Sublime

More qualitative accounts could also shift hearts and minds—and, again, stir imaginative empathy. The Works Progress Administration (WPA) in the US in the 1930s brought the voices of the poor into the public realm and turned people who might otherwise be invisible, or merely statistics, into living flesh and blood.

provision of eight social benefits

What about the wider social infrastructure of communities that affect the needs that people have? Who should be accountable for how well social care works in meeting people’s needs? These are questions about organisation and delivery.

systems that should enable human beings to flourish often do the exact opposite.

In her book Thinking in Systems,22 Professor Meadows highlights the need to locate accountability in a complex adaptive system so as to optimize outcomes. In the United States’ health care sector, putting Meadows’s teaching into practice would mean identifying ways by which actors (for instance, hospitals) feel the impact of their actions on other

This undercuts the quality of relationships (manifested in a distrust of strangers and status anxiety, for example). The resulting stress, in turn, is a major determinant of illness and chronic health problems.

chapters, as when researchers apply an economy-wide value for disability-adjusted life years in evaluating health interventions that disproportionately favor poor communities. In these cases, as with distributional weights, the analyst places greater value on the well-being of the poor than their own willingness to pay would be able to reveal.