In my essay Eugenics and the Welfare State I explain how cash-strapped European welfare states resort to extreme measures to cut costs. The common denominator of those measures is the discarding of lives in single-payer health care system – lives that are unworthy of the welfare state’s budget. The lives discarded, deleted, thrown away, are not the lives of very old people. They are the lives of babies, children and teenagers who have been classified as ill beyond the reach of medical treatment.
While in some cases this may be true, there is a pressing suspicion that most of the lives that are terminated in the name of cost containment. Regardless of which, the very fact that medical practitioners in single-payer health care are sentencing people to die based on budgetary considerations is horrifying. It awakens echoes from one of the darkest periods of the 20th century – echoes that grow even louder when we take into account the despicable conditions under which these patients die.
But the authoritarian practice of discarding lives does not have to lead to medical practitioners starving and dehydrating patients to death. The following report from The Raw Story, a blog affiliated with British newspaper The Guardian, provides another view of what the welfare state does to people when it can no longer afford them:
Growing numbers of elderly and sick Germans are being sent overseas for long-term care in retirement and rehabilitation centres because of rising costs and falling standards in Germany. The move, which has seen thousands of retired Germans rehoused in homes in eastern Europe and Asia, has been severely criticised by social welfare organisations who have called it “inhumane deportation”.
The welfare state promised to care for them when they grew old. The welfare state is delivering on its promise. Just not in the way it promised to deliver.
Germany’s chronic care crisis – the care industry suffers from lack of workers and soaring costs – has for years been mitigated by eastern Europeans migrating to Germany in growing numbers to care for the country’s elderly. But the transfer of old people to eastern Europe is being seen as a new and desperate departure, indicating that even with imported, cheaper workers, the system is unworkable.
Let’s not forget that the standard argument that statists make for expanding government control over health care, elderly care, child care and education is that the government can provide high-quality, affordable health care for everyone – while of course successfully containing costs.
The cause behind this crisis in Germany’s elderly care is precisely that it is run by government. The fundamental mechanisms that throw the welfare state into perpetual budget problems have nothing to do with demographics, regardless of how much The Raw Story wants to make that connection. To their credit, though, they broaden the approach angle to include austerity as well:
Germany has one of the fastest-ageing populations in the world, and the movement here has implications for other western countries, including Britain, particularly amid fears that austerity measures and rising care costs are potentially undermining standards of residential care. The Sozialverband Deutschland (VdK), a German socio-political advisory group, said the fact that growing numbers of Germans were unable to afford the costs of a retirement home in their own country sent a huge “alarm signal”.
They, of course, would like to see more government “intervention” to mitigate the problem, when in reality the problem is that government promised to take care of them in the first place.
Researchers found an estimated 7,146 German pensioners living in retirement homes in Hungary in 2011. More than 3,000 had been sent to homes in the Czech Republic, and there were more than 600 in Slovakia. There are also unknown numbers in Spain, Greece and Ukraine. Thailand and the Philippines are also attracting increasing numbers.
It makes you wonder what their relatives are doing. Before the welfare state it was common practice that each family cared for its elderly, just like it cared for its own children. That did not lead to mass deportations for cost containment purposes, a fact worth keeping in mind here.
And now for the really compassionate part of this policy:
[C]ritics of the move have voiced particular worries about patients with dementia, amid concern that they are being sent abroad on the basis that they will not know the difference. Sabine Jansen, head of Germany’s Alzheimer Society, said that surroundings and language were often of paramount importance to those with dementia looking to cling to their identity. “In particular, people with dementia can find it difficult to orientate themselves in a wholly other culture with a completely different language, because they’re very much living in an old world consisting of their earlier memories,” she said.
Instead of making promises it can’t keep, the welfare state needs to start a roll-back phase where it allows people to take back control over their own lives. That is not yet on the agenda in Germany, and maybe it never will be. But at the end of the day there is no other solution.