Years ago, I was having lunch with the Chief Risk Officer at American Express. We were talking about potential customers being declined. He corrected my assertion that we declined some customers for bad credit. “We don’t tell customers no,” he said. “We tell them what it will take, and they tell us no.”
It was helpful framing, but by the same token we did obviously decline customers. I had a memorable guy escalate to me over his decline once. He owed basically every credit card company out there, and he was in arrears across the board. I explained this to him, politely, and he said, “But you don’t understand! I’m going to move all that debt over to your card! That’s why you should approve me.” Right, buddy. So, yes, he was declined, and if he wanted to be approved he needed to pay off some debt first. But to his point, it’s a circular argument: pay off some debt so you can be approved for more debt.
I mentioned in the comments last week that a homeless woman has moved onto the sidewalk in front of one of our offices, and I chatted with her and her cute little dog last week, running out to buy her some snacks at the local QT. I remembered Carolyn’s excellent post at BCC about whether homeless people get to make choices (in contrast to the old “beggars can’t be choosers” adage), and that if we are trying to help people, what they want should matter. If I were offering this woman a drink, all I had in our office fridge was Diet Coke, and what are the odds that’s her favorite too? Slim to none. It actually made me think about all the choices I make, and how they are informed by my own station in life. I might prefer a salad because I’m making up for the abundance I ate the day before. But if I were homeless, would I prefer a hot meal because it’s cold outside? Add to that the fact that people just like different foods, and it feels logical that we should buy people what they actually prefer if we are trying to bring them comfort and make life easier for them.
But we aren’t mostly trying to help the homeless in this country from what I can see. We mostly want them to either go away or be invisible. We want them to “get with the program.” Often, we are afraid of them. I was disturbed as I thought about her vulnerable situation, and I wondered what I would do if I were her. I was listening to a podcast series about how the homeless problem got so out of control in this country, and I was surprised to hear that this problem rose in the 80s, that it wasn’t as big an issue in the 70s. But in the 80s, part of what made the problem worse was our shifting values as a country. We adopted a paternalistic attitude toward the poor. The poor could have help, certainly, but only if they ticked all the right boxes. The homeless needed to deserve our help. They had to be drug-free. If they were mentally ill, they had to take their meds. If the poor received food stamps, they could only buy certain foods with them, not things deemed “luxuries” and also not things deemed nutritionally bad.
Where did we get this attitude? Although Reagan didn’t invent the idea of welfare fraud, he certainly used the term for all it was worth. He got a lot of mileage out of it and galvanized the nation against the poor, implying that most poor people were cheats and freeloaders, too lazy to hold down a job. They didn’t deserve our help, and he preached that “handouts” didn’t help anyone anyway because if you didn’t have to change yourself to get help, you were still going to need help endlessly; the person asking for help is always, always broken. Real people, whole people, never need help.
There’s a woman in Chicago, Reagan told voters, who “used eighty names, thirty addresses, fifteen telephone numbers to collect food stamps, Social Security, veterans’ benefits for four non-existent deceased veteran husbands, as well as welfare.” And she wasn’t the only one. Reagan bemoaned a welfare system infested with fraud, although he kept returning to the woman in Chicago. She wore a fur coat. She drove a Cadillac. She paid for T-bone steaks with food stamps. He didn’t refer to her by name but by a sobriquet—one he didn’t invent, but which he repeated so often it metastasized into an ugly stereotype: She was the welfare queen.https://www.thenation.com/article/archive/josh-levin-the-queen-book-review/
We adopt this attitude with all sorts of problems. For example, if your BMI is greater than 25 and you go to the doctor, the notes from your visit will claim that the doctor talked to you about your weight, even if you don’t really have a weight problem. This is due to the “obesity epidemic.” Rather than address the root causes of obesity (corn starch and sugar in everything we eat now combined with sedentary jobs), we will instead shame and cajole people based on their weight, and blame them for being “unhealthy” regardless of their actual healthiness, just based on a number. It’s open season on larger people in this country. It’s generally acceptable to mock and belittle people for being “unhealthy” when it is literally none of our business what they eat or how much they exercise or whether or not they have genetic factors that contribute to their body type. A woman reported going to the doctor about her allergies. He told her she should eat more fruits and vegetables to lose weight. She said that wasn’t the problem that she was there about. Finally, in exasperation, she said, “What advice would you give a skinny person?” and she finally got the help she needed. It was just impossible for him to see past her weight to actually address the problem she was there for.
In this story, the doctor’s paternalism was on full display; he was not only a resource for the needs she had, but also believed that he could better diagnose what she really needed, what her real problems were. If she wasn’t asking the “right” questions, he was still going to force her to listen to those things as well. That’s fine if 1) there really is a health problem, 2) that she doesn’t know about, and 3) that can be improved. This situation didn’t meet any of these three criteria. A lot of people are just never going to be a “perfect” weight. Telling them to diet themselves into a personal hell isn’t going to lead to a happier, healthier life. Nobody who is overweight (aside from Trump, maybe) is unaware of it. Nobody is unaware that we should eat healthy choices and exercise more.
The podcast about homelessness that I referenced talked about a shift in the last decade or so, away from paternalism and toward choice. The shift was called “Housing First.” Rather than make people work to qualify for government housing, the focus was changed to getting those in the greatest need off the streets first, those with addictions or who were in physical jeopardy, those who were the most unsafe and vulnerable. It’s easier to quit taking drugs when you have a place to sleep, clean water, and plumbing. This was the first step away from paternalism and toward giving the poor and the homeless more say in solving the problems they faced.
This new approach wasn’t without problems. As I’ve frequently quoted Henry Kissinger saying “Every solution is a ticket to a new problem.” In this case, a side effect is racist outcomes. More white people who are homeless are placed in housing under this model because black people often become homeless due simply to poverty, but white people have more safety nets and fewer cards stacked against them. When a white person becomes homeless, there is a higher chance that they also have problems with addiction, mental illness, or other ailments that render them particularly vulnerable and in distress. They’ve had to make course corrections to how they evaluate homeless people to make the outcomes more fair (so long as there isn’t suitable housing available for all).
The next discovery they made was that some people who got housing eventually left it to become homeless again. They chose homelessness over shelter. The Reagan era mindset would say that they washed out because they were too weak to stay drug-free or they refused to take their meds or they didn’t have the skills to make it work in a real job. But when social workers actually talked to these people, they found that they had missed their community, their friendships. Living in government paid housing was often isolating in a way that living in their ramshackle mobile dwellings was not. This listening allowed those working to help the homeless to create alternate living arrangements rather than just the individual apartments that were the norm. There are some group homes. There are cities that simply provide an apartment or condo anywhere in the city that the person wants to live, and they have to pay 30% of their income toward rent while the city covers the rest.
My daughter and I were recently talking about what things we do today that in 30 years will be viewed the way sexism and racism are viewed today. I think paternalism is a likely contender of the attitudes that need to be relegated to the trash heap. Instead, we need to start listening to the people we are trying to “help” and actually work with them to design the solutions that meet their needs.
Paternalism is behind colonialism. It’s when privilege gets to decide what problems to solve and how to solve them. Privilege is frankly terrible at identifying and solving the problems of those who aren’t privileged. It ultimately ends up blaming those with problems for the problems because privilege doesn’t experience those same problems in the same ways. Paternalism is also behind movements like religious freedom. Don’t bake the cake, it whispers. If we can keep gay people from celebrating, maybe they’ll go back in the closet and quit being gay. What paternalism really hates is freedom and choice for other people, those that see things differently than you do or those whose choices differ from yours. Paternalism really really wants to compel them to follow the designated path, to check the boxes laid out for them, so that they resemble and preserve the paternalistic norm. Paternalism cures eyesight with only one pair of glasses, and if they don’t work for you, it’s your fault.
That’s the rub. People do need different prescriptions. There are exceptions to rules, and we shouldn’t be terrified that if we allow for exceptions suddenly it will be chaos and everyone will get what they need instead of what we are willing to let them have. The rule of law is a continuous investigation into our principles to understand something bigger and better than our predecessors count imagine or articulate. Paternalism hates change and hates when the illusion of timelessness is shattered because it’s a challenge to the power of status quo.
- Do you agree that paternalism will be the future “outcast” behavior, something we will finally get away from in the next 30 years or so?
- Are there other social behaviors you see on their way out?
- What would the Church look like if it no longer had a paternalistic attitude?
 She did say food-wise “anything” was fine, but she prefers Squirt soda. And why shouldn’t she enjoy the thing she most likes to ring in the New Year?
 I think this is like when the people of Lost wanted to return to the island after being back in civilization. They found civilization depressing.