Social Spending Policies

🌍 𝗧𝗵𝗲 𝗠𝗶𝘀𝘀𝗶𝗻𝗴 𝟮 𝗕𝗶𝗹𝗹𝗶𝗼𝗻: 𝗠𝗮𝗸𝗲 𝗦𝗼𝗰𝗶𝗮𝗹 𝗦𝗲𝗰𝘂𝗿𝗶𝘁𝘆 𝗧𝗿𝘂𝗹𝘆 𝗜𝗻𝗰𝗹𝘂𝘀𝗶𝘃𝗲 𝗶𝗻 𝗮𝗻 𝗔𝗴𝗲 𝗼𝗳 𝗨𝗻𝗰𝗲𝗿𝘁𝗮𝗶𝗻𝘁𝘆! Despite notable progress, 2 billion people in low- & middle-income countries remain uncovered or inadequately covered by social protection systems, as highlighted in the World Bank’s State of Social Protection Report 2025. While social protection coverage has expanded to over 4.7 billion globally, it often remains: 📌 Too little (low benefit adequacy), 📌 Too late (limited crisis responsiveness), 📌 Too narrow (missing informal, migrant, & female workers). In low-income countries, social assistance contributes just 11% to poor households’ incomes - barely enough to cushion basic shocks. At current pace, it’ll take two decades to cover the bottom 20% of populations. Yet, countries like India are rewriting the script - one policy at a time. 🇮🇳 India’s approach blends universal schemes, digital infrastructure, & state-level innovations: 📍e-Shram (eshram.gov.in): national database for 280m+ unorganized workers 📍Ayushman Bharat: ₹5 lakh health insurance for 50 crore people 📍EPFO & ESIC: institutionalized security for formal workers 📍National Pension Scheme: voluntary retirement planning 📍PM-KISAN, Atal Pension Yojana, Ladli Behna Yojana, & other DBT schemes providing income support to farmers, women, elderly, & gig workers 📍Cross-subsidies like free electricity for agriculture & small households, zero-fare public transport for women, and state-sponsored healthcare/education These financial interventions are instruments of dignity, aimed at reducing exclusion, especially for women, the elderly, and informal workers. But there's another silent shift we must acknowledge: the fracturing of joint families into nuclear units. 👪 Traditionally, Indian households relied on extended family systems to shoulder care responsibilities and income shocks. Today, urbanization, migration, and shrinking households have eroded these informal safety nets. This isn’t just about affordability - it’s about the viability of social protection in a rapidly changing value system. As family support structures weaken, the state must step in as the default caregiver - with systems that not only offer financial support but also foster care, community, and continuity. The World Bank outlines four pathways forward: 1️⃣ Expand coverage - especially for the informal and invisible 2️⃣ Enhance adequacy - benefits must empower, not just alleviate 3️⃣ Build adaptive systems - to withstand crises and transitions 4️⃣ Reform financing - from regressive subsidies to targeted, equity-focused transfers 🔁 Social protection must be a pre-emptive platform for resilience. In an age of climate risks, tech disruption, geo-political conflicts, and demographic shifts, it’s time to evolve our systems from safety nets to springboards. Because security isn't just about schemes - it's about the society we choose to build.

From 1990–91 to 2021–22, public expenditure on social services in India rose from 5.5% to 8.3% of GDP. In other words, for every ₹1 the Indian state spent on defence in 1990, it spent ₹2.2 on social services; by 2021, that had nearly tripled to ₹3.3. But does higher spending automatically translate into a stronger, more resilient social foundation? Or has it become a statutory checkbox to tick? The answer, perhaps, lies in how the spending is delivered. Ask a frontline worker how they verify a beneficiary qualification, and the answer is: “If the phone rings, we assume they’re around.” Cases like 7.5 lakh Ayushman Bharat beneficiaries linked to a single phone number in Kerala, or an international cyber fraud ring in Bihar exploiting SIM-based DBT authentication, expose just how fragile the delivery machinery is. I don’t blame them. When you’re serving 1.4 billion people, government capacity is always going to be a constraint. To mitigate this, many states are rightly adopting AI-based invoice audits, biometric verification, and predictive analytics. But tech is, at best, one layer. Dig deeper, and it becomes clear: we need adaptive state capacity - systems that can learn, evolve, and self-correct. Karthik Muralidharan’s piece in The Times Of India and his book bring out this point brilliantly. Programs like Ayushman Bharat, Pradhan Mantri Awas Yojana, and MGNREGA reflect the country’s commitment to investing in human development. But the real test lies in building state capacity that can deliver despite the scale and complexity of that ambition.  #PublicPolicy #GovTech #SocialImpact #DigitalGovernance

CSR spending in India touched ₹23,894 Cr in FY 2022-23. A big number. But does it reflect real impact or just compliance spending? Where the Money Went vs. Where It’s Needed - Education, Livelihood & Differently Abled – ₹9,776 Cr - Health, Hunger & Sanitation – ₹7,135 Cr - Environment & Resource Conservation – ₹1,661 Cr - Rural Development – ₹1,605 Cr - Gender Equality & Social Inclusion – ₹551 Cr - Sports Development – ₹287 Cr - Heritage & Culture – ₹319 Cr - Slum Area Development – ₹87 Cr 5 Big Takeaways for CSR Strategy 1. CSR is Still Urban-Centric The top five states—Maharashtra, Gujarat, Karnataka, Tamil Nadu, and Delhi—got 50% of the total CSR funds. Meanwhile, rural development received only ₹1,605 Cr. Are we truly addressing India’s development gaps? 2. Climate Action is Not a Priority Despite climate risks, only ₹1,661 Cr was spent on environment, conservation, and sustainability. At a time when floods, heatwaves, and pollution are escalating, this is concerning. 3. Gender & Social Inclusion is a Side Note Only ₹551 Cr went into women empowerment, old age homes, and reducing inequalities. For all the diversity and inclusion talk, are companies investing in systemic change? 4. The ‘Easy-to-Report’ Sectors Get More Funding Education and healthcare dominate because they are easy to showcase—schools built, hospitals funded, meals distributed. But impact is more than just numbers. Are we funding long-term systemic change or just feel-good projects? 5. CSR is Still Compliance-Driven Companies are spending, but is it outcome-driven or just meeting legal mandates? - Are CSR projects integrated into long-term business sustainability? - Are we measuring impact beyond reports and PR activities? - Do these funds truly empower communities to be self-sufficient? CSR should not just spend money—it should create lasting impact. Where Do We Go from Here? For CSR to be more than compliance, we need: - A shift from charity to impact investing. - More focus on sustainability and resilience. - Better rural penetration and climate-focused interventions. - Stronger measurement frameworks to track real outcomes. The numbers tell a story. The question is—are we listening? How do we move CSR from spending to real change? Let’s discuss.

Social Security’s Old-Age and Survivors Insurance (OASI) Trust Fund is now projected to deplete its reserves in the fourth quarter of 2032. If Congress does not act before then, continuing income would cover only about 78% of scheduled retirement and survivor benefits. The solutions are known. Congress can raise revenue, reduce scheduled costs, or combine both. That could mean higher payroll taxes, a higher taxable wage base, changes to benefits for higher earners, adjustments to cost-of-living increases, a later retirement age, or some blend of these approaches. The math is straightforward, but the politics are anything but simple. What makes this moment especially important is that delay does not preserve choices. It narrows them. The longer lawmakers wait, the more concentrated the burden becomes on workers, retirees, taxpayers, and future beneficiaries. Time is one of the most expensive variables in the model. The real question may be whether Social Security should continue treating every retiree the same, or whether reform should focus first on protecting those who rely on the program most. That conversation will be politically difficult, but avoiding it only makes the eventual decisions harder. Social Security is one of the most successful retirement security programs in American history. Preserving it requires more than defending the promise. It requires updating the financing, benefits, and assumptions behind that promise for the demographic reality now in front of us. #SocialSecurity #RetirementPlanning #TaxPolicy #PublicFinance #TrustFunds #PayrollTax #RetirementSecurity #PolicyDebate #Demographics #FinancialPlanning

The Government recently announced reforms which propose to cut £5 billion from the welfare bill. This would include ending the universal credit health top-up for those under 22, decreasing the health top-up for new claimants, tightening the criteria for receiving personal independence payments (PIPs), and increasing reassessments for PIPs. While economic concerns appear to be central to these cuts, the Government has framed the changes as a moral obligation to support individuals transition from benefits into employment. However, making cuts to disability benefits will not achieve this goal or fix the system. In an open letter, signed by many organisations across the sector, including Turning Point, to the Chancellor Rachel Reeves, Scope argued: “There is little evidence to suggest cutting benefits increases employment outcomes. We know the benefits system is broken and needs reform. There are disabled people out of work who want to work given the right support. And for some disabled people, work isn’t appropriate. Changes to welfare must start here. Not with cuts.” Darzi’s recent Independent Review pointed out that the 2010s were the most austere decade since the NHS was founded, with spending growing at around 1 percent in real terms until 2018, against a long-term average of 3.4 percent. Adjusted for population growth and changes in age structure, spending virtually flatlined. Any reform aimed at getting people into work needs to focus on building sustainable and holistic support systems across health, social care, housing and welfare provision, aiding the transition from benefits into employment. An individual who is supported by Turning Point said: “I agree that the benefit system does need change, and I know there is a small group of people potentially claiming benefits who don’t need to. But there are many people who do need that help and they should not be penalised. I claim PIP and am lucky that I have people who will advocate for me, but not everyone has that support. Rather than cutting people’s benefits, there needs to be a focus on funding social care properly and putting less red tape in the way for people who need help.” Cutting benefits without addressing the root causes for people being out of work will only serve to exacerbate challenges faced by those in need.

FACT CHECK: In his National Press Club address yesterday, Health Minister Mark Butler presented a narrative regarding NDIS spending that does not align with the NDIA's own data. Mark said that they were going to take the cruel step of cutting costs to disabled people for 'social & community participation' - for many people in group homes & other institutions, this is their only time outside their houses, including to see their families. He said that 'social & community participation funding is proposed to reduce from $31,000 to $26,000 per participant - a reduction of approximately 16%.' Bit of a fact check there for the boys in the back room, or Mark himself. Especially if he's expecting to make those Big Cuts by reducing social & community participation. What ARE the figures? Here is the actual breakdown, straight from the NDIA’s data & their Scheme Actuary baselines. Firstly, there is the "Committed" vs. "Actual" spend to understand. The political narrative relies heavily on the projected $50 billion total scheme cost for 2025-2026. The NDIA’s financial reporting explicitly states that 20% of total scheme payments go toward social and community participation. That's committed spend - the amount they say is in average standardised plan amounts. That's what they SAY they will give you. This, they say, equates to $10 billion directed at social & community access nationally. But that is not the ACTUAL spend. Committed support is not money out the door. The 'utilisation gap' is a massive factor when it comes to actual spending. Due to systemic barriers - sometimes thin provider markets or lack of accessible transport, often the NDIA giving you money that you *can't* spend, to create an artificial underspend - the utilisation for these specific supports hovers around 50-70%. Let's go with the higher figure, because people have been further unable to spend their funding due to the new 'funding periods rule'. The reality of that is that the actual spend drops from the promised $10 billion down to $7 billion. How? Well, the NDIA tracks approximately 760,000 active participants. When we look at what participants actually use for community access, the numbers shift drastically downward: - Average annualised committed support: $13,150 per participant. - Actual spend average: $9,210 per participant, pa. So - you'll be saving only $1.12 billion. If you only cut 16% from the actual community spend, you are short of your savings target by $2.68 billion. I don't think this was a stumble. I think it's been presented as a winnable argument, with some neatly plated overstated figures. We need rigorous, evidence-based policy discussions, not skewed figures used to justify shrinking essential funding for disabled people. Transparency matters. Sources: NDIA Quarterly Reports (Active Participants, Utilisation Rates, Outcomes); NDIA Annual Pricing Review (Category Expenditure); NDIA Scheme Actuary Presentations (Demographic Baselines). #NDIS #auspol

The biggest impacts on mental health come from addressing fundamental life conditions rather than from clinical interventions. Evidence from the WHO's comprehensive review demonstrates how social conditions drive mental health outcomes: Housing & Depression: CDC's National Health Interview Survey (2019) found adults experiencing housing insecurity were 3x more likely to report frequent mental distress. Economic Impact: - In Europe, every 1% increase in unemployment was associated with a 0.79% rise in suicides among people under 65 (data from 26 EU countries, 1970-2007) - Debt is a major factor: Studies show the more debt people carry, the more likely they are to have mental disorders, even after adjusting for income Social Protection Works: A powerful example comes from comparing Spain and Sweden during economic crises. Spain, with lower social spending ($88 per head on labor market protection), saw direct correlations between unemployment rises and suicide rates. Sweden, spending more ($362 per head), showed no corresponding rise in suicide rates during similar unemployment increases. While treatment access matters, creating conditions for good mental health through social and economic policies may be even more impactful. This means: - Robust social protection programs - Housing stability initiatives - Employment protection - Debt reduction programs - Early childhood support We need an integrated approach that addresses both treatment AND social determinants. The data shows it's not an either/or - it's both/and. What social policies do you think would have the biggest impact on population mental health in your community? #MentalHealth #PublicHealth #SocialDeterminants #HealthEquity #EvidenceBasedPolicy

DAY 4 OF 5 – SDOH/HRSN/FHS SERIES 📍 THE POLICY LANDSCAPE: FEDERAL SHIFTS & STATE INNOVATION The federal "floor" for social care just dropped. At the same time, state demands are accelerating. In 2026, we aren't seeing a slow drift in SDOH policy – we’re seeing a structural divergence. The organizations that read these signals correctly will be the ones still standing when the Medicaid fiscal cliff arrives in 2027. 👉 THE FEDERAL SHIFT: FROM PRESCRIPTION TO SCRUTINY Most SDOH watchers tracked the 2025 rescission of the Biden-era HRSN waiver guidance. While existing 1115 approvals remained intact, it signaled that new social care applications would face "case-by-case" scrutiny rather than a defined federal pathway. But the real seismic shift is the One Big Beautiful Bill Act (OBBBA). ➡️ The Fiscal Cliff: RAND’s 2026 analysis projects OBBBA will reduce state Medicaid budgets by $665 billion over the next decade. ➡️ The Downstream Effect: With 6-month redeterminations starting December 2026 and work requirements hitting in 2027, state budgets are compressing. When enrollment contracts, "optional" benefits – like social care – face the first line of fire. 👉 THE STATE DIVERGENCE: THE "PROOF IN THE GROUND" SURVIVES Here is the paradox: Federal headroom is shrinking, but states that have already operationalized HRSN are doubling down because they have the data to prove it saves money. ➡️ North Carolina: The Healthy Opportunities Pilot (HOP) continues to show $85 PMPM savings, making the actuarial case for the state to protect this investment even under federal pressure. ➡️ New York: Social Care Networks (SCNs) are live, with over 650,000 screens completed. ➡️ California: CalAIM’s mandatory closed-loop referral requirements (as of July 2025) have moved social care from a "pilot" to a "condition of participation." 👉 THE STRATEGIC IMPLICATION FOR 2026 For leaders, the reality is now bifurcated. 1️⃣ In Waiver States: SDOH infrastructure is no longer a "nice-to-have" – it’s a compliance and quality performance mandate. 2️⃣ In Non-Waiver States: You must demonstrate local ROI to compete for shrinking discretionary budgets. 💡 The window to build "durable" programs is closing. If you waited for federal permission to build your infrastructure, you are already behind. 💬 In a post-OBBBA environment, how are you making the case to Finance to protect social care investment? #Medicaid #SDOH #HRSN #HealthPolicy #OBBBA #1115Waiver #HealthcareLeadership #PopulationHealth SOURCES: State-Level Impacts of Key Medicaid Provisions - OBBBA – RAND: https://lnkd.in/e3U-AZ8i 50-State MCD Budget Survey for FY 2026 – KFF:https://lnkd.in/eUY3aJ5C MCD Spending & HRSN in North Carolina – JAMA:  https://lnkd.in/eUJh-6Vf

Just out of interest, I looked at what countries invest in social development (both public and private) as a % of their GDP. It's interesting and thought provoking. While governments contribute significantly, private sector participation—through philanthropy, CSR, and impact investments—also plays a crucial role. Here's a breakdown, from a simple Internet query... United States • Total social sector funding: ~24% of GDP • Public sector: 80% • Private sector: 20% Europe & New Zealand • United Kingdom: Total: ~21.5% of GDP | Public: ~90% | Private: ~10% • Germany: Total: ~25.0% of GDP | Public: ~92% | Private: ~8% • Netherlands: Total: ~33% of GDP | Public: ~66% | Private: ~34% (one of the highest private shares due to private pensions & health insurance) • Denmark: Total: ~28.8% of GDP | Public: ~95% | Private: ~5% • Sweden: Total: ~26.7% of GDP | Public: ~93% | Private: ~7% • New Zealand: Total: ~19.7% of GDP | Public: ~90% | Private: ~10% India’s Social Sector Funding (FY24) • Total social sector funding: ~8.3% of GDP • Public sector: ~95% (~₹25 lakh crore) • Private sector: ~5% (~₹1.3 lakh crore) NITI Aayog recommends that India should target 13% of GDP in social spending. This highlights a funding gap of ₹14 lakh crore ($170 billion) in FY24. One thing that jumps out to me is, unlike the U.S. (20%) and the Netherlands (34%), India’s 𝐩𝐫𝐢𝐯𝐚𝐭𝐞 𝐬𝐞𝐜𝐭𝐨𝐫 𝐜𝐨𝐧𝐭𝐫𝐢𝐛𝐮𝐭𝐞𝐬 𝐣𝐮𝐬𝐭 5% 𝐭𝐨 𝐬𝐨𝐜𝐢𝐚𝐥 𝐟𝐮𝐧𝐝𝐢𝐧𝐠. I would imagine that with India’s growing wealth, CSR and philanthropy from HNIs & UHNIs must go beyond traditional donations to strategic, impact-driven funding. If we aim for 13% of GDP in social spending as per NITI's recommendations, 𝐰𝐞 𝐦𝐮𝐬𝐭 𝐮𝐧𝐥𝐨𝐜𝐤 𝐩𝐫𝐢𝐯𝐚𝐭𝐞 𝐟𝐮𝐧𝐝𝐢𝐧𝐠 𝐚𝐭 𝐬𝐜𝐚𝐥𝐞. How do we do that? And what do you infer from the data above? #SocialImpact #Philanthropy #CSR #India #FundingGap #Sustainability (Sources: OECD - OCDE, Bain & Company, NITI Ayog)

The Social Investment Agency has released New Zealand's Impact Measurement Standards (June 2026) - a shared framework for measuring the outcomes and impact of government social spending. At the centre are three levels of evidence: Level 1 - an evidence-based theory of change: how a programme's inputs, activities and outputs are expected to lead to outcomes, with assumptions and limitations stated. Level 2 - evidence of change: measured shifts in short, medium and long term outcomes for those receiving a service, often at an individual or whānau level. Level 3 - causal evidence: robust methods that test whether a programme contributed to, or caused, the outcomes observed. A few features worth noting: the standards don't prescribe a single method, leaving the approach to fit the programme and the decision; they set expectations from the design stage rather than only at evaluation; and they ask agencies to apply the levels proportionately, matching the strength of evidence to the scale and risk of the decision. They apply to agencies that fund, commission, deliver or oversee social services, and sit alongside the wider social investment approach. The standards and companion guidance are freely available Standards — https://lnkd.in/gWgGAhbQ Guidance: https://lnkd.in/gPiUMCgB Worth a quick read if you work in commissioning, evaluation or programme design.