From Neoliberal Punitive States to Care States

Abstract

As has already been made clear in Chaps. 1 to 3, under the impetus of economic neoliberal ideology in the past four to five decades, there has been a global push for strengthening the free market forces, at the expense of the role of states and governments.

5.1 General

5.1.1 Economic Neoliberalism’s Reshaping of the State Model

As has already been made clear in Chaps. 1 to 3, under the impetus of economic neoliberal ideology in the past four to five decades, there has been a global push for strengthening the free market forces, at the expense of the role of states and governments.

Ironically, it has been states themselves—in addition to certain international and supranational entities to which nation states have ceded part of their competence and which, so approached, can still be considered an emanation of state authority—that have been the most vocal about in this transition.

Indeed, whereas economic neoliberalism has its roots in a number of academic, economic schools that gradually emerged in various Western countries in the post-World War II period—in many cases thanks to a major involvement of industrial interests (and financial resources provided by these)–, it still owes its unparalleled success mainly to the fact that, particularly since the 1980s, it got implemented in practice through the efforts of some national governments, including those of the United States of America and the United Kingdom. (Cf. already in Sect. 1.5.3.)

The economic crisis of the 1970s—which was essentially one of the first severe energy crises of the capitalist economies—in addition to, as far as the United States of America was concerned, the heavy cost of successive wars overseas, undoubtedly played a catalytic role in this, since because of this crisis, several (Western) countries started to experience difficulties in keeping their own finances healthy.

Economic neoliberalism was found to be particularly attractive because it offered several, prima facie, simple recipes to remedy these problems, however, without taking into consideration the medium- and long-term effects of the implementation of its ideas (which have manifested, especially in recent years, in ever-increasing manners and numbers).

With this, the political dimension of the economic-neoliberal ideology also readdressed the liberal “laissez-faire, laissez-passer” principle—rather than continuing a previously imposed Keynesian policy (based, among other things, on government spending)–, except in terms of resorting to measures aimed at dismantling the welfare state model itself, for which neoliberal governments themselves began to advocate strongly.

5.1.2 Deconstruction of the Welfare State Model and Monetarism

As already mentioned in Sect. 1.5.3, within economic neoliberalism, the idea was pervasive that the welfare state model, the expansion of which had begun in the post-World War II period, implied that states had begun to get involved in too many domains that were of no concern to them, and that all of this was far too expensive.¹

Neoliberal thinking therefore focused on the deconstruction of all kinds of public services and social security mechanisms that make up the ingredients of the welfare state, with the underlying idea that savings in their related expenditures would automatically—as if directed by an invisible hand (?)—result in healthy public finances.²

In parallel, in the monetary domain, monetarism took hold, which is itself an umbrella term for a range of monetary theories that hold that the main task of monetary institutions is, through influencing the supply of (newly created) money, to steer the economy in the direction of ever more growth, and of ever more profit-making to the benefit of the entrepreneurial class.

Whereas one of the main objectives of monetary policy had traditionally been to fuse the purchasing power of money—or, put another way, to avoid inflation—the application of monetarism would itself usher in an era of abundant, additional money creation. The rationalization of this was that the increase in money creation is a requirement for economic growth—itself one of the basic dictates of unbridled capitalism.

In recent times, the question has been raised whether, through monetarism, a semblance of economic prosperity was not rather created. Although this has admittedly benefited the interests of the corporate sector and its underlying capital providers in the short run (which made the latter become ever richer at the expense of the rest of society; cf. Sect. 3.3), it also has greatly compromised the (Western) welfare state model (which in recent times has even begun to erode the purchasing power of money).

5.1.3 General Implications of the Implementation of Neoliberalism

5.1.3.1 General

It is in all this becoming increasingly clear that the implementation of neoliberal ideology has been anything but a good thing for the average citizen who has, to an ever-increasing extent, less access to public services and to social security mechanisms, and instead finds himself referred to substitute services offered, at high cost (read: at ever higher prices), on the free market.

Indeed, as explained before (cf. Sect. 1.5), one of the basic premises of economic neoliberalism is that it advocates a transfer of former public services and social security systems to the private markets, with the result, however, that, increasingly, such services—even some which in the more distant past were still described as human rights—are no longer (readily) accessible to the poorer sections of the population because the latter, quite simply, can no longer afford them anymore.

A textbook example concerns the problematic nature of access to (certain forms of) medical care, which in traditionally prosperous countries such as the United States of America and the United Kingdom, is barely still accessible to the poorer sections of the population. Many forms of education risk going (or have already gone) down the same path. (Cf., already, in Sect. 3.2.3.4.2.)

5.1.3.2 Impact of Economic Neoliberalism on Public Finances in Particular

Without prejudice to the foregoing, it has become apparent that the neoliberal austerity frenzy that has begun to determine the policies of various countries since the 1980s, has not even managed to get public finances healthy, notwithstanding the fact that achieving healthy public finances has from the start of the implementation of economic neoliberalism, always been considered as one of its main goals.

On the contrary, under neoliberal rule, the public finances of numerous countries have become extremely problematic, with ever-growing mountains of public debt that continue to expand from year to year, without economic neoliberalism being able to provide any adequate response to it (or even trying to do so).

On the contrary, it seems that the problematic nature of public finances, is greatly enhanced by another segment of neoliberal policies, notably unjust taxation policies.

Going back to the ideas of Adam Smith himself, within neoliberal reasoning, the idea prevails that enterprises—and their capital providers—should be as much as possible exempt from taxes (and similar charges). This is an expression of the so-called trickle-down economics doctrine (cf. Sect. 3.2.1.1), that relies on the assumption that enterprises (and their wealthy capital providers and other dominating stakeholders, such as CEOs) reinvest their wealth in economic projects, and that society benefits from this. It has thereby even been suggested that the wealthy entrepreneurial class are the only ones who contribute substantially to economic prosperity. Hence, this wealthy entrepreneurial class should be exempted from taxation as much as possible, so that they can continue to work undisturbed to optimize societies.

In modern times, this classical-liberal approach to entrepreneurial taxation (in the broad sense of the word) has been further reinforced by systems of corporatocracy, in which the corporate sector, through all sorts of mechanisms (e.g., the financing of political parties; lobbying …), exerts a strong influence on government policy, including the content of tax legislation.³

However, safeguarding corporate interests from taxation has had some significant, perverse side effects (which we shall look at in more detail in this Chapter).

As it became less evident to tax enterprises (and, by extension, the wealthy classes within society), governments had instead to turn to the lower and middle classes, which explains why, in most countries of the world, under neoliberal rule, the latter are hit relatively much harder by taxation than the wealthy classes.⁴ Proverbial in this regard is the statement by one of the world’s richest people, Warren Buffet, dating back to 2013 (or even before), that he (at the time) paid less taxes than his own secretary.⁵

A second effect of this, from an equity perspective, reverse taxation is that countries that have adopted neoliberal, fiscal policies, during the past decades, increasingly, faced severe revenue shortfalls to sustain their current expenditures. This in turn provided a further argument to justify already before initiated austerity policies. In addition, this led to the search for additional financing in the form of massive borrowing on the financial markets.

The latter factor has pushed numerous countries even further into a neoliberal logic, as a result of which public policy is increasingly steered by the financial markets themselves, thus completing the inversion of democracy: it is increasingly the institutional lenders that determine the content of public policy, with even the underlying question of whether achieving this effect has not from the outset been one of the intended designs of economic neoliberalism.

5.1.4 Implications for the Extent to Which States Still Manage to Serve the General Interest

The latter observations bring us to the current ‘status questionis’ of numerous countries in the world.

Burdened by ever-increasing public debts, states are in many cases no longer able to fulfill their role properly, which is evidenced, on the one hand, by the underfunding of many forms of public services, such as education, police, justice, and infrastructure and, on the other hand, by the systematic dismantling of previously established systems of social security.

This obviously also affects the modal citizen who, on the one hand, is increasingly burdened by heavy taxation, and, on the other, can rely less and less on public services and social security support.

The neoliberal society that is thus taking shape is one in which citizens must fend for themselves in all areas (and, if they belong to the lower or middle classes of the population, especially also pay their share of taxes).

Meanwhile, in numerous neoliberal(ized) countries, the retirement age is being systematically raised, the hiring of labor for the corporate sector is being made ever more flexible—or, put another way, labor and social protection for the benefit of the working classes, is being systematically dismantled–, and the opportunities to withdraw from the labor market early in life, either in whole or in part, are being systematically withdrawn at.

The neoliberally designed lifeworld has in this manner even come to run counter to the famous prediction once made by John Maynard Keynes, that because of technological developments, future societies could start relying on 15 h/week workweeks, with people increasingly having time to do other things in their lives besides work (and pay taxes).⁶

All this leads us to the question of whether and how, based on our proposed, new money creation model for the benefit of governments, the tide could still be turned to some extent, a question that will be addressed in more detail in the following Sect. 5.2.

5.2 Ideas About Shaping a Fair Society

5.2.1 General

In this Sect. 5.2, we shall discuss how the application of the system of money creation newly proposed in Chap. 4 for the benefit of countries might allow governments to again start serving the general interest, instead of merely providing the ideal set up for the establishment of free markets.

The discussion in this Sect. 5.2 will take the form of an anthology of themes, without intending to outline a comprehensive overview of what the outlook of the new NMWO-based states might be. In this sense, the discussion of this Sect. 5.2 is primarily intended to illustrate the possibilities offered by the NMWO by means of some concrete, contemporary examples.

In the more distant past—say, the period after World War II until the 1970s –, the evolutions were rather the opposite of those outlined in the Sect. 5.1. In that period, as already mentioned, work was still done on the development of welfare states, with various forms of public services and social security as the main ingredients, resulting in a distribution of wealth that was much fairer than in the current economic-neoliberal era. (Cf., already, in Sect. 1.3.)

Our newly proposed system of money creation to the benefit of countries could allow for a return to such a fairer distribution of wealth, with the main difference being that, in our proposals, the financing of the newly emerging states will be based on annual allocations that they will receive from the central monetary institution (referred to above, in Chap. 4, as the NMWI), rather than from taxation, levy of social security contributions and debt financing on the financial markets.

Below, we shall take a closer look at some possible building blocks of the ideal (care) states that could emerge out of the newly proposed system of money creation to the benefit of countries.

It goes without saying that the various building blocks of such care states will constitute coherent ingredients for the realization of the welfare state model, which should be read together with the intention to no longer maintain an economic model based on ever more economic growth—and ever more pointless production and consumption –, but rather to strive for a reasonable economy that takes into account the carrying capacity of the Earth (and its natural resources).⁷

5.2.2 Overview

Central concerns for the newly proposed care state model include:

• 1. The installation of a universal basic income.

• 2. The establishment of a universal, free education.

• 3. The establishment of a universal system of care (for all relevant sections of society).

• 4. Rethinking infrastructure and energy.

• 5. A different view of justice, police, and military.

We shall briefly discuss each of these elements below.

5.2.3 Universal Basic Income Versus the Organization of Labor

In recent years, the introduction of a universal basic income has already been advocated from various quarters, both at an academic and policy level.

Such a system is, of course, at odds with economic neoliberal thinking itself, since under economic neoliberalism the creed is that the average human being exists only to provide labor for the benefit of enriching the entrepreneurial sector and its capital providers—even though, within neoliberal thinking, this credo is neatly wrapped under the sustained lie of trickle-down economics–, which also raises the expectation that anyone subjected to that system, especially just about any human being who does not belong to the wealthy elite(s), should be especially very grateful for it.⁸

Adding to this, economic neoliberalism at the same holds that systems that supposedly encourage laziness, including systems of social security and public service, should be out of the question anyway.

With this, economic neoliberalism adheres to an extremely materialistic and utilitarian image of man, in which (the modal) people (other than those who belong to the class of entrepreneurs and bankers, in addition to those fulfilling certain top positions in government service) are reduced to radars in an economic radar work that exist only in this economic dimension.⁹ This has already been addressed in the past by eminent thinkers, e.g., Erich Fromm and Herbert Marcuse, who on top of that have also demonstrated the heavily problematic nature of such a view on man and his life purpose.¹⁰

The hope plays that an era will ever return in which the pernicious view on life propagated by economic neoliberalism could be abandoned in favor of an approach that addresses dimensions of human life other than that of slavery to an economic system.

The universal basic income is most probably one of the most appropriate formulas for this purpose, in which—simply put—a fixed basic amount of money would be granted to each person, periodically, to (help) provide for their livelihood.

Under the public financing model proposed above—cf. Chap. 4–, such a system should become perfectly feasible, since the financing of such a universal basic income will be made possible from the allocations granted to the participating states, with the caveat, however, of finding a right balance between the amount of such a basic income and the need to keep the economy going (however bearing in mind that this will have to be a more austere economy than the capitalist growth model itself envisions, and that the elimination of so-called bullshit jobs¹¹ alone would save a gigantic amount of collective time and energy).

This would, of course, involve a change in mentality in which (massive) financial support by states would no longer be the absolute prerogative of the class of rich entrepreneurs and bankers, but would instead be conceived as a well-thought-out system that benefits the entire population.

One idea (to be explored further) could be to tailor the amount of such a basic income to people’s stages of life, whereby the amount would be lowest during the period in a person’s life in which people are most energetically active (albeit after completion of their vocational training), say, between the ages of 25 and 50, and higher during periods when a person is not yet professionally active (particularly for studies), as well as of the age when a person would like to gradually withdraw from performing labor (for example, from the age of 50, until a time when a person wishes to leave the labor market altogether).¹²

Such a basic income would obviously provide numerous additional benefits.

For example, its universal application—on a global scale—could allow to finally put an end to poverty (and all phenomena derived from it, such as exploitation, child labor, economic migration, etc.; cf. in Chap. 3).

Such a basic income could also accompany the transition to a negative economic growth model, in which the average working week of people, worldwide, could evolve toward the 15 h/week ideal that Keynes once envisioned (and which, in a resumption of Keynesian economic thinking on which the proposal for establishing a universal, basic income is based, could again become an achievable goal of economic policy).

A further measure to redefine the content of jobs could, as aforementioned, take the form of eliminating so-called bullshit jobs,¹³ so that employment would again be refocused on useful production and services.

Finally, such a universal basic income could also allow to take account of technological evolutions, including the automation of production processes,¹⁴ so that the loss of jobs in certain sectors should not necessarily result in a growth of poverty among common people.¹⁵

5.2.4 Care

5.2.4.1 Theoretical Background of the Neoliberal Reforms of the Health Care Sector from the 1980s Onwards

In Sects. 1.5 and 3.1.2.2, it has already been explained how, under the impetus of economic neoliberalism, in recent decades, there has been a strong push throughout the Western world to dismantle various systems of social security, under the classic neoliberal argument that these systems are no longer financeable. In other (developing) countries, moreover, there have hardly ever been such systems of social security put in place.

In parallel, in a similar vein, there has also been a strong push in recent years to phase out various forms of public service in the health care sectors in the broad sense of the word.

The ideal image of economic neoliberalism, as mentioned several times above, is that each person should fend for themselves in life, with no room for government-organized forms of solidarity. Those who, in such an ideal neoliberal world, wish to cover themselves against the consequences of unexpected things such as illness and disability, or foreseeable things such as having children or growing old, should, on the contrary, preferably do so by appealing to private insurance techniques offered on the free market.

Those who wish to know more about the theoretical underpinnings (and the problematic nature of these) that economic neoliberalism has provided to justify the dismantling of the social security apparatus and public services in the care sectors in the broad sense of the word can turn, for example, to the work, entitled ‘Family Values Between Neoliberalism and the New Social Conservatism’, by Melinda Cooper.¹⁶

In this work, Cooper explains in detail how the traditional American welfare state model of the 1960s and 1970s in general, and the sector of health care institutions in the broad sense of the word more specifically, were dismantled to a great extent from the late 1970s onwards, as a result of a combination of three major schools of thought: (1) Left-liberals from the 1960s onwards started to become critical of the welfare state model, not out of principle, but because they believed it worked too patronizingly, as well as to formulate proposals of far-reaching (albeit often unrealistic) alternatives; (2) Neoliberal thinking itself gained more and more ground, especially after the economic crisis of the 1970s set in, and Keynesian remedies to prop up the economy seemed to fail; and (3) Neoliberals entered into an ‘ideational’ coalition with (neo)conservatives, with their combined discourse, over time, becoming dominant in the public policies of numerous Western countries (in addition to much of public opinion).

As far as health care in the broad sense of the word is concerned, a typical illustration of this coalition between the emerging, neoliberal, and long-standing, conservative ideas on socioeconomic issues has been the approach proposed to combat the AIDS epidemic that struck in the early 1980s, especially among drug users and homosexual men. AIDS was hereby stigmatized—entirely incorrectly—as a limited societal problem relevant only to the most immoral degenerates within society, including drug users and homosexuals. Drug use and unsafe (homosexual) sex were thereby stigmatized as lifestyle choices, with the argument going that the risks associated with such immoral lifestyle choices, including AIDS itself, should be borne entirely by those who had made such wrong lifestyle choices.¹⁷

As a result of this symbiosis between the ideas of neoliberal economists and the conservative right, the AIDS crisis started to take on moral connotations: If people abstained from sex before or outside marriage and did not use drugs—in other words, made healthy life choices–, they would never contract the disease. This attitude inspired, for example, Nancy Reagan’s slogan-like appeal to America’s youth: “Just say no (to sex and drugs).”¹⁸

As a result, the AIDS issue became an ingredient of neoliberal rhetoric in the United States of America that argued against further expansion of public health care, in which it was no longer considered acceptable that decent American taxpayers should have to pay for other people’s risky lifestyle choices.¹⁹

The consequence of this type of argumentation was that, in the late 1970s and early 1980s, an ethic of moral hazard, blame and accountability—which had, until then, not yet been addressed in the critique of the welfare state conceived by academic neoliberalism itself—took on a more pronounced expression in the form of a new public health rhetoric that began to focus increasingly on the link between irresponsible lifestyle choices and the rising cost of public health care. This gradually recognized the overriding importance of individual behavior and lifestyle as a major factor in the country’s unsatisfactory health status and the ever-rising cost of health care. What was worse is that this rhetoric would soon become one of the guiding principles of American—and later European—public health policy.²⁰

Under Ronald Reagan’s presidency of the 1980s, this diabolical combination of theoretical arguments advocating a thorough reorganization of the welfare state model, advanced by, on the one hand, left-wing intellectuals and, on the other hand, neoliberal economists and neoconservatives, began to shape U.S. public policy in a large number of socioeconomic areas, for example, in the following areas: poverty reduction and social security, inheritance and property taxes, student loans, and especially health care policies (the latter, as explained, strongly influenced by the AIDS epidemic itself).²¹

A similar fusion of the ideas of leftist critics, neoliberal economists and neoconservatives would, shortly thereafter, start to take shape in Western Europe. The result here was that, as early as the 1980s, an alliance of neoliberal, conservative, and communitarian ideas began to shape the reform of the Western European model of the welfare state. In the formulation of the neoliberal policies based on this, classical and left-wing economic schools—and on a practical level: the political parties corresponding to them—were taken on board, insofar as they could help provide ideas to reorient the model of the welfare state in accordance with the doctrines of economic neoliberalism itself.²²

One of the most practically relevant consequences of this evolution has been that throughout the Western world—and taking into account differences from country to country—an increasing number of social security systems was transferred (in whole or in part) to private insurers and, in addition, an increasing number of forms of public services became privatized, or otherwise subject to free market principles.

Influenced by this neoliberal thinking, policymakers in various countries began to assume that traditional, public health care systems—including public social security systems –, offered insufficient incentives for sound policy, which was attributed to the absence of market mechanisms and the separation of financing and planning. This view would, in turn, trigger new regulatory changes, as a result of which, throughout the Western world, public health insurance systems themselves would be made subject to mechanisms originally developed for the private insurance sector. The result was that both private, and public health insurance, began to rely more and more on the logic of the free market, rather than on the provision of care based on an idea of mutual solidarity. Eventually, in several Western European countries, this evolution would culminate in a streamlining of the packages of compulsory systems of social security. The aim of this was to guarantee every citizen a minimum basic package, to be supplemented by supplementary private health insurance. A further consequence of this evolution has been that (private) health insurance packages became an increasingly important part of the compensation systems by which (large) enterprises began to remunerate their staff.²³

Of course, these new models soon led to even greater inequality, since highly profitable enterprises with a large workforce generally had the resources to offer attractive private insurance packages, while employees of small(er) enterprises and the self-employed were largely left out in the cold. In this way, private health insurance systems themselves became a system that contributed to ever-increasing social inequality. In countries such as the United Kingdom and the United States of America, this would gradually lead to distressing situations in which the lower classes hardly had access to, for example, dental care or (specialized) medical care. Thus, health insurance systems themselves increasingly became a playing field of inequality in health care opportunities.²⁴

This inequality has—of course—also been an important relevant factor during the COVID-19 pandemic²⁵ (as we ourselves have already explained in more detail in our book Covid-19 and capitalism).²⁶

5.2.4.2 Practical Impact of Economic-Neoliberal Policies on Health Care

Needless to say, during the past few decades, care for the sick and disabled has suffered greatly from the implementation of the neoliberal ideas discussed under the previous Sect. 5.2.4.1.

The constant in public policy on care related matters has since been that care for one’s fellow human being (in their capacity of patient or disabled person), increasingly, has had to give way to a financial logic.

Hereafter follow some (extreme) examples to illustrate this.

One neoliberal method that has hit the health care sector in general very hard is the method of austerity.

Such austerity, on the one hand, in social security and, on the other hand, in sectors relying on (semi-)public institutions (for example, hospitals and nursing homes), already started to occur, throughout the Western world, since the 1980s.

As part of further austerity measures imposed on various countries in the wake of the 2007–2008 financial crisis, savings in these sectors would be pushed even further up the agenda.

Although these savings have manifested themselves in various domains of both social security and the design and financing of public health care institutions, one of the levels at which this savings behavior has reached worrisome proportions has been that of the numbers of health care providers.

This issue has already been extensively discussed in (this Chapter and Chap. 6 of) our previous book Covid-19 and capitalism, in which it has also been explained how this problem of austerity, particularly in terms of personnel, seriously undermined the resilience of (Western) hospitals and nursing homes to respond adequately to the COVID-19 pandemic.²⁷

However, the implementation of neoliberal thinking in the medical and nursing sectors has taken numerous other forms.

One of the other methods of ‘neoliberalizing’ the healthcare sector, stemming from the so-called Washington consensus model, consists in privatizing former public institutions, in addition to, more generally, increasingly subjecting them to the logic and working methods of the free market.

In recent years in particular, the question has arisen as to whether the privatization—in addition to subjecting to the logic and working methods of the free market—of health care institutions, in the broad sense of the word, has proved to be as successful a formula as the adherents of economic neoliberal thinking would have us believe. Indeed, numerous studies have shown that the resulting ‘neoliberalization’ of the care sector has been negatively impacting both access to (medical and other) care, as well as the quality of such care, especially for the poorer sections of the population. For example, it has been observed that private care institutions tend to focus on services that are sufficiently profitable and divest other forms of services—including, for example, ICU beds—as much as possible, to leave them to the remaining public care institutions.²⁸

Other research has pointed to the fact that private care facilities suffer to a much greater extent from understaffing of caregiving staff, which finds its explanation in the profitability model applicable to private legal entities. This has been another fact that proved to be very problematic in the context of the COVID-19 pandemic. Still other research has addressed the impact of privatization and marketing efforts on the quality of services, generally pointing to a negative quality impact.²⁹

As Stiglitz has pointed out in general terms, the privatization story, especially regarding the health care sector, is not as rosy as the supporters of neoliberal ideologies would have us believe, quite the contrary.³⁰

In addition to these classic neoliberal prescriptions of austerity and of privatizing, or otherwise subjecting institutions to the logic and working methods of the free market, the negative impact of the implementation of economic neoliberalism on the health care sector has taken perhaps even more worrisome forms.

Em. Prof. Dr. Walter Foulon—who was in the past the head of the Department of Obstetrics UZ Brussels (Belgium), then to become a board member of the Masereel Fund Vilvoorde–, has pointed to another, important effect of applying neoliberal logic to the health sector.³¹ In addition to market deregulation and the dismantling of public health institutions, a key objective of neoliberal policies has been the reduction of social security expenditure. For instance, to make rational savings in healthcare and not give the impression that cost cuts would come at the expense of quality, the American Registration System was introduced to map the sector. To this end, the DRG (diagnosis related groups) classification system was installed, not surprisingly on the initiative of the Reagan administration.³² A code was thereby assigned to each disease treated in a hospital, which initially was intended to make it easier to find out which pathologies ended up for treatment in hospitals. However, soon this system allowed to deduce how long a hospital stay was needed for a particular treatment of a well-defined pathology. One could, e.g., also start calculating how many staff members were to be involved for treating a particular pathology, how much the medication was to cost, how long the average surgery time would be for an operation, etc. Foulon notes that although such information can on itself be useful and not necessarily needs to be intrinsically harmful or dangerous, the system soon became harmful when it started to get used to propagate further savings in healthcare. As a result, hospital physicians were soon confronted with the concepts of ‘a responsible duration of stay’ (in a hospital) and of ‘responsible hospital expenditure’. Hospitals were even financially rewarded for shorter hospitalizations and penalized for an excessively long hospitalization for a particular pathology. In this manner, the hospitalization duration gradually got shortened for all conditions. Shortening the average length of hospitalization, in its own turn, justified the reduction of the number of redundant hospital beds. E.g., In Belgium, there were in 1990 56,327 hospital beds, a number which was progressively reduced to 52,565 by 2019. This amounted to a reduction of 8% (considering the population growth).³³

Based upon this calculation method for every aspect of treating any disease, savings were also accomplished in the staffing of hospitals. At the beginning of 2021, the nursing supervision in Belgium was 1 per 9.4 patients, while it is generally assumed that a safe level of supervision requires minimum one nurse per eight patients. Raising the number of nurses has since then become increasingly difficult, moreover given the relatively low salaries and heavy workload.³⁴

Because of such approaches (such as austerity on a macro-level) and DRG-reporting systems (or similar systems) on a micro-level, neoliberal health policy has mainly been about reducing costs. As a result, staffing must be kept as small as possible in all hospital services. According to Foulon, in many hospital departments throughout the EU, there is already a problem when a staff member is unexpectedly absent. According to the same author, one does, of course, not necessarily build out a healthcare system with the assumption that a pandemic (such as the COVID-19 pandemic of 2020–2022) is permanently at hand, but neoliberal policy of extreme downsizing the entire healthcare sector, has still made the European healthcare systems extremely vulnerable to the slightest overload. For Foulon, the inadequacy of the healthcare systems of the Western world to deal with a pandemic such COVID-19, has hence as one of its most important causes, the neoliberal health policy of recent years.³⁵

Further examples of the impact of neoliberal policies of recent decades on the (health) care sector are legion. One can think, for example, of the advance of home care systems and voucher systems, which have begun to find increasing application (instead of hospitalization and reimbursement of actual necessary expenses, respectively).

The common thread throughout all of this is that, driven by economic-neoliberal ideology, savings should be made at all levels of healthcare spending. Although in some cases attempts are made to justify this from the standpoint of concern for better service, this latter argumentation is, as a rule, far from convincing, for which, by way of illustration, reference may be made to the various abuses revealed in the context of the COVID-19 pandemic.³⁶

5.2.4.3 Remedies for a Way Out

To get out of the impasse created by economic neoliberalism with regard to the healthcare sector, a radical reversal of the policy-based approach presupposed by this ideology is advocated here.

Health care is, in our opinion, not a sector that can be subjected to so-called austerity. Nor is it a sector that should lend itself to unbridled monetary gain (and, therefore, not to privatization and/or marketization).

On the contrary, from the awareness that every human life is equally precious, a policy insight should gradually prevail again that, when necessary, every human being has the right to full and equal medical care. There should no longer be inequalities in this area based on class, soci(et)al status, race, age, wealth, or any other distinguishing criterion.

In other words, to establish a globally equal health system, a complete reappraisal of the sector is imperative. Accomplishing this intent will, at the very least, require the following:

• Healthcare should be completely removed from any market and profitability logic. The idea that medical (or other forms of) health care provision can be a method of money-making for the corporate sector is plainly perverse. Such thinking should end.

• Health care should become universally accessible, without its users having to pay for it. Adequate health care rather constitutes one of the services that modern health states should provide to their subjects, entirely free of charge.

• Of course, the foregoing implies that the (public) health sector must have the necessary financial resources to fulfill its mission.

The latter assumes that, under the financing model proposed above, under which states would, henceforth, obtain their operating funds from allocations provided by the monetary institutions (cf. Chap. 4), sufficient budgets will need to be released to reestablish a full-fledged, public health sector.

An important aspect in all this concerns the provision of adequate staffing. Rather than the chronic understaffing that has been caused under the impulse of neoliberal ideology, it would be better to have a surplus of personnel in the health care sector, so that there is room again for humane treatment of everyone who depends on their care, while the health care personnel itself would then no longer be overloaded with work, at the risk of burn outs or similar mental diseases.³⁷

5.2.5 Children and Youth

5.2.5.1 General

Besides the sick and disabled, there are, worldwide, two other main groups of people who, by definition, rely on care provision by others, namely, on the one hand, children and young people (who are still too young to stand on their own feet) and, on the other hand, the elderly (from the moment when, for whatever reasons, they are no longer able to care for themselves).

Obviously, this is a subject matter that lends itself to a comprehensive discussion on its own accord, which is however not the intent of this book itself. On the contrary, we shall limit ourselves in this Sect. 5.2.5 to several selected topics of youth care, with the intention of illustrating how the proposed allocation model, discussed in Chap. 4, could allow for the return to a full and universal system of child and youth care. In a further Sect. 5.2.6 we shall devote a similar discussion to elderly care.

The topics we shall discuss in this Sect. 5.2.5 are the following:

• 1. The problem of child poverty at a global level, where the focus will rest on the situation in developing countries, that also in this matter continue to suffer the most from capitalism.

• 2. Point (1) does not imply that there are no problems of child poverty in Western (prosperous) countries. Since the latter is usually underemphasized in literature, we shall, based on empirical data provided by UNICEF, elaborate on this as well.

• 3. Finally, we shall elaborate on a few specific problems that have manifested themselves in the Western world in the recent past and that are mainly the result of the implementation of economic-neoliberal ideology, in particular the problem of inadequate models of infant care in general, and of the so-called baby formula crisis.

5.2.5.2 Child Poverty

5.2.5.2.1 General

The care needs of children are obviously high and, therefore, need little further argument. Nevertheless, over the past decades, ensuring adequate care for (all) children has far from been a policy priority of neoliberal governments and international policy agencies.

Let us look first at the situation of children and young people living in poverty, from which it will appear that, on a global scale, there is still much work to be undertaken.³⁸

It has long been known that in most developing countries, children cannot count on the care that, for reasons of human dignity, is due to them.

According to the UNICEF website, although in recent years the world has made progress in development, in 2022, more than 700 million people still lived in so-called extreme poverty. Moreover, within this group of extreme poor people, children were disproportionately represented. Although children make up (only) one-third of the world’s population, they represent half of those who must make ends meet on less than USD 1.90 per day (i.e., the extreme poverty threshold). Children growing up so impoverished often lack food, sanitation, shelter, health care, and education to survive and thrive. In addition, according to the UNICEF website, by early 2022, around 1 billion children around the world were multidimensionally poor, implying that they lack basic needs such as food or clean water.³⁹

The consequences of this are extremely serious. For instance, worldwide, the poorest children are twice as likely to die during childhood than their wealthier peers. Wherever they live, children who grow up impoverished suffer poor living standards, develop fewer workforce skills, and earn lower wages as adults.⁴⁰

Notwithstanding these disturbing data, only a limited number of national governments have so far committed to making child poverty eradication a national priority.⁴¹

5.2.5.2.2 Information Provided by the World Bank Group

The disturbing data mentioned in Sect. 5.2.5.2.1, moreover, find confirmation in a paper from the World Bank Group, which builds on previous collaboration between the World Bank Group and UNICEF, aimed at mapping the global extent of child poverty.⁴²

As this paper contains a great deal of detailed information that embraces numerous sub-aspects of the subject matter, it is discussed in a little more detail below, albeit with the caveat that these 2018 data did not yet reflect the negative impact of the situation since the COVID-19 pandemic.

The World Bank Group note estimated that, in 2017, 17.5% of the world’s children (or +/− 356 million children) under the age of 18 lived on less than PPP 1.90 USD per day, compared to 7.9% of adults aged 18 and older. The poverty rate of children who had to live on a daily amount of USD 3.20 and USD 5.50 was 41.5 and 66.7%, respectively. In 2017, sub-Saharan Africa accounted for two-thirds of extremely poor children, and South Asia for another 18%.⁴³

The number of children living in extreme poverty (i.e., having less than 1.90 USD/day at their disposal) had decreased by about 29 million from 2013 to 2017, according to this source. However, since these estimates refer to 2017, they did not yet consider the negative economic impact of the COVID-19 pandemic and its subsequent socioeconomic developments.⁴⁴

Be as it may, the findings of this analysis conducted by UNICEF and the World Bank Group show that children are disproportionately affected by extreme poverty.

In 2017, children were twice as likely (amounting to 17.5% of all children) to be part of households living below USD 1.90 PPP per day, compared to 7.9% of adults. While this implied an improvement compared to 2013, extreme poverty among children, relatively speaking, nevertheless did not appear to have decreased as much from 2013 to 2017 (from 19.5 to 17.5%) as among adults (from 9.2 to 7.9%). Moreover, this analysis showed that the youngest children were the worst off—nearly 20% of all children under age 5 in developing countries lived in extremely poor families. These estimates also indicated that the concentration of child poverty increased between 2013 and 2017. In other words, in 2017, a higher proportion of the world’s poor were children, compared to the situation in 2013. One possible explanation is that the average poverty gap at the USD 1.90 PPP line of children (i.e., 5.8%) under 18 is larger than that of adults (i.e., 2.5%). In other words, children live further from the poverty line than adults. This makes sense because larger households are also more likely to be poorer.⁴⁵

The geographic distribution of children who, in 2017, lived in extremely poor households is also striking. Sub-Saharan Africa had both the highest percentage of children living in extreme poverty (just under 45.8%) and the largest share of all extremely poor children in the world (65.8%). Two out of every three extremely poor children in the world, in 2017, lived in sub-Saharan Africa.⁴⁶ Among all geographic regions, South Asia, at 10.2%, had the second highest percentage of children living in extreme poverty and 18.1% of all extremely poor children in the world. This implies that, in 2017, 84% of the world’s extremely poor children lived in sub-Saharan Africa or South Asia. These findings kept holding true even when higher poverty lines of USD 3.20 and USD 5.50 PPP per day were used. The poverty rate among children at the USD 3.20 limit was 41.5% and at the USD 5.50 limit was 66.7%.⁴⁷

Tables 5.1 and 5.2 provides more detail of these percentages considered by country (Tables 5.1 and 5.2).

Table 5.1 Percentage of children in financial poverty in 2017 (data in English)

Table 5.2 Percentage of children in financial poverty in 2017 (data in English)

5.2.5.2.3 Child Poverty in Developed Countries

What is less known is that child poverty is also problematic for part of the population in supposedly rich countries. Indeed, according to data provided by UNICEF, even in the world’s richest countries, one in seven children still lived in poverty in 2022. In June 2022, as many as one in four children in the European Union was at risk of poverty.⁴⁸

By means of a further illustration of child poverty in supposedly rich countries, let us cite some data from a UNICEF report, issued on May 23, 2022, and entitled ‘Innocenti Report Card 16. Worlds of Influence. Understanding What Shapes Child Well-being in Rich Countries’,⁴⁹ which examined in more detail the living situation of children in 41 OECD and EU rich countries.

Innocenti Report Card 16 showed in general terms that a strikingly large number of children in wealthy countries do not exhibit good mental well-being. For example, the report found that in 12 of the 41 examined countries, less than 75% of children up to age 15 showed high life satisfaction. In the surveyed group of rich countries, suicide was mentioned as one of the most common causes of death for adolescents between the ages of 15 and 19.⁵⁰

Physical health indicators raised similar concerns. For example, it appeared that 1 in 15 babies in rich countries are born underweight—a significant risk for survival. In 10 of the group of rich countries, more than one in three children was reported to be overweight or obese.⁵¹

In the group of the surveyed, affluent OECD and EU countries, many children were, in addition, reported to lack basic academic and social skills by age 15. For example, it appeared that, in the group of countries surveyed, two in five children (on average) had not yet acquired basic reading and math skills by age 15. In seven countries, this number was even less than one in two.⁵² According to the report, in nearly half of rich countries, more than one in five children lived in poverty. In many of these countries, the poorest children were at greater risk of depression, obesity and poor performance.⁵³

Figure 5.1 provides an overview of the percentages of the number of 15-year-old children with adequate basic learning skills in reading and mathematics (in the countries surveyed in ‘Innocenti Report Card 16’).

Fig. 5.1

Percentages of the number of 15-year-old children with adequate basic learning skills in reading and mathematics (in the countries surveyed in Innocenti Report Card 16). Source: UNICEF (2022). Innocenti Report Card 16, p. 18, Figure 10

Innocenti Report Card 16 defines children (belonging to the group of 41 wealthy OECD and EU countries examined in the report) who belong to families with incomes below 60% of the national median income, as living in poverty. In doing so, it found that, in 2018, in the group of 41 countries surveyed, as many as 20% of children lived in such a state of poverty, with the understanding that there were large differences between the countries surveyed (for example, a rate of 10% in Iceland vs. a rate of 30% in Turkey).⁵⁴

Figure 5.2 provides an overview of the percentage of children belonging to families with incomes below 60% of the national median income in the years 2008, 2014 and 2018.

Fig. 5.2

Percentage of children belonging to families with incomes below 60% of the national median income in the years 2008, 2014 and 2018. Source: UNICEF (2022). Innocenti Report Card 16, p. 36, Figure 25

5.2.5.2.4 Summary and Conclusions

The Global coalition to End Child poverty has tried to summarize these figures on their website. When consulting this website on September 15, 2022, it appeared that:⁵⁵

• There were, worldwide, 355.5 million children living in extreme poverty (as of 2017). These are children struggling to survive on less than USD 1.90 PPP per day.⁵⁶

• 841 million children were living under the higher limit of USD 3.20 PPP, and as many as 1.35 billion under the USD 5.50 PPP limit.

• An estimated 1.2 billion children were multidimensionally poor.⁵⁷

• Child poverty was not only a phenomenon in lower- and middle-income countries. In the EU, 22.5% of children were at risk of poverty and social exclusion (as of 2020).

• In all OECD countries, nearly 1 in 7 children is income poor (as of 2018).

The question even arises of how large these numbers of poor to extreme poor children would be if a system of measuring poverty were used that met Balla’s criticisms mentioned above (cf. in Sect. 3.3.2.3.2) (to the effect that the limits used to measure poverty since the 1990s⁵⁸ are ridiculously low, which does not allow for the painting of an accurate picture of global poverty).

At any rate, it is questionable that after more than four centuries of capitalism and more than four decades of economic-neoliberal policies, the condition of many of the world’s children is of great concern and the classical, (neo)liberal concepts to remedy this—including, in particular, the trickle-down economics approach—keep failing to bring any hope for relief.⁵⁹

5.2.5.3 Some Specific Problems (in the Western World)

5.2.5.3.1 Opportunity Inequality

The mythological view of life propagated by economic neoliberalism generally holds that Western societies offer everyone, richly, equal opportunities. This allows the adherents of neoliberal ideas to argue that poverty is rather the result of personal failure than of objective, socioeconomic factors. An argument often heard is that the Western education system is both readily accessible to all people and of high quality.

We have already elaborated extensively on this matter in our work ‘The unfree market’,⁶⁰ to which we therefore refer.⁶¹

For those who need further convincing of the importance of the impact of one’s socioeconomic background during their childhood, reference can additionally be made to the book on this subject by Tessa Roseboom, titled ‘Gelijk goed beginnen’, in which the author explains how the quality of life during the first 1000 days of a person’s life (and even before that, in the womb) determines the later course of life, including how successful or unsuccessful someone will be their later life.⁶²

Since this work can be considered one of the most important in this field, we draw from it the following (introductory) quote⁶³:

As it becomes increasingly clear that people's health, behavior and life chances are determined by their own early environment, and even that of generations before them, it becomes clear that we need to change our view of health and behavior. When poverty has been passed down from generation to generation, it gets under the skin, and becomes ingrained in the brain. Then it turns out that addiction is not a character weakness but the result of a series of events that began long before the first cigarette was lit, even before you were born. So then the susceptibility to addiction is actually a vulnerability passed down from our ancestors, an echo from the past. Then it becomes clear that free choice is only limited and very dependent on the environment in which you and your ancestors grew up. That not only which genes were passed on to you, but also in which environment those genes were expressed is important. Whether there were enough building blocks to build the organs. Whether it was safe enough to build trust in the world around you and start exploring it. Whether you learned that you are loved and worthy of love. A lot is determined by your fate in the birth lottery. This offers a vastly different view of health, choice and opportunity. It also calls for a different approach, and new policies.—(Own free translation.)

Particularly in the neoliberal world that began to take shape from the 1980s, the problem of inequality of opportunity from the cradle has begun to display a number of additional characteristics, some of which will be highlighted below by way of further illustration, including: (1) the problem of organization of infant care (including unequal access to maternity leave), and (2) the Baby Formula Crisis occurring in 2022, in the United States of America.⁶⁴

5.2.5.3.2 Organization of Infant Care

5.2.5.3.2.1 Organization of Childcare in Capitalist Countries in General

When considering the situation in industrialized, capitalist countries (recognizing that, over the past few decades, more and more countries have begun to fit that profile), one cannot ignore the fact that over the past two (or even more) centuries, the role of women has increasingly changed, with the constant being that women, too, were made to become involved, increasingly, in socioeconomic processes.

The modern, neoliberal world boasts that women are equal to men, which is reflected in the idea that both genders—in addition to those who do not agree with such a purely biological division of people into two genders—should be employed equally in the capitalist machinery.

Regardless of whether the welfare of anyone is best served by such a worldview, in which everyone must constantly, and as much as possible, be put to work to help maintain the capitalist model of economic growth and to maximize the profits of the wealthy entrepreneurial classes, a consequence of this has been that caring for young children has become a problem in itself.

Where systems of maternity leave exist in several Western countries, these tend to be time-limited, with the result that young children (infants, toddlers, or preschoolers) need somewhere to stay and be looked after when their parents, or parent, are (is) at work. Moreover, very wide variations apply between countries.

Mindful of the essential feature of exploitation that characterizes capitalist employment, within countries with a pronounced capitalist profile, everyone should be at work as constantly as possible. For members of the working classes, periods of interruption—for whatever reason—should be avoided as much as possible.⁶⁵ Moreover, this attitude of capitalism affects the lower classes of the population much more than the upper and middle classes, on the understanding that, under the impetus of economic neoliberalism, strong efforts have been made in recent decades, in many countries, to set the (social protection) bar as low as possible for everyone—except the rich.

One consequence of this is that, worldwide, new mothers from low population groups must, in most cases, return to work as soon as possible after giving birth.

In Western countries, this issue is dealt with in a twofold way, the constant being that in many cases (and a few exceptions notwithstanding) the fulfillment of this soci(et)al need is increasingly left to the domain of the free market—how could it be otherwise?

A first model is that in which the enterprises employing parents organize the care of such young children themselves, implicitly making this form of childcare part of the compensation package of such parents. However, it appears that this model is only available to sufficiently large and wealthy employers, to the extent that such a model must boast the appropriate hiring of staff members who are made responsible for the operation of such in-house daycares.

Those employed in enterprises (or by other types of employers) that do not have the resources to set up such in-house daycares are in turn more likely to rely on private market players who provide such early childhood care, in most cases small-scale enterprises. It moreover appears that the quality of such small-scale infant and toddler care enterprises is variable, with much depending on the person of the furnisher of such a small-scale enterprise—often constituting of a sole proprietorship—themselves. This is, in addition, especially a fate that befalls those belonging to the lower social classes, to the extent that these people are mostly employed by less attractive employers.

In such cases, the parent(s) who have to rely on such childcare offered on the market (because their employer does not offer this service itself) must—of course—pay a market price for it. This implies that the parents who must use such free market services of childcare are often doubly disadvantaged, on the one hand because they do not have access to a service organized by their employer and, on the other hand, because they must pay extra for this service at the free market.

In this way, the way childcare is provided in a free-market environment accentuates the class inequalities that characterize neoliberal societies even more.

5.2.5.3.2.2 Illustration: Some Recent Problems of Infant Care in Belgium

By way of illustration, in Belgium, the infant care sector is because of the foregoing evolving in a very alarming way. In a newspaper article that appeared in the newspaper De Morgen of September 14, 2022, (based on an interview with Professor of Family Pedagogy, Prof. Dr. Vandenbroeck of the University of Ghent, Belgium),⁶⁶ it has been held that the entire Belgian system of childcare is on the verge of collapse.⁶⁷

According to the newspaper article (and its interview with Prof. Vandenbroeck), one of the major problems facing the Belgian childcare sector is that, for years, there has been an acute shortage of places, especially in Flanders and Brussels. It is, for instance, mentioned that in Brussels alone, one demand out of two for Dutch-speaking childcare cannot be met. This goes hand in hand with—and/or is caused by—a second problem, which is growing by the day, namely a complete lack of qualified personnel. Because of this, numerous vacancies in the sector remain unfilled, with moreover many existing employees dropping out because of bad working conditions.⁶⁸

Although the newspaper article does not mention so in so many words, its content suggests that the severe problems facing the sector may have resulted from the neoliberal policies implemented from the 1990s onward (which, moreover, caused similar effects, including large staff shortages, as in the comparable education and health care sectors; cf. already in Sect. 3.2.3.4). As concerns the childcare sector specifically, the main aim of past neoliberal policies has been to eliminate the place deficit as cheaply as possible (cf. the so-called, neoliberal austerity policy that started affecting all public sectors from the 1990s onward). It is precisely this policy that is, increasingly, beginning to take its revenge. As a result, between 1990 and 2000, although many new places were created in the sector, their social status has been so abominable that by 2022, young people have become completely uninterested in working in this sector,⁶⁹ while the older guard of caregivers who still put up with the severe levels of exploitation are starting to retire massively. Between 2000 and 2010, the government especially mainly supported small, independent caregiving enterprises, that required fewer subsidies. By 2022, this group of small, independent caregivers has gradually disappeared, with no interest of current young people to replace them, given the abominable working conditions (especially low pay). But also for the large, licensed childcare enterprises that used to receive more subsidies, the situation has gotten worse (in keeping with the neoliberal principle of getting more done with less staff): for example, these childcare initiatives have been forced to admit eight to nine children per attendant since 2014, whereas before only about six was deemed justified.⁷⁰

Of course, even worse is the situation in poor(er) countries—at least for parts of the population of such countries—that do not even have access to such services, where their absence often goes hand in hand with great disadvantage to women and, in extreme cases, real poverty.

5.2.5.3.3 Baby Formula Crisis

In the recent past, in what counts as one of the most capitalist and prosperous countries in the world, particularly the United States of America, an unexpected, harrowing problem has further demonstrated the great importance of dealing with infant care differently than the laws of capitalism dictate.

Indeed, in early 2022, the issue of childcare—and especially the absence of social safety nets to adequately deal with it—would assert itself in the United States of America in a most surprising way, specifically through a crisis that came to be known as the Baby Formula Crisis.

The background to this crisis was that, due to a concurrence of circumstances, a major shortage of the powder needed to prepare infant formula had begun to emerge on the American market from early 2022.⁷¹ As a result, throughout the United States of America, young mothers were no longer able to purchase the necessary supplies of this product.

Although the underlying causes of this scarcity were, of course, themselves related to the peculiarities of the free market—including the fact that the U.S. market for formula powders was/is highly concentrated in the hands of a limited number of market players,⁷² the fact that a number of them had to stop or reduce their production because of problems with the FDA,⁷³ and problems with the supply of raw materials for the production of the formula powders –, what interests us here are mainly the socioeconomic factors, as a result of which poor population groups were much more severely affected by this scarcity than the rich and middle classes.

The latter has been due to two (related) factors, specifically: (1) the virtual absence of social safety nets in the infant care sector, and (2) the virtual absence of maternity leave rights for young women from poor population groups.

In a column that appeared on May 13, 2022, in the New York Times under the title ‘The Baby Formula Crisis’, columnist David Leonhardt expounded on this point that in terms of Social Security, the United States of America has given a much higher priority to the care of the elderly, than to the care of young families, over the past few decades. The columnist, for instance, points out that Americans over 65 have access to universal health insurance (specifically Medicare),⁷⁴ and that most American seniors also receive regular government benefits (from Social Security). In contrast, many young families and children in the United States of America live in poverty. According to Leonhardt, compared to other prosperous countries, the United States of America spends a remarkably small portion of its budget on children (albeit President Biden’s ‘Build Back Better’ plan aimed to change this).⁷⁵

According to Alyssa Rosenberg, a columnist with the Washington Post, the shortage of powders to prepare infant formula is part of this story. According to Rosenburg, babies and their well-being have never been a priority in the United States of America, albeit the admittedly very alarming shortage of infant formula—and the lack of any kind of national mobilization to keep babies fed—points to a new measure of how deep that (policy) indifference runs.⁷⁶

A second socioeconomic factor that had a major impact on the Baby Formula Crisis concerned the uneven impact of the crisis on distinct population classes.

According to columnist Dylan Scott, the Baby Formula Crisis provided a textbook example of how the shortcomings of the U.S. health care system, consistently, hit hardest on those with complex medical conditions and those who are socioeconomically disadvantaged. The latter is related, among other things, to the strong, unequal regulation of maternity leave. Bearing in mind the principles of the capitalist organization of employment, it turns out that the lower classes of the population have, on average, less entitlement to maternity leave, so that women from these classes must return to work much more quickly after giving birth, with the result that they must give up breastfeeding more quickly, and thus switch to bottle feeding more quickly as well. On top of this, there is the additional observation that women from the lower population classes have fewer opportunities to pump milk at work.⁷⁷

According to Scott, nearly one in five babies in the United States of America is already bottle-fed within the first 2 days of birth. After 3 months, less than half of mothers exclusively breastfeed their babies, implying that their babies are at least receiving formula as a supplement. According to data from the CDC (as quoted by Scott), people living in poverty are most likely to need to use formula as early as the first 3 months of their baby’s life. Especially Black, Hispanic, Asian, and American Indian parents are much more likely to use formula within 3 months of their baby’s birth than white parents.⁷⁸

Still according to Scott, the weak social support that the United States of America provides for new parents and babies has been one of the major obstacles to coping with the baby formula shortage created because of the Baby Formula crisis. A stronger social safety net would have better armed the United States of America to respond to this shortage. The lack of paid maternity leave for many new parents is one of the biggest problems in this regard, as it is one of the main reasons why many new mothers must return to work very soon after giving birth to ensure they have sufficient income to help provide for their families, making breastfeeding virtually impossible.⁷⁹

5.2.5.4 Remediation

5.2.5.4.1 Towards a New Model of Financing Childcare

Considering the foregoing, the case is made here for achieving a sufficiently level playing field in childcare, both between countries and, within countries, between population groups.

The basic idea here would be that, under validation of the systems of public financing discussed in Chap. 4, the national governments of all countries in the world (which will participate in the NMWO), would receive a sufficient budget for the establishment of a full-fledged children’s health care system.

5.2.5.4.2 Ideas About a New Model of Infant Care

Regarding infant care in particular, the budgets referred to in Sect. 5.2.5.4.1 should serve both to finance adequately paid maternity leave for each new parent and to establish high-performance infant and toddler care centers, so that these services would become completely free of charge for all members of the population.

Since infant policy in many capitalist countries leaves much to be desired, this Sect. 5.2.5.4.2 will consider this issue a little more closely.

A prerequisite of the establishment of adequate childcare concerns the establishment of a universally equal system of paternal leave, where the bar should be set sufficiently high.

Whereas the automatic reflex of economic neoliberalism is to keep such social safety nets as limited as possible, and even more so for the members of the lower social classes of the population, the new monetary financing model to be set up for the benefit of countries would, henceforth, allow a reverse approach.

An inspiration for such improved models of paternal leave may be found in Germany.

Indeed, it appears that Germany has one of the most far-reaching regulations in the world in this regard. In Germany, parental leave is regulated by law, in a dual way, in the form of parental leave and parental benefits. For women, parental leave is also called maternity leave, and for men paternity leave. In Germany, this maternity and/or paternity leave takes the form of state-subsidized work leave that can be requested from the employer. During the duration of the leave, a parental allowance is paid, instead of salary. This allows working women or men to stay home for a sufficient period after the birth of their child. Interestingly, both parents are entitled to such parental leave. Indeed, each parent is legally entitled to 3 years of parental leave per child and enjoys protection against dismissal during this period. The periods of leave may, moreover, be taken alternately by the two parents, or jointly. In addition, the total of the 3 years of maternity or paternity leave can be taken up to the child’s third birthday, but parts of it (for a maximum of 24 months) can be accumulated to be taken between the child’s third and eighth birthday. How long each of the two parents takes maternity or paternity leave during each of these periods is at their own discretion. The result of this arrangement is that more and more families in Germany can make work of a partnership-based division of work and family time.⁸⁰

In addition to the need for such a universal parental leave system, there is also a need to establish effective infant and toddler care centers, so that young parents have a real choice between returning to work shortly after giving birth and exercising their full rights to parental leave. The latter should include a real choice between fully-fledged, alternative models (rather than a neoliberal compulsion to fall back on expensive and/or low-quality free market solutions).

In terms of the establishment of such infant and toddler care centers, efforts should above all be made to ensure adequate staffing, both in terms of quantity and quality, within such centers, so that parents will be able to entrust their children to this form of care with full peace of mind in the future.

5.2.5.4.3 Attention to Further Levels of Childcare, Including Education

Mutatis mutandis, the concern mentioned in the previous Sections also applies regarding several other dimensions of child and youth care, until adulthood.

Obviously, in large parts of the world, schools and, for slightly older youth, colleges and universities, play a key role in this regard, even to the extent that there is a perception that caring for children and youth is synonymous with assuring them a sound education and appropriate training (with the side question, however, of the extent to which the systems of schooling thus set up, in the current context, serve to do much other than prepare them for entry into the capitalist machinery itself).⁸¹

In less fortunate parts of the world, even the establishment and/or attendance of such schools is often not evident.⁸²

If we consider this issue from the perspective of a child itself, especially the extreme degree of (opportunity) lottery that characterizes the global system of design of and access to schools (in the broad sense of the word) becomes apparent. Here, one child will have access to the most expensive, elite (generally private) education, while another will not even be assured of any form of quality education.

In addition, children themselves have no impact on this, since whether they have access to education and to education of what quality is determined purely by factors beyond their control, such as: country of birth, class to which they belong, wealth (or not) of the parent or parents, and so on.⁸³

As a result, access to education is itself characterized by all the disadvantages that characterize capitalism itself, including especially then an extremely high degree of inequality and injustice (or, put another way, by a so-called lottery of life chances).

Ever since Plato, it has been understood that more can be expected of a civilized society.⁸⁴ The goal should be that every child, worldwide, should have access to education of an equivalent level of quality (possibly taking cultural specificities into account).

One of the few countries that have succeeded in achieving these goals is Finland, whose education system is one of the best—if not the best—in the world and does not suffer from the many ills found in countries where education has been heavily ‘neoliberalized’.⁸⁵ Although Finland does not spend more on education than other high-income countries, yet Finnish students are among the best in PISA tests (= the Program for International Student Assessment). The secret of the success of the Finnish education system lies in the high quality of teacher training and in humble principles of governance that are completely averse to the usual, neoliberal grandstanding.⁸⁶ Goldman summarized these principles as follows: (1) No one pays school fees. Finnish education is completely free—in other words, entirely financed from public funds—from early childhood to university education. (2) There are no standardized, mandatory tests. Students in Finland are not ranked, compared, or forced to compete in any way. (3) All Finnish schools are fully publicly funded. Students from every economic background are mixed and there are no elite schools. On the contrary, wealthy parents are encouraged to invest in all schools and in the general education system. (4) Every school has the same national goals. (5) The difference between weak and strong students is minimal and everyone has the same opportunity for higher education. Therefore 93% of Finns have a university degree.⁸⁷

The reason why, thousands of years later, this Platonic ideal has still not been achieved in most other countries of the world is, of course, related to the issue of financing in terms of the provision of such education, the common thread being that the wealthier a child’s parent(s) is, the greater the likelihood of access to high quality education, and therefore the higher the life chances such a child will enjoy.⁸⁸

That sound, global financing of education is a crucial requirement in this regard needs little explanation and, in fact, was explicitly stated in a nomination by UN Secretary General António Guterres on September 19, 2022, in which Guterres explicitly pointed out that improving the dire situation of education is impossible “without a sharp increase in education financing and global solidarity.”⁸⁹

According to Guterres, improving education financing should be a top priority for governments and, in fact, may be considered the most important investment a country can make in its people and future. In doing so, spending and policy advice should be geared toward providing quality education for all. Still according to Guterres, these goals can only be achieved by mobilizing “a global movement.”⁹⁰

As Guterres himself put it⁹¹:

None of this will be possible without a surge in education financing and global solidarity.

During these difficult times, I urge all countries to protect education budgets and ensure that education spending translates into progressive increases in resources per student and better learning outcomes.

Education financing must be the number one priority for Governments. It is the single most important investment any country can make in its people and its future.

The international community has a critically important role to play.

I urge development partners to reverse cuts and to dedicate at least 15 percent of official development assistance to education.

International financial institutions should make resources and fiscal space available for developing countries to invest.

Their spending and policy advice should be aligned with delivering quality education for all.

I also urge IFIs to draw upon the International Finance Facility for Education.

This facility is a new tool that aims to mobilize $10 billion to help 700 million children in lower-middle-income countries to access quality education.

The model of public financing we ourselves have proposed in our earlier work,⁹² as well as in Chap. 4 of this book, could help overcome these problems. In the allocations (discussed in Chap. 4) that each country would receive out of monetary money creation, a sufficient budget item could be provided for the establishment of high-quality, public education, with the aim of guaranteeing that, worldwide, all children (and young people) would have access to an equivalent quality education. The Finnish model discussed above could provide an important inspiration in this regard.

In doing so, sufficient attention should be paid not only to the interests of the children and young people themselves, but additionally to those of the staff employed in the education sector, with, for example, adequate attention to issues such as: a sound statute; a full salary; addressing the issue of understaffing and overdemanding of teaching staff, etc.⁹³

In a similar vein, state-of-the-art infrastructure should be provided to all schools, so that schools throughout the world may become centers of learning where it is not only pleasant to spend time, but where all teachers and children and young people themselves have access to everything that a quality learning and living environment requires.

School curricula should, moreover, be filled out in a contemporary way, so that in addition to school education, things like culture, sports and—more generally—a full preparation for adult life will become at least as important as the mere transfer of knowledge itself.

Notwithstanding the foregoing, care for children and youth should, of course, extend far beyond the provision of education, however high quality.

Civilized societies should make maximum efforts to make the youth of every human being on earth as meaningful and pleasant as possible. Those who are better versed in the matter of youth care will be able to indicate much better than is possible here what all this will imply in more concrete terms.

In any case, if the system of money creation for governments—or a sufficiently similar system—explained in Chap. 4 were ever to come about, the allocations to be paid out to the various countries should include a sufficient budget item to make all this possible, with a sufficient sense of reality regarding the ultimate parameters of the newly proposed new money creation system (including taking sufficient account of the limitations of the planet).⁹⁴

In any case, the Finnish example appears very hopeful, to the extent that it indicates that the establishment of the best system of (public) education in the world need not be more expensive than elsewhere.

5.2.6 Elderly Care

5.2.6.1 General

It has become almost a witticism to state that, throughout the Western world, the COVID-19 pandemic has revealed serious problems in the elderly care sector. We ourselves have already elaborated on this matter extensively in (the Chap. 6 of) our book Covid-19 and capitalism.⁹⁵ More specifically, the latter outlined how in numerous Western countries, during the COVID-19 epidemic, extremely alarming deficiencies in especially private care facilities for the elderly were revealed. It is also explained in the aforementioned book how, throughout the West, before the era of economic neoliberalism, elderly care was to a much greater extent in the hands of either public institutions or non-profit organizations (often in the religious sphere), but that this model, from the 1980s onwards, has largely come to an end due to massive privatization and marketization operations, to which many Western countries began to resort.⁹⁶

The COVID-19 pandemic has demonstrated how pernicious this has been for the elderly throughout the Western world. In particular, the COVID-19 pandemic has poignantly exposed how, considered from the perspective of elderly people that are admitted to a nursing home—in present days even referred to as ‘the clientele’ of a private nursing home–, private for-profit institutions are unfit to take on such task of elderly care.

Factors that (have) play(ed) a role in this (and have, as a consequence, been partly responsible for thousands of deaths in nursing homes for the elderly throughout the West) have been: (1) understaffing; (2) lack of sufficiently qualified staff; (3) absence of prevention plans; (4) absence of protective equipment; (5) dependence on staff working in multiple nursing homes at the same time,…, all characteristics that mainly characterize private for-profit care institutions.

Further negative characteristics of the nursing home sector reported during the COVID-19 pandemic include: (6) poor housing; (7) inadequate nutrition; (8) dehydration; (9) medication overdose; (10) excessive use of physical restraints; (11) failure to provide prescribed therapies; (12) neglect of psychosocial needs, among many other concerns.⁹⁷

Perceived as particularly problematic in private nursing homes was, in addition, the downward pressure on ratios of staff per resident, on the number and qualifications of staff members, on the wages of staff members and, more generally, on their other conditions of employment,⁹⁸ all motivated by neoliberal logic holding that (staff) costs should be reduced in order to maximize corporate profits.

In a more general sense, the market-dictated necessity for private, profit-driven nursing homes to make between 25 to 35% of their turnover available as profit to shareholders (which, of course, implies that the associated revenues cannot be spent on their actual core mission, namely the provision of care to the nursing home residents themselves), is impossible to ignore in evaluating the ability of such private, for-profit care homes to have been able to respond adequately to the COVID-19 pandemic and, more generally, to provide appropriate care to the residents of such care homes.⁹⁹

5.2.6.2 Remediation

The COVID-19 pandemic has shown that, throughout the Western world, substandard elderly care and, more generally, the low quality of life in nursing home facilities, remain serious concerns.

In our opinion, the key, rhetorical question is even whether retirement homes and similar care institutions lend themselves at all to being organized by private market players.

As the COVID-19 pandemic has amply demonstrated, there are numerous arguments pleading against this, including, on the one hand (after a lifetime of being exploited by the capitalist machinery), the limited financial capacity of most of the elderly who are taken into rest and nursing homes, and, on the other hand, the fact that certain things, such as care for the elderly, simply should not be considered as yet another method of gross monetary gain for private market players.

In our opinion, the elderly have a fundamental right to adequate care and it is up to society to provide it. This is not a task that can simply be outsourced to the private corporate sector that is only interested in profit maximization for the benefit of its shareholders.

As is the case with the hospital sector, it is therefore preferable to leave the nursing home sector entirely in public hands—or at the very least in the hands of non-profit entities—as well.

This sector should, moreover, remain safeguarded from any neoliberal austerity policies referred to above. The COVID-19 pandemic itself has hereby sufficiently proven that neoliberal austerity and the outbreak of a pandemic—and, by extension, providing adequate care to the elderly population—are, anything but, a beneficial combination.

Again, the key to running a strong and civilized public sector for elderly care (and by extension, the care of other people in need of institutional care, including, e.g., people with severe disabilities), lies in having sufficient financial resources, which, in our opinion, requires abandoning the currently prevailing, capitalist money creation model.

Under appliance of the alternative system of money creation proposed above (in Chap. 4), therefore, in addition to health care in general, elderly care should also be borne by the allocations that will periodically be granted to governments from monetary money creation. It would, in addition, be recommended that the establishment of such institutions for elderly care be brought back, in the main order, within the public domain (or, in other words, that the privatization and marketization of this sector of the past decades would be scaled back again).

5.2.7 Infrastructure and Energy Supply

5.2.7.1 General

Since Classical Antiquity already, it is obvious that a civilized society requires an adequate infrastructure. Moreover, having a sound infrastructure is something that concerns everyone, which is why infrastructure is pre-eminently a matter of public interest.

What is true of infrastructure is in contemporary societies equally true of energy, to the extent that, on the one hand, everyone needs access to energy and, on the other, the technological advances that have occurred over the past century and a half have even made (much of) humanity addicted to energy.

With the rise of capitalism, these domains of infrastructure and energy supply have, increasingly, fallen into private hands, with all the distortions that this entails. This has happened even more so in the past 4–5 decades, where, as a result of the implementation of the ideology of economic neoliberalism, virtually all energy and resource exploitation and trading has been placed entirely in the hands of private individuals.

This, of course completely, contrasts with the fact that, in a better world, the Earth (including all its resources and supplies) belongs, or should belong, to everyone, whereby there are no meaningful arguments to be made for the current situation whereby the entire exploitation and trading of resources and energy is exclusively for the benefit of a few, to the detriment of the common good and with great risks to the security of the Earth (and all that lives) itself.

In this matter, we ourselves remain, in any case, of Rousseau’s opinion, particularly that there are certain economic sectors that (should not have) lent themselves to private appropriation—and by extension: private exploitation—including infrastructure and energy.¹⁰⁰ Under capitalism, especially this fact has been all too misunderstood, with all the dire consequences this has entailed.

5.2.7.2 Consumption of Energy and (Other) Resources

As far as energy—and, by extension, consumption of natural resources in general—is concerned, one may observe that, on the one hand, its production completely relies on the natural resources of the Earth itself (which, in an ideal world, should belong either to no one, or to everyone equally), and, on the other hand, during the past centuries, the economic growth model on which capitalism relies has resulted in a completely irrational consumption of energy (and, by extension, natural resources in general) which, in the current era, has taken on both unmanageable proportions and dramatic consequences.

At the same time, the realization that the rate of energy consumption (and, by extension, the consumption of other natural resources) on which capitalism relies is unsustainable in the long run, has already been present for several decades.

Regarding the latter, reference can be made, for example, to the work of the Club of Rome of the 1970s, including its 1972 report ‘Limits to growth’, which (among other things) reached the following conclusion¹⁰¹:

If the present growth trends in world population, industrialization, pollution, food production, and resource depletion continue unchanged, the limits to growth on this planet will be reached sometime within the next one hundred years. The most probable result will be a rather sudden and uncontrollable decline in both population and industrial capacity.

This implied the prediction that unless humanity began to change course in terms of energy and resource spending, human society would collapse in the twenty-first century due to the overexploitation of Earth’s resources.¹⁰²

However, since then, these research findings have been largely ignored (not to say downplayed) during the decades to follow,¹⁰³ until it appeared from a 2020 empirical study that the research findings of the time had indeed been correct.

The author of the 2020 study is Gaya Herrington, (at the time) head of the Sustainability and Dynamic Systems Analysis Department at KPMG in the United States of America, who wanted to know to what extent the research findings of the Club of Rome and MIT of the 1970s still held value (and, in doing so, conducted her research in a personal capacity, i.e., not in her capacity as employee of KPMG).

Herrington’s research findings were then published in the Yale Journal of Industrial Ecology and also made available on KPMG’s website.¹⁰⁴ The conclusion Herrington reached in her 2020 study was quasi identical to the one from the aforementioned 1972 report of the Club of Rome itself: if humanity continues on its current path, and in particular sticks to the economic growth model of the capitalist system, within the decade it will be heading for a definitive decline in economic growth, which in the worst case scenario could result in the collapse of civilization by about 2040—the timeframe on which the Club of Rome had also arrived in 1972.¹⁰⁵

In essence, Herrington’s findings suggest that the model of continuous economic growth cannot be maintained. By way of alternatives, a better use of technological capabilities, combined with societies that rely more on public services rather than free market forces, could avoid the risk of civilization’s collapse and even lead to a new, stable, and prosperous model of civilization that considers Earth’s limits.¹⁰⁶

According to Herrington, however, this would require a very urgent change of course—particularly within the decade from the date of her study.¹⁰⁷ Herrington hence concluded her study with the message that a deliberate change of trajectory, brought about by a model of society that focuses on a goal other than economic growth, is still possible. However, the window of opportunity is getting smaller by the day.¹⁰⁸

The foregoing underlines the fact that, notwithstanding the insights about the extremely harmful impact of the capitalist, economic growth model on the environment were already (at least) available in the 1970s, a short time later, an ideology emerged that took an entirely opposite course to these insights, namely the ideology of economic neoliberalism. For example, from this ideology, especially in the 1980s, so-called consumerism would be advocated as a way out of the economic recession that had begun to occur at that time. This theory (initiated by the Reagan administration) boiled down to encouraging consumption, so that the demand for goods and services would increase.

The flip side of the coin, of course, has been that such an increase in consumption has also presupposed an increase in production—in other words, not a more prudent use of energy and raw materials, but an even more thoughtless approach than the one in which industrial capitalism had beforehand ended up.

As a result, the production-for the sake of production and consumption-for the sake of production approach that was already an inherent feature of capitalism anyway, under the impetus of economic neoliberalism itself, would begin to assume even greater proportions.

Moreover, this approach was part of an increasing degree of globalization of the world economy, pushing some former agricultural and/or developing countries themselves, increasingly, towards industrialization, including several South American and Asian countries. It is against the background of this economic policy approach that, starting in the 1990s, the emergence as a new economic superpower of China occurred, with the result in current times that China itself has become one of the biggest polluters and consumers of energy and raw materials in the world.

As if the ongoing increases of energy and resource consumption have as such not caused enough harm, in recent decades economic neoliberalism has also brought about a significant turnaround in the energy market in the narrow sense of the word—i.e., the market of production, transmission and distribution of energy–, in particular through a systematic ousting of the public sector, as a result of which the energy market is, today, in many areas of the world, largely in private hands.

Globally, a major cause of this has been the fall of communism in the former Soviet Union and its then vassal states, as a result of which numerous formerly state-owned companies were transferred to private hands.¹⁰⁹ However, such a systematic transfer of the energy market into private hands has also occurred within other regions of the world, which in the EU has been the result of a series of (neo)liberalization measures that have taken place since the 1990s, while in the United States of America the sector has benefited from far-reaching deregulation measures that have significantly reduced previous government intervention (for example, in the form of supervisory mechanisms on the operation of energy markets).

As a result of all this, the current energy market has taken shape, in which a limited number of large market players call the shots and which is further characterized by the fact that nothing has come of the great promises under which its neoliberalization was announced at the time—in particular that the (neo)liberalization of the market would lead to more competition and that the consumer would benefit greatly from this–, on the contrary.¹¹⁰

5.2.7.3 (Other) Infrastructure

Infrastructure has fared somewhat less badly in the Western world, even though this sector has also suffered greatly from neoliberal theorizing, as evidenced by the outsourcing of infrastructure construction, management and/or exploitation to the private sector through so-called PPP techniques.

As a first result, such infrastructures entrusted to the private sector are no longer freely accessible to all, but only at a certain price (for example, tolls to use a highway, waterway, bridge or tunnel) that is itself function of the revenue model of the private partner to whom such infrastructure is entrusted.

In other areas of the Earth, particularly in developing countries, the infrastructure needed to keep a basic economy going is, if possible, in even worse shape, generally because these countries do not have sufficient financial resources to set up such a basic infrastructure (and, furthermore, their population itself is not sufficiently wealthy to support a revenue model for any PPP approach).

On the margins of all this plays the classic argument to exempt the world’s rich classes from taxation as much as possible, based upon the trickle-down economics argument that, by leaving the rich as untaxed as possible, they will reinvest their wealth in new economic projects, from which the entire society will benefit. The latter helps explain why numerous countries are facing budgetary problems, which in turn, on the one hand, helps explain why privatization and similar operations of transferring former public sectors to the private markets had to take place, and, on the other hand, why, as a result, the rich have been able to set up new earning models, such as PPP structures.

The result of all this is that the rich classes, on the one hand, are themselves the main beneficiaries of many forms of infrastructure and the main culprits for its rapid wear and tear (e.g., roads that suffer greatly under freight traffic), and, on the other hand, the least willing to contribute financially to its maintenance (but, on the contrary, are eager to make such maintenance themselves a new method of monetary gain).

5.2.7.4 Remedies

The question arises of how to remedy the quagmire created by capitalism of inefficient energy markets and irrational resource consumption, in addition to unbalanced infrastructure design policies.

Hopeful is that there is a growing awareness that things cannot go on like this, especially among young people.¹¹¹

At present, this awareness especially translates, among other things, into a push for a transition to so-called more sustainable economic models, including in energy production and supply.

However, it is questionable whether these initiatives will have enough impact to turn the tide sufficiently, especially given the high degree of regional diversity of dealing with the problems. It is, moreover, to be feared that, as has previously been the case with the so-called corporate governance movement, the debate on the transition to a sustainable economy will end up producing little to no concrete results.

The latter even raises the fear that the notions ‘sustainable’ and ‘sustainability’ are increasingly becoming marketing labels, and therefore being accommodated by the mainstream economy itself (without leading to fundamentally different working methods than those of capitalism itself).

Hence, we ourselves keep arguing for a much more fundamental approach, on a global scale.

For example, in the area of energy supply, it could be agreed upon by treaty (e.g., a treaty in line with the treaties establishing the New International Monetary Order discussed in Chap. 4) that, as part of the allocations that will be paid annually to the countries participating in the NMWO, a budget item will be provided to proceed, in each of these countries, to the establishment of a new governmental institution having as task of achieving, within each country, the conversion to a completely green energy, within a clear framework of time.

The budgets that could be made available for this end could safely be very substantial, given the importance of this issue to the restoration and preservation of the planet (including for future generations of people).

This public institution could (and should) make such a transition in the manner most appropriate for each country (which will depend on the natural resources available for this purpose in each country, including, for example, the presence or absence of rivers with large flows, the possibility or not of building dams, the amount of sunlight, the amount of wind, etc.).

After their establishment, each of these government institutions could then draw up a drastic plan of action, including a realistic timeframe for achieving the said transition and the legal methods needed to do so (e.g., expropriations, where necessary).

The future world could thus become one in which energy production and supply, in each country, would be accomplished in such a green/sustainable manner, including through the construction of gigantic wind farms, dams, solar panel zones, systems for recovering otherwise wasted energy (e.g., hot water from industry to be recycled for domestic heating, geothermal energy production, etc.), and in which there would be ample room for subsidized private energy production as well (e.g., through solar panels and heat pumps in private homes).¹¹²

This is obviously an issue that should be addressed in a sufficiently grand manner, where all taboos against government initiative raised by neoliberal theorizing, including lobbyism from the part of the polluting industries, should be, decisively, jettisoned.

The provision of a sufficient budget—as mentioned above, to be financed from the government allocations that will be granted to the countries participating in the NMWO referred to in Chap. 4—should thereby guarantee a sufficiently planned and large-scale approach, as well as a clear and realistic timeframe within which all this is to be realized.

In addition, the following lessons should be drawn from the past: (1) The relevant public institutions to be set up will need to retain their full public character at all times, without ever allowing private parties to become stakeholders (this in view of the natural tendency of the latter to milk consumers and personnel, to walk away with the profits, and to leave the costs and risks in public hands); and (2) The purpose of the relevant public institutions should always remain purely focused on the production and supply of the country’s own green/sustainable energy, with the explicit exclusion of all energy produced by other means (such as energy from fossil fuels or nuclear energy).

There will, of course, also be a need for sound governance of such public institutions, whereby it will be necessary to ensure that the appointment of the leading managers stays removed from the game of political appointments, in such a way that the quality of the people to be recruited for this purpose will always prevail over political affiliations (in addition to all other possible forms of nepotism). To this end, work could be done, for example, on anonymous forms of recruitment, which could include a sufficient degree of rotation, in addition to systems of adequate oversight.

There will also be a need for a sound pricing policy geared to the nature of the customers, where, for example, different rates could apply to individuals than to businesses, and where within these two categories a sufficient degree of diversification would play a role as a function of sufficiently objective criteria.

In an analogous way, work could also be done on a renewed approach to infrastructure, but in conjunction with other policy dimensions, including policies aimed at reducing mobility problems.

If the COVID-19 pandemic has brought anything good, it is the realization that numerous jobs do lend themselves to being performed by digital/electronic means, which is the case for almost every job, except for those that require moving goods or providing physical labor elsewhere. Recently, this has also been referred to as striving toward a ‘digital-first’ world.¹¹³

For everything that concerns meetings, discussions, and talks, but also matters such as teaching, presentations, lectures, pleadings before a court, contract negotiations, and so on, it is perfectly conceivable to have these henceforth run entirely, or at least for the most part, by digital/electronic means. The argument that social interaction suffers as a result does not outweigh the need for a resolute approach to the underlying problem itself, namely the reduction of the energy- and infrastructure-consuming (and heavily polluting) traffic problems, whereby the social dimension of the professional practice can surely be assured in other ways, such as rationed, physical meetings (to which, if necessary, a festive touch could be added, on occasion).¹¹⁴

With regard to the actual design of infrastructure itself, taking into account the above-mentioned parameters, a more planned approach than has ever been possible under capitalism, has been long overdue on a global scale. Such a planned approach would, preferably, be based on international planning and agreements, with at least thorough consultation between neighboring countries. This should result in infrastructure planning that strikes the right balance between the need to create a healthy economy and sustainability, i.e., a sufficient degree of respect for the planet and its limitations.

It is obvious that the requirement for a more mature approach to the issue of mobility will play a vital role in all this, including the question of which forms of passenger and freight transport can still be found to be sufficiently compatible with the objective of using transport—and, by extension, travel—more economically.

Obviously, the issue of how to make healthy use of the planet’s resources should in no way remain limited to the transport sector, but rather concerns various other (large) infrastructures as well, such as sports facilities, leisure centers, in short, everything necessary for the establishment of a mature, civilized society that finds itself ready to do away with the excesses that capitalism has been guilty of over the past centuries (albeit that there have also been earlier models of civilization that have indulged in such excesses detrimental to the planet in the past).

Perhaps most delicate in all of this is the issue of resource management, with the underlying questions of how long the world can continue to afford the current capitalist approach of a model based on ownership of resources in private hands (or in the hands of corrupt governments), and whether a model should not be promoted in which the resource management of the planet, as well as its consumption, is organized and managed on an international basis (for example, by a special institution operating within the framework of the United Nations), so that the interests of not only resource and energy consumers (ergo mainly the capitalist producers), but also the Earth and all other living beings, will henceforth be taken into account.

5.2.8 From States Based on Repression, Bickering, and Warfare, to States Providing Civic Care

5.2.8.1 General

Traditionally, the domains of security in the broad sense of the word—here further divided here into three main categories, specifically justice, police, and militia¹¹⁵—are domains of government operation that neoliberal thought is still most inclined to favor.

The main explanation for this seems to be that even the wealthy classes still attach a sufficient importance to the orderly organization of society, if only to secure their own personal wealth, alongside the unjust models of society that have grown out of capitalism (to the extent that the referred to systems of societal organization, among other things, put the protection of private property central).

In addition, there is (apparently) not yet a sufficient private alternative available to replace these services for the benefit of an entire society of a given country, which does not prevent recourse to private alternatives in certain niche segments of society (e.g., the establishment of prisons through private initiative, private security services within certain large enterprises, gated communities, …).

Hence, within the internal framework of state structure, sectors such as the judiciary and the police primarily fulfill the task of securing the interests of the established order against deviant behavior. In the 19th–20th century liberal societies and the contemporary neoliberal societies, this implies that these services mainly secure the interests of the rich classes, because of which a strong emphasis has come to be placed on the security of property, in addition to curbing possible forms of protest from the poor classes within society.¹¹⁶

In the relationship between states, the focus is on the establishment of sufficiently strong armies (including a sufficient arsenal of weapons), in part to keep the arms industry, at public expense, sufficiently sustained and profitable.¹¹⁷

If (or when) humanity will ever reach a higher degree of enlightenment, presumably the many periods in history in which imperialism and warmongering reigned supreme and, as far as the post-World War II era is concerned, what twists and turns ideologies and political movements have wriggled into to rationalize and justify this behavior, will be probably looked back on with great amazement.

It should, furthermore, be clear that the injustices and inequalities that characterize capitalism have also proven to be recipes for social unrest, both nationally and internationally. This observation is true even to the extent that one might wonder whether the pursuit of greater socioeconomic justice is not a sine qua non for creating a more secure and conflict-free world.

Viewed through the lenses of enlightened philosophers and enlightened spiritual minds, at least the observation holds that it is the ongoing task of people (of good will) to work for a conflict-free world. By way of example, it may be recalled here once again the attitude to life without conflict embodied in the concept of Ahimsa, which, during the 20th century, has repeatedly proved to be a breeding ground for important, societal changes—albeit far from enough. (Cf. Sect. 1.2.4)

In any case, this is a matter that has already enjoyed considerable attention in various academic disciplines other than law itself. It is not the purpose hereafter to reproduce in extenso the state of the sciences within all these other disciplines (which would be beyond both the intent of this treatise, as well as the capabilities of its author).

On the contrary, it is only aspired below to indicate how the new system of money creation cited in Chap. 4 might result in a redrawing of the public services that were once conceived to watch over the orderly running of societ(y)(ies).

5.2.8.2 Justice

Obviously, the term justice is a broad flag that covers many connotations.

Where we shall address justice in this Sect. 5.2.8.2, we mean mainly that part of justice that watches over the ordering of society, ergo mainly the criminal and repressive part of justice.

In the new societal order that will be made possible when, thanks to the new system of money creation explained in Chap. 4, countries will again have enough financial possibilities to adequately take care of the common good, the expectation is that this function of justice will become less necessary than under the current ‘neoliberal penal/punitive states’.¹¹⁸ Indeed, research has indicated that the advance of economic neoliberalism has gone hand in hand with an increase in the penalization of all kinds of petty crimes, implying that justice in its penal dimension mainly affects the low social classes in a negative manner. Moreover, this observation applies on a global scale, with the large representation of the poor strata of the Black population in American prisons as a telling illustration (albeit the situation is not fundamentally better in other countries).

A second phenomenon is that the lower classes of the population of most capitalist countries, hardly have an outlet to express their dissatisfaction with the numerous injustices and inequalities brought about by capitalism. In some cases, this has given rise to appropriate forms of deviant behavior, for example, the flight into drug use and/or the associated trafficking of drugs. Neoliberal governments, in a similar vein, pursue repressive policies toward various expressions of protest (e.g., demonstrations).¹¹⁹ In even more extreme cases, dissatisfaction of marginalized population groups has even degenerated into acts of terrorism.

What characterizes neoliberal (penal) states above all is that they remain primarily committed to curbing these various kinds of crimes against the neoliberal order and do not pay significant attention to combating their causes. This should come as no surprise, to the extent that many of these so-called crimes have their exact origins in the various forms of socioeconomic injustice and exploitation that characterize capitalism (and the (neo)liberal state structure associated with it).

This implies that, to remedy these problems, work must be accomplished on more equitable socioeconomic models (and on the abandonment of existing, capitalist forms of socioeconomic organization), which, based on the new system of money creation proposed in Chap. 4, could become a realizable objective.

Even a simple societal intervention such as the establishment of a universal living wage—and this on a global scale—could have immediate and greatly beneficial consequences in the fight against one of the greatest soci(et)al injustices that capitalism (as well as certain of its predecessors, such as feudalism from the Middle Ages and slavery from Classical Antiquity) has generated, namely poverty.

And in a world that, finally, would do away with poverty—at the very least would start to show a willingness to do so—the reason for numerous crimes that find their breeding ground in poverty will gradually disappear.

This implies that if countries around the world were to start working again for more just societies, including more just socioeconomic order models (and more just legislation framing them), a substantial proportion of crimes might, of their own accord, gradually disappear. That this will not happen overnight and that not all of humanity will suddenly become completely crime-free seems obvious, although it cannot be seriously disputed that a greater degree of societal justice, especially regarding the systems of socioeconomic ordering, would already represent a major step forward.

Immediately, this will also allow the role of justice within society to be diminished and/or altered.

Whereas in neoliberal (penal/punitive) states the latter role mainly focuses on the curbing and punishment of what their legal systems label as crimes, within the new societies that will become possible based on the new system of money creation explained in Chap. 4, this role could gradually be reduced to that of prevention and even life coaching.

Why indeed not, at least for those who wish to do so, make work of a social and public system of life coaching that would be established under the auspices of the new care states that, under the newly proposed system of money creation, will take shape.

As already suggested in some of our earlier work,¹²⁰ this could be accompanied by a new remit of the civil service, which within the prevailing (neo)liberal (penal) states is mainly deployed for all sorts of forms of repression in the broad sense of the word—including, for example, taxation, in addition to all sorts of pointless administration that mainly benefit the ruling classes of neoliberal societies –, but which, in the future, could be deployed for shaping just societies.

It is to be expected that, as societies gradually take on a fairer (and even more people-friendly) outlook, thanks to the money creation system proposed in Chap. 4, the need for such systems of (public) life coaching itself will eventually diminish, even to a level where it will only still be needed for people affected by an accident, disability, old age, or similar objective circumstance that creates a greater need for support and guidance. For these latter groups of people, moreover, life coaching itself could go much further from the outset, taking the form, for example, of the assignment of a personal caregiver, with the justice system itself playing a moderating role of assignment of such life coaches and/or caregivers.

5.2.8.3 From Police to Citizen Coaching

In a more distant past, (Western) police forces campaigned in schools to come and explain that they are our friends. Whereas in the former, traditional welfare states, police forces may indeed have been on the way to mainly function in the service of citizens, with the rise of economic neoliberalism, this role has receded into the background, in favor of the repressive role and the role of curbing all kinds of (petty) crimes.

Anyone who has ever seen images of how police forces break up demonstrations of the lower social classes, or of minority groups, will probably have great questions about the role of friendship that police forces believe they play in this regard. Those who belong to racial minorities in the United States of America will probably ask themselves such questions even more. Those who live in Belgium will, at best, see the police force as unavoidable and, above all, experience how police services seem to be primarily concerned with curbing traffic offenses (thus providing the public purse with a lucrative, additional source of income at the expense of the average citizen in their capacity of road user).

In any case, it cannot be ignored that, with the rise of neoliberal penal/punitive states, the repressive role of police forces has also returned.

Still, it remains possible to envision societies in which this repressive role of police forces would again be reduced.

In the societies that could be established based on the alternative system of money creation described in Chap. 4, it would not be inconceivable, for example, that a service of life coaches that are daily present in the streets would be established. The policy mission of such a service would not consist, in main order, in the detection and curbing of crimes, but in providing (first line) help and assistance for those who have an immediate need for it.

Although one could argue, at least in theory, that such service is already included in the scope of police duties today, few citizens would probably perceive this as such.

Under the new societies that might take shape on the basis of the newly proposed system of money creation, such front-line service could be pushed forward as the main remit of police forces, while the traditional functions of detection and curbing crime would be relegated to a secondary place, and this all the more so as, worldwide, societies emerge in which poverty is eliminated in favor of a truly level playing field of equal opportunities and possibilities for all citizens.

5.2.8.4 From Militias to Civilian Protection Services

On the role of armies and armaments, we can be even briefer, if possible.

In a new world where the international community will be based on mutual global solidarity, it is hard to see why states—or anyone else for that matter—should still have armies and weapons.

Hence, it could be a principle of the monetary order referred to in Chap. 4, and of the system of money creation contained therein, that no room be provided for budget items that would imply the formation and/or maintenance of (national) armies and armaments.

At most, provision could be made for budgeting for an international military force in case there were countries unwilling to participate in the new international, monetary order (and in the socioeconomic order established on its basis), a fortiori in case such countries would be hostile to the efforts of the rest of the international community to conceive such a just system of international, monetary, and economic order.

It is hoped, however, that all countries in the world will be willing to recognize the importance of working towards such a new international monetary and economic system and show a sufficient willingness to cooperate with it.

It is hereby expected that, to the extent that a just, global economy will result from this, one of the main reasons for (most) international political—and in further stages, military—tensions will disappear. As a result, in such a new international order, there will no longer be any need for such things as armies and armaments.

Instead, states, on the one hand, and the international community, on the other, could work on optimally functioning civil protection services, with the task of protecting their countries, respectively the international community, from all kinds of calamities, such as, for example, the consequences of natural disasters, assistance in situations of food or water scarcity, etc. (not coincidentally all issues to which the world, driven by the economic policies of the past half century and the consequent worsening of climate change, has become increasingly vulnerable).

If the past few decades have taught us anything, it is the great need for such high-performance civil protection services, which can, for instance, be witnessed in the fight against major forest fires and floods that have occurred in recent years on almost every continent, or in the fight against a pandemic (as the world has experienced in recent years), but which can also be seen in the fact that some countries, such as Belgium, have had to call on the military several times in recent years for civil protection purposes anyhow (mainly due to the fact that, under the rule of economic neoliberalism, the police forces themselves lack the means to adequately fulfill its role, especially in emergencies).

In the allocations that each country will periodically receive from the system of new money creation already discussed in Chap. 4, a budget item could thus be provided to each country to enable the establishment of such national, high-performance, civilian protection services, both in terms of personnel and logistics.

In addition, work could also be done on an international, civil protection service that would have a similar task for the cases of cross-border disaster situations and/or serve as a reserve for the cases when the civil protection service of a given country would not be able to cope with a disaster scenario that would occur within said country’s borders.

How much more civilized would not be the outlook of a world in which the billions of dollars currently spent annually on armaments and on the establishment of armies, in addition to the reconstruction of countries or territories in which armed conflicts have occurred,¹²¹ would instead be spent on the establishment of such civil protection services, whose primordial task would be to aid people in need.

In full awareness that all of this may seem utopian, however, it can be pointed out that all this is at the very least conceptually possible, starting with a willingness to work on an alternative money creation model in which attention to the common good would once again take precedence over the role of free markets (read: over the interests of the rich).

5.3 Conclusions

It is obvious that the ideas expressed in this Chapter for improving the socioeconomic order possible thanks to the new money creation model proposed in Chap. 4 of this book do not aspire to completeness, nor do they pretend to have the last word in this, from a soci(et)al point of view, crucial debate.

Instead, the main intent of this Chapter has been to demonstrate how an alternative money creation model—and therefore an alternative monetary system based on it—could allow for a restoration of the domain of the common good, which itself has suffered all too much in recent decades from the implementation of economic-neoliberal thought.

In all this, it cannot be emphasized enough to what extent the prevailing, capitalist money creation model is, in part, responsible for the capitalist, economic growth model, with all its adverse consequences, not least of which are the serious environmental problems that are plaguing the world, and which, among other things, manifest themselves in the form of the ongoing climate change.

In a similar vein, it cannot be emphasized enough how much the prevailing, capitalist money creation model—and by extension, the capitalist, monetary system based on it—is a crucial part of the free-market model itself and, as a result, is also a central tool in the strategy of economic neoliberalism to ever further expand free market forces at the expense of the realm of the common good.

A further consequence of this is that the current money creation model is also partly responsible for the current economic system that only functions in the interest of the rich (= the top 1% or, at best, the top 10% or 15%), and thus helps shape a socio-economic order that is unjust in its foundations.

We ourselves remain convinced that, to get out of the mess of over four centuries of capitalism and over four decades of economic-neoliberal policies, it will be necessary to start with a new system of money creation—and, by extension, a new monetary system building upon it.

With reference to our previous work, this has been the central thesis of the previous Chap. 4, which was supplemented in the current Chapter by a description of the outlook of an imaginable, new socioeconomic order that could be advocated on that basis.