Rethinking social protection: a conceptual discussion

Social protection has been subjected to critical discussions over the years, partly because of neoliberal reforms leading to the privatisation, commodification and financialisation of public goods, especially in the area of well-being. In the context of COVID-19, the failure of market-based health social protection systems must come under even more scrutiny. The tension between social protection as a public right and social protection as a private commodity has shaped the way well-being policies have been framed and articulated (Lazonick and O'sullivan 2000; Fine 2017). In the neoliberal context, market demands generally take precedence over community needs and this often creates inequality of access to health and social insurance, evidenced by the privatisation of health programs, which benefit pharmaceutical and insurance corporations (Viana and Silva 2018).

Figures provided by an International Labour Organisation (ILO) report (ILO 2020b) leave no doubt that fiscal austerity policies, broadly inspired by neoliberal prescriptions and implemented in virtually all regions of the world, have had a negative impact on social protection programs, especially those directed at children. The report shows that between 31% and 66.7% of the workers globally do not have unemployment protection schemes With respect to health, despite an extension of universal coverage, major deficits remain, particularly in rural areas and among the world’s poor population (WHO 2017). It is estimated that to meet the Sustainable Development Goals (SDG) and universal health coverage, an additional 18 million health professionals are needed by 2030 (WHO 2019). It is also important to note that major regional disparities exist even within developed countries (Doorslaer and Koolman 2004). Meeting the health needs arising from epidemiological shifts (the increasing burden of chronic diseases that require long-term care) remains a challenge for many public health systems, and social protection is targeted at those who are able to pay, who are generally workers employed in the formal sector. The consequences for the well-being of individuals are numerous, with an increase in the prevalence of various diseases and mental disorders (Natasha et al. 2020).

Previous crises such as the 2008 global economic crisis and now the COVID-19 pandemic have demonstrated the fragility of marketised well-being (Mirowski 2013). In both cases, significant privatised social protection measures became dysfunctional and corporations had to seek public finances through direct state intervention. This has forced people to look within their own communities for alternative and more resilient forms of social protection, often based on indigenous solidarity economies (Ratuva 2014).

Social protection is generally defined as strategies that address the disadvantaged situations of vulnerable groups through direct assistance or development of opportunities and capacity in the areas of poverty, health, education, employment and other aspects of well-being (Walsham et al. 2019). According to Devereux and Sabates-Wheeler (2004) social protection needs to be seen as an encompassing process of prevention, protection, income-generation and transformation. But there is no generic way of framing and applying these concepts given the many multilateral, bilateral and private institutions with diverse and often competing ideological, economic and political interests engaged in social protection programs (Waring et al. 2013). What’s more, multilateral agencies that use social protection as part of their broader developmental agenda, such as the World Bank (WB) and Asian Development Bank (ADB), have a more economistic approach to social protection where they attempt to create a synergy between austerity and growth on one hand and poverty alleviation on the other (World Bank 2012). Social protection and other measures to get people out of poverty are seen as dependent on growth, their approach is largely influenced by neoliberal assumptions about managing risks to the labour market to ensure that productivity is maintained (Asian Development Bank 2011). Poverty reduction is seen not necessarily through humanitarian lenses but in relation to how the labour market can be protected and made more efficient through minimising people’s exposure to risks (Holmes and Jones 2009).

The ADB’s Social Protection Index (SPI), which is designed to ‘gauge the extent of coverage of social protection programs and the depth of their impact’ (McKinley 2013, p. 2), uses variables such as social insurance, social assistance and labour market programs, which are by and large based on formal market-based systems. These are then translated into four quantifiable variables using a simple ratio formula to determine the SPI. The variables are Social Protection Expenditure (SPEXP), Social Protection Coverage (SPCOV), Social Protection Distribution (SPDIST) and Social Protection Impact (SPIMP) (McKinley 2013).

The problem with the ADB system is that it does not take community-based and indigenous social protection systems into consideration, although it does consider the issues of systemic inequality and unequal access based on class, ethnicity and gender. Over the years, the ADB had fine-tuned its social protection strategies in a systematic way as a result of engagement with policy-makers and researchers from a region of the world where poverty and dislocation of millions have prevail. Some of these considerations have been embedded in the SPI formula and while these may have policy value for the ADB, they still do not fully reflect the intertwined and multi-dimensional complexities of culture, politics, economics and health. In a similar way, while the World Bank has developed a very comprehensive policy on ‘resilience, equity and opportunity’ as part of its social protection strategy, economic growth is still seen as the main driver for social transformation (World Bank 2012). By and large, economic imperatives are still seen as important, especially when social protection is linked with ‘managing social risk’ which might otherwise impact on the market (Heltberg et al. 2008).

However, there are strong pessimisms about these institutional approaches by some as it is seen as providing ‘potentially illusory expectations’ and optimism about future growth and wealth for all, a process Beckert (2020, pp. 319–320) refers to as ‘promissory legitimacy’. The argument here is that these institutions draw on social protection narratives to project an illusion of humanitarianism and corporate social responsibility, which serves to conceal their implicit austerity intent.

Another major weakness of the market-based strategy to social protection is its failure to address power dynamics as it is assumed that the market has a self-regulatory levelling effect (Hathaway 2020; Viana and Silva 2018). This view overlooks the fact that there are marked power differentials between providers and recipients, manifested in different ways such as ownership of process, the motives of actors, incentives, reasons for implementation and impact on political relations and context (Mccord 2009; Hickey 2007; Zucco 2009; Devereux and White 2007). At the national level, social protection can even be a lever to reinforce state hegemony, developmental reach, legitimacy and dominance (Darcy 2004; Harvey 2009; Harvey and Holmes 2007). Thus, social protection policies that are imposed from above can have the effect of reinforcing power inequalities, and can be used as insurance against potential subaltern resistance.

The underpinning power relations coupled with the primacy of the market approach, especially the emphasis on economic risks such as financial shocks and recession, overshadow the significance of communal capital and other important social issues such as gender inequality, domestic violence, social tension and racial discrimination at the community, household and intra-household levels (Holmes and Jones 2009). This has prompted (Waring et al. 2013) to call for a more ‘anticipatory’ and ‘transformative’ approach that incorporates gender-responsive and human rights-based approaches. The anticipatory aspect refers to putting in place preventative measures to respond to future crises. With regards to COVID-19, the anticipatory response was very low and much of the world was ill-prepared to respond to the pandemic. The transformative aspect refers to how social protection can be proactively utilised as a fulcrum for progressive structural changes to address inequality and social exclusion beyond the mere philanthropic and charitable niceties ‘where the poor are patronised as ‘beneficiaries’ of the generosity and social conscience of the market’ (Ratuva 2014, p. 43).

Market strategies also differ in relation to the different ideological and political approaches of states. For instance, in the US, the neo-liberalisation of public health means social protection in relation to health is left largely in the hands of corporate entities involved in insurance and other well-being services (Fullman et al. 2018). In comparison, New Zealand has a robust public health system, despite its neoliberal stance in economic development, and thus its public health-related social protection policies are far more comprehensive and well-being based. In both states, though, there is an inherent contradiction (a characteristic of the market-driven health system) where health as a social good and health as a private good compete for centre stage (Viana and Silva 2018).

The global crisis of 2008 which was associated with the dramatic increase in fuel and food prices and exacerbated by the financial crisis, further exposed deficiencies in market-based social protection systems, which failed to cope with increasing demand, leading many people in the Global South to fall back on community-based social protection systems for survival and prompting a major rethink of alternative well-being and people-centred approaches by development experts and international aid agencies (Slater and McCord 2009; Davies and McGregor 2009; Parks and Abbott 2009). Alternative modes of social protection, as suggests, ‘flows from endowment of mutually respecting and trusting relationships’ and ‘depends on the quality of the set of relationships of a social group’. A further aspect is that, to be empowering and effective, social protection needs to be rooted in an organic way within the cultural norms of local communities (Schiller and de Wet 2019). This may involve community-based coping mechanisms relating to cultural practices and behaviours drawn from peoples’ indigenous cultures and sometimes synthesised with contemporary experiences in adaptation to evolving social environments (Ratuva 2010; Schiller and de Wet 2019).

A further issue with the market-based SPI assessment framework is its primary focus on quantifiable formal social protection systems that are state-based and is silent on the diverse range of informal, community and indigenous systems which have served as means of social safety net for centuries. . This may be due to the subconscious cultural bias endemic in many official policy discourses and this could have long-term consequences in reinforcing inequality and marginalisation of minority groups and indigenous knowledge systems (Ratuva 2009). A new way of capturing indigenous forms of social protection is needed and this requires a deep understanding of cultures, meanings and systems of resilience (Ratuva 2010). Fundamental to how social protection should be approached are issues of equity, inclusiveness and human dignity, beyond just ticking the official humanitarian box (Waring and Carr 2011).

Despite the global dominance and imposition of the neoliberal ethos, we must realise that people still construct the world in diverse ways and this should be recognised as a basis for framing alternative means of building a culture of resilience and sustainability (Barrientos and Hinojosa-Valencia 2009; Devereux and Cipryk 2009; Köhler et al. 2009). This should also require greater control of resources, transformational capacity and empowerment by local communities (Norton et al. 2001; Shepherd et al. 2004). In a world where COVID-19 is a major human security factor, on top of the threat of the climate crisis, inequality and conflict, social protection based on community needs and aspirations needs to be redefined and readapted to suit the ever-changing realities (Davies et al. 2008; Raworth 2007; Heltberg et al. 2008).

In New Zealand, health-related social protection toward Māori and Pacific communities are based on an integrated approach involving the state, NFPOs and the community. This model is informed by a number of key ideological narratives. The first is Te Tiriti which values biculturalism and respect for indigenous identity. While this is principally focused on Māori as tangata whenua (indigenous people), it has indirect resonance for Pacific communities through their cultural connections and their minority and disadvantaged status in the nation’s socio-economic stratification. Secondly, New Zealand’s philosophy on welfare capitalism still provides room for state social protection policies for Pacific and Māori communities. This welfare-based public policy approach has been enhanced under the Labour Government’s 2019 Well-being Budget (Ministry of Treasury 2019).Thirdly, in the context of their diaspora status, Pacific communities have been able to build a resilient transnational cultural base and identities, which, along communal capital and traditional social protection systems, provides the basis for social protection for Pacific communities to address the consequences of inequality and marginalisation.

Inequality and COVID-19 amongst Pacific communities

Framing innovative social protection strategies should involve an understanding of the institutional and systemic issues of inequality, access and power and how these impact on health outcomes (Behrendt and Nguyen 2018). Socio-economic conditions and position within the societal hierarchy of power can shape people’s well-being as well as perception and attitude towards each other. Research on historically marginalised minority groups shows that explicit and implicit cultural biases, social marginalisation and lack of opportunities can lead to individual and collective stress which may be passed down through generations either through family socialisation or even changes to genetic responses (Sullivan 2013).

The coronavirus pandemic has unveiled the stark reality of inequality in societies where Pacific communities find themselves at the bottom of the social stratification. In the US state of California, for instance, Native Hawaiians and Pacific Islanders (NHPI) had the largest increase in the poverty rate from 2007 to 2012; at 97%, higher than any other racial group. The average increase in rate of poverty over the same period was 31% (U.S. Census Bureau 2008). At the same time, the number of unemployed amongst NHPI increased 158%, again, higher than any other racial group.

These inequalities are reflected in COVID-19 figures where the rate of COVID-19 hospitalisation for Pacific communities in the US is up to 10 times the rate of other racial groups (Jackson 2020). This is for a group which makes up only 0.5% (1.5 million) of the total population of almost 330 million. Poor socio-economic conditions have forced Pacific communities to live together in large extended family groups, which, together with high rates of chronic diseases, lack of insurance, exclusion from Medicaid due to immigration status, and the fact that many Pacific communities are involved in frontline essential work such as the military or security and service industries, make the Pacific community more vulnerable to the pandemic (Jackson 2020). Worse still, the invisibility of the Pacific community as a designated official category at the US federal level means the federal government is not able to allocate funding for Pacific communities. Underpinning the bureaucratic hurdles that they have to overcome is systemic racism against minorities of colour (Jackson 2020).

The US scenario is used here to provide a comparative lense in relation to similar vulnerable situations of Pacific diaspora in New Zealand. Two major lessons we can draw from these are the significant roles of systemic racism and the debate relating to health as a private or public good. While there are systemic inequalities and subconscious biases within both systems, what worsens the US case is the fact that health care is a private corporate commodity compared to New Zealand where it is still regarded as an essential public good. This requires a more detailed analysis of the health equity situation of Pacific communities in New Zealand, we deal with this next.

Research on the ethnic (single prioritised) breakdown of poverty in New Zealand shows that Pacific communities are heavily represented in the lowest socio-economic bracket, with 11.6% of the Pacific community classified as ‘poor’ compared to 5.9% for New Zealand Europeans (Plum et al. 2019, p. 5). In-work poverty for males is 5.7% for New Zealand Europeans and 10.1% for Pacific communities, and for females 6.8% and 11.0%, while the figures for children are 7.5% and 17.7% respectively (Plum et al. 2019, p. 4). This inequity is also reflected in housing amongst the in-work poor; only 17.3% of the Pacific community own houses compare to 51.1% of New Zealand Europeans, 28.9% Māori and 41.65 Asian (Plum et al. 2019, p. 23). Other figures show that rates of low income for Pacific communities are consistently higher than those for New Zealand Europeans. Household Economic Survey (HES) data from 2013 to 2015 shows 36% of Pacific children lived in low-income households compared with 14% of European/Pākehā and 32% of Māori children (Perry 2017).

This long-standing structural inequality is also evident in health conditions and outcomes which are well-documented (Walsh and Grey 2019; Ajwani et al. 2003; Moui 1999); research on the life expectancy gap between Pacific and non-Māori non-Pacific revealed the proportion of all potentially avoidable deaths is twice as high for Pacific communities (47.3%) compared to non-Māori non-Pacific populations (23.2%) (Walsh and Grey 2019). This is partly due to the high incidence of diabetic conditions. Figures for 2015 show the rate of diabetes for Pacific adults (20–79 years) was 20%, the highest amongst all ethnic groups (Māori 10%, Asian 8% and NZ European 6%) (Bloomfield 2017). This is also connected to the high incidence of strokes and multimorbidity (Millar et al. 2018; Ryan et al. 2019).

Given these conditions, Pacific communities were assumed to be among the most at risk of COVID-19, yet during the first outbreak the Pacific community was largely ‘insulated’ from the virus, which in the first wave was largely associated with Pākehā returning from travel (Ma'ia'i 2020). This ‘second wave’ proved to be a different story, and was not only specific to Auckland where most Pacific communities in New Zealand live, it also hit the Pacific community hard. The ethnic breakdown of this 2nd wave of infection () reveals a pattern almost similar to the US cases as we saw earlier. As of 24 August 2020, Pacific communities made up 75% of the Auckland cluster, the largest coronavirus cluster in the country.