishments, must reinforce the values and aims of civil society as a whole.

For this reason, the economy as a whole must be socialized and humanized. By this, we mean the support and expansion of those forms of enterprise and economic relations that utilize the market for the pursuit of social objectives. This includes all types of co-operatives, social enterprises, and private companies that aim at social utility — not merely the pursuit of profit. In sum, it means the expansion of enterprises in which capital is under social control. Presently, markets are treated as if they are the preserve of private, for-profit, capitalist firms.

One outcome is that the space that is available for other forms of enterprise is increasingly reduced as more of the market comes to be dominated or monopolized by large corporate interests. By contrast, the Partner State fosters an economy whose institutions support and reward plurality, co-operation, sharing, social benefit, and open access to the market. As an enabler of civic forms of economic development, the Partner State has a crucial role to play in the formation of economic policy that supports the growth of enterprises that promote social value, environmental sustainability, equity, and economic wellbeing.

Central to this is the use of participatory planning and localized co-operative systems to support the emergence and operation of micro, small and medium sized enterprises MSMEs in strategic sectors of the economy. The Partner State seeks to develop policies that align economic development with the expansion of economic opportunity for all kinds of enterprises. Priority is placed on those enterprises that contribute to local and regional development through the growth and diversification of productive capacity that is rooted to community.

Economic policy is thus geared to the strengthening of local economies that can maximize economic opportunity for individuals and micro, small, and medium enterprises, whether privately or collectively owned. As stated in the policy documents produced by the Inter Institutional Committee for Transforming the Productive Matrix ,. The micro, small and medium enterprises have a strategic importance in the growth of the economy, for the transformation of the local production system, and the best competitive position for the country.

The aim is that MSMEs have priority treatment at all stages, from initiatives to improve productivity, quality, and marketing to those that promote strategic and rewarding participation in domestic and international markets. Throughout, the documents stress the central importance of collaboration among economic actors, the sharing of research and innovation, and the creation of institutions that facilitate economic and social solidarity in the region. This focus on economic democratization through the support of local small and medium enterprises, as well as the promotion of representative Regional Councils in the development process, are key aspects of a Partner State approach.

As enabling agent, the Partner State develops policies and resources that provide a supportive framework for this kind of development. A number of elements are essential to this. Most of these practices are now accepted as standard policy for strengthening the performance and resilience of small firm economies. However, the vital question remains… How are these policies to be realized in practice so that the institutions that are vital to their success reflect the principles of a Partner State? Perhaps the most effective means of implementing a Partner State approach to economic development is to focus on sector development and the creation of partnering institutions at regional and local levels.

This allows for a concentrated focus on strategic areas of economic activity and on the mobilization of partnerships and resources at those levels of governance that are most appropriate for the implementation of policy. Focusing on sectors allows policy and practice to be tailored to the unique institutional and organizational characteristics of a defined area of economic activity and its actors.

This approach also has the advantage of activating the governance structures and giving effect to the democratization and decentralization of decision—making and economic planning. The first step in sector development using a Partner State approach is the establishment of a partnering agency that has the capacity to undertake a detailed sector analysis of the economy at both national and regional levels. Needless to say, this development agency would be designed as a vehicle for the inclusion of both government and non-government stakeholders in the formation of strategic planning that relates regional development to global realities and provides a counterweight of regional and small-scale entrepreneurial interests to those interests that form the current power status quo.

Included in the governance of this agency should be micro, small and medium sized business interests; organized labour; the co-operative and social enterprise sector; the credit union sector; and key academic institutions. As with the co-construction of social goods and services, the second element in the development of a sector-based economic policy is the creation of specialized service centres that can promote the development of strategic sectors by assisting micro, small, and medium firms to succeed through the provision of shared services; the development of co-operative production networks; the promotion of shared use of technology, research, and equipment; and the utilization of open knowledge systems for collective economic benefit in the region.

These centres would form the organizational infrastructure that facilitates the utilization of open knowledge and open source technology for greatest effect in the sectors they are intended to serve.

The overall direction and control of these centres must rest primarily in the hands of those enterprises that use their services along with representation of other regional and sectoral stakeholders such as government, universities, and local financial institutions such as credit unions. The sectoral centres should also be closely linked to the strategic planning role played by the national economic development agency and the corresponding ministry in government.

All these attributes of a sector strategy are well illustrated in the case of Emilia Romagna. Emilia Romagna is a region of four million people in the north of Italy.

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It is one of the best examples of how a government can employ co-operative and commons-based principles as part of a Partner State approach for both economic and social development. The co-operative economic system in Emilia Romagna has achieved an internal coherence and integration that is unique. How was this accomplished? Industrial clusters were perfected in this region and an extensive literature has been devoted to what has since come to be known as the Emilian Model. One of the first tasks of the regional government was to create a mechanism through which the regional economy as a whole could be understood, its strengths and weaknesses diagnosed, and a program of development established.

While the particular services provided by each service centre were tailored to the needs of the sector in which they operated — ceramics, agricultural machinery, footwear, clothing, etc. Some of these service centres ASTER, Democentre were engaged exclusively in research, training, and technology transfer. The service centres were structured on a co-operative model — they were funded through a mix of ERVET funds and member fees and directed by elected representatives of the firms that used their services. The co-operative nature of these networks were a key reason why SMEs were able to access the research, training, and knowledge that were central to creating the innovations that were indispensible to the success and survival of these enterprises.

The programs and services of ERVET and the centres reinforced the co-operative bonds between firms and within the industrial districts. For example, research funds for product development or the development of new technology were granted only to groups of firms that had agreed to work together. On the question of capital investment, firms would organize credit co-operatives. These groups, or consorzi, would then take responsibility for the loans taken out by their members, operating much as a loan circle for small firms.

Adapted to the credit needs of Emilian firms, consortio loans are provided at very low rates by co-operative banks, many of which were first established as a source of credit for farmers. So successful are these consortia, and the default rates so low, that the large national banks have been trying to break into this market for years, but with little success. Undoubtedly, countries and regions differ. The economic, social, and political antecedents that gave rise to the Emilian Model are in some ways unique.

However, the lessons of co-operation as an instrument of regional development and of small firm empowerment are even more relevant in the case of countries like Ecuador where economic inequities and the domination of established power structures are even more adverse to the interests and prospects of small and medium firms. In these contexts, co-operation among MSMEs at a regional level is even more of an imperative if they are to develop and contribute significantly to a new, more pluralistic, productive matrix.

Open source technology provides a means for small farmers to access information online that greatly enhances their capacity to improve production by adjusting their practices to the particularities of crops, soils, and climates. New avenues for global marketing of local products are available, as is the integration of products into fair trade distribution networks that are meant to support the kinds of locally controlled production models described above.

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Most important of all are the examples of successful development strategies that can benefit both private and collective forms of ownership through the use of co-operative systems. Just as these systems have proven successful in regions like Emilia Romagna and the industrial districts of Germany, France and the US, so too have these models been adapted to serve the needs of regional economies in countries like Sri Lanka, Mexico, and Costa Rica. Here, the challenges of small scale, isolation, absence of secondary processing, inaccessible markets, and the control of product distribution by intermediaries are identical to the problems faced by small producers and entrepreneurs in Ecuador.

What do we mean by the commons? The commons refers to any resource whose use is freely accessible to a community of users and which in turn, is managed by them in common. A commons is not owned in the conventional sense. Rather, its value lies in the fact of its free and open access. It is the antithesis to enclosure of a resource for private benefit. Instead, a commons is based on the social ethics of interdependence and co-operation and the value of a commons is generated through the practice of sharing.

Most importantly, a commons is the product of those social relationships that enable this use. Traditionally commons have referred to such natural goods as water, fisheries, forests, pastures, etc. However, the concept has been broadened to include also non-material common resources such as knowledge, culture, free software, and the Internet. These same qualities of open access, sharing, and collective management by the users are common to all of them.

Historically, the commons may be seen as the material and economic foundations that helped sustain collective forms of living. They were, and remain, both the product and the indispensible support of those social relations that bind people to each other and to their environment. The idea of the commons is thus central to the aims of Buen Vivir and is also intimately linked to the protections afforded to nature by the Constitution.

These protections are deeply linked to the protection and promotion of the commons and to the notion of subsidiarity that grants local territories and indigenous peoples the constitutional right to participate in the decisions affecting the development of their territory and the enjoyment of their traditional ways of living. Protection of the material commons, especially natural resources, is intimately connected to the establishment of a plurinational polity.

The notion of collective rights is inseparable from the idea of the commons and of the common good. Collective rights are those individual rights that belong to the individual as a member of a community. The individual has the enjoyment of these rights as protected by law — but only as a member of the community.

It is the community as a whole that embodies these rights and exercises them through the agency of each individual member. The collective enjoyment of these rights is linked to the notion of use, and in particular to the concept of civic use as opposed to merely free use or public use.

More specifically, common goods refer to those things that may be used by anyone belonging to the community that has use rights over a commons. Enclosure and commodification of the commons undermine the material basis for collective forms of living and of the social relationships that in turn, reproduce those forms. As such, the protection and expansion of the commons must be a basic aim both of civil society and of any government that wishes to promote the social aims envisaged in the idea of Buen Vivir.

The commons however, should be distinguished from public goods or public property. For this reason they may also be privatized by the state, commodified, and sold for profit. Today, the enclosure and commodification of public goods by governments and capital constitute the greatest encroachments against social wealth in the world.

The evolution of the relationship between states and capital, between public and private property, has led to a condition in which privatization and statism now endanger the very survival of the commons as an indispensible resource for the satisfaction of basic human needs. In this we include such essential life supports as access to water, the sharing of seeds for agricultural production, and clean air.

But it is now clear that conventional models of democratic governance, conceived as government acting on behalf of citizens, are no longer capable of protecting and preserving the public interest and what remains of the commons along with it. What is required is a wholly new relationship in which formal political authority legitimizes its operations in a given territory through the direct involvement of local communities in governance.

The protection of the commons requires a framework which formalizes the civil and communitarian attributes of commons and which tie them inalienably to their users and to the territory as a shared collective resource. This means the enactment of legal protections for their preservation and the pursuit of public policies for their expansion. Above all, it means the recognition by the state of a distinct and inalienable space of commons wealth that can neither be appropriated nor purchased. It is a uniquely civil space that is protected by legislation which recognizes this distinctive civil — as opposed to political — quality of the commons.

A current example of this kind of legislation — focused on urban commons — is to be found in the city of Bologna, which has become the first Commons City in Europe. The salient characteristic of this new relationship between the City and its citizens is collaborative governance on the principle of horizontal subsidiarity.

Horizontal subsidiarity requires all levels of governments to find ways to share their powers and co-operate with single or associated citizens willing to exercise their constitutional right to carry out activities of general interest. And, as opposed to conventional subsidiarity, which is vertical and hierarchical, horizontal subsidiarity stresses choices that are made collaboratively by social actors and government at the level at which an action is to be carried out. The management of commons is central in this respect.

The Cities as Commons project started in June in Bologna thanks to the support of Fondazione del Monte di Bologna and Ravenna and the technical support provided by the Laboratory for Subsidiarity — Labsus — in Rome. The draft of the regulation that was adopted was then subjected to public consultation and reviewed by some of the most prominent Italian scholars of administrative law. A Spanish translation of the regulation is included in Appendix 3. The Regulation on Co-operation Between Citizens and Government on the Care and Regeneration of Urban Commons is a framework for the joint care and management of urban commons.

As stated in the Document,. The regulation refers to the care and stewardship of a broad range of public assets and services that fall under its jurisdiction. These are described as including,. Assets of urban municipalities and tangible, intangible and digital property that the citizens and the Administration recognize as instrumental for realizing individual and collective wellbeing and … to share with the administration the responsibility of their care or regeneration in order to improve the collective enjoyment.

The regulation also promotes the creation of a range of social economy organizations for implementing this work. The municipality pursues the objectives referred to in this article encouraging the creation of co-operatives, social enterprises, start-ups in social vocation and the development of economic, cultural and social activities and projects. A key provision of this regulation is the requirement for local authorities to designate municipally-owned assets as resources to be used for the realization of these aims. Spaces and buildings referred to in this regulation constitute a resource functional to the achievement of the purposes referred to in this article.

The City reserves a portion of these assets to projects that foster social innovation or the production of collaborative services. All citizens, whether acting as individuals or as members of associations, have the right to participate and contribute to this work of caring for the commons. These are intended to be enabling as opposed to prescriptive. Importantly, the regulation promotes informality in the arrangements between participating stakeholders and requires formal, legal agreements only when required by law.

In the remaining cases ensures flexibility and simplicity in the report, as long as it is possible to ensure compliance with public ethics, as well as declined the code of conduct for civil servants and the principles of fairness, good performance, transparency and certainty. One additional point may be noted with respect to the regulation. The notion of the commons is extended to the management of immaterial common goods and the promotion of digital innovation as a component of commons co-management. This is an important feature that links the co-management of the commons to the concepts of open technology, the promotion of open government, and to the broader aims of a social knowledge economy.

The Municipality encourages innovation through digital interventions participation in the conception, design and implementation of services and applications for the civic network by the community, with particular attention to the use of open data and infrastructures, in perspective of digital commons. To this end, the City agrees with the parties that participate in civic life and the evolution of the network and provide the collaborative environment and civic skills for the co-design and realization of innovative services, data, spaces, infrastructure and digital platforms, such as the medium of the Civic Network.

Finally, the implementation of these collaborative projects entails the enactment of a co-operative covenant or pact between government and citizens. The co-operative pact describes the work to be done, the procedures to be followed, the monitoring and evaluation of the results, and the resources, guarantees, and responsibilities involved. And it is interesting to note that both the idea of the co-operative pact and its form have been strongly influenced by the civic agreements signed by local authorities with social co-ops for the provision of health, education, and social services commissioned by the municipalities.

The regulation adopted by Bologna provides a concrete and comprehensive framework for implementing a project for the co-management of public and common goods by a municipality and its citizens. Its aims and principles reflect many of the elements that are characteristic of how a Partner State might approach the protection and co-management of the commons in an urban context.

But whereas the Bologna initiative has broken new ground with respect to the regeneration and care of urban commons, the principles involved may be adapted to the requirements of other forms of commons and at larger scales. Combined with the idea of horizontal subsidiarity and of the constitutional rights of nature and of indigenous communities, a regulatory framework could be developed for the identification of such commons as waterways, forests, and natural resources for joint management with the peoples of the territories where these commons exist.

A Partner State approach through a form of co-operative pact with the communities of these territories would give concrete effect to the decentralization of decision-making mandated by the Constitution and the National Plan. This approach would also secure the material basis for the expression of those social values of reciprocity, mutuality and the common good that are the basis for collective life in these territories. But while the Bologna initiative has developed the regulatory framework for the co-management of urban commons, these municipal assets are still owned by the state and as such are public… not entirely common in the sense we have described.

For this to be the case, the management of the common resource needs to be paired with legal protections that secure its use as a commons in perpetuity. Such a commons, while legally protected and constituted for this use, may not be appropriated by the state as government or public property, nor be sold. For this to have effect, a form of collective and civil ownership must be devised.

Examples of these forms of commons ownership and governance, as well as the rules for their operation, have been well documented by Elinor Ostrom. In its constitution and national aims, Ecuador has already travelled a great distance in the direction of empowering its citizens to take an active role in the development of the territories in which they live.

However, the development of a true Partner State would require the formulation of a legislative and regulatory national framework that would entrench the commons, in all their forms, as a true national patrimony beyond the reach of those interests that would seek to enclose them for private or political gain.

It is important to note that a transition to this type of development is contingent on existing patterns of production and the cultural attitudes that drive economic behaviour. The most important of these is the presence or absence of high levels of social capital and a predisposition among people to work together to realize mutual aims. Where these social values and attitudes are strong, and where co-operative institutions already exist, the collaborative approach to economic development has a far higher chance of changing the productive matrix through the use of social knowledge as a resource for economic and social development.

Where social capital is weak, a key strategy for promoting such a development model is the creation of production systems that foster habits of economic collaboration and that are oriented toward common benefit. Unlike conventional capitalist models, which serve to undermine and deplete social capital, co-operative and peer-to-peer models depend upon social capital as a necessary condition of their operations. Co-operation reinforces and cultivates further co-operation. Co-operative systems replenish social capital and the attitudes and skills that promote sharing.