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Europa y bienestar, ¿cuál es el modelo? (I)

Giorgio Vittadini | 222 comentarios valoración: 3  76 votos
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Uno de los elementos que caracteriza de forma exclusiva a la cultura europea, cuya conquista ha interesado durante toda su historia, es el bienestar universal: el derecho para todos, independientemente de la clase social, a acceder a servicios sanitarios, educativos, asistenciales, de igual calidad. Para confirmar su unicidad basta pensar no solo en los países emergentes, sino hasta en los Estados Unidos, con las dificultades que la reforma sanitaria de Obama está encontrando.

Formado a lo largo de los siglos, a partir de obras sociales surgidas de la libre iniciativa de los ciudadanos y asociaciones, el bienestar europeo ha ido implementando poco a poco su capacidad para responder a las necesidades de la población. Progresivamente, ha sido cada vez más importante, sobre todo en el siglo pasado, el papel del estado de bienestar que, fundado sobre un proyecto de justicia social, se sirvió de la progresividad de los impuestos y la capacidad del sector público para redistribuir la riqueza. Dicho de otro modo, Europa se dio a sí misma una sanidad que puede usar también de manera privada pero que es pública, una asistencia en caso de infortunio, una prevención social y la obligación de ofrecer una instrucción generalizada.

La generalización y la nacionalización de la protección social llegó gracias a una masiva intervención de los estados en términos de gasto público que, al menos hasta los años sesenta, se difundió de varias formas y de manera centralizada: no prevé una subsidiariedad horizontal, si no muy limitada y en ciertos sectores, ni una subsidiariedad vertical. El estado central es quien se ocupa de prestar los servicios de bienestar.

La tendencia del bienestar europeo para configurarse según una dimensión universal ha convivido siempre con  una constante dialéctica sobre qué debe ser, cómo se debe financiar, a quién debe beneficiar y qué dinamismos debe caracterizar a un sistema de protección social. Cuestiones que los países europeos han respondido de formas distintas, sobre la base del nivel de gasto total, composición de los distintos programas (pensiones, sanidad, política laboral y familiar) y criterios para garantizar la cobertura a los ciudadanos.

En la Europa continental (por ejemplo en Francia, Bélgica, Alemania), el bienestar garantiza un elevado nivel de protección social sobre todo a la población activa. El modelo que interesa los países del norte (Suecia, Dinamarca, Noruega) ofrece una elevada protección social a un mayor número de ciudadanos en la medida en que se basa sobre criterios de ciudadanía o residencia, más que sobre la participación en el mercado laboral. Este sistema tiene un gran recurso en el mercado, por ejemplo con aseguradoras privadas en el ámbito médico. El bienestar familiar está muy difundido en la Europa meridional o mediterránea (Italia, España, Grecia, Portugal), ofrece un elevado nivel de protección social a los cabezas de familia, que se encargan después de repartir los recursos entre los miembros de la unidad familiar. El recurso al mercado para la adquisición de servicios y seguros es más limitado. En el bienestar que caracteriza a los países anglosajones como Reino Unido, el recurso al mercado para adquirir seguros privados es elevado; a la protección social garantizada en todo caso bajo unos niveles mínimos para todos, se puede añadir, de forma voluntaria, un seguro privado ulterior disponible en el libre mercado.

Mediante el cálculo de la reducción del riesgo de pobreza que se puede atribuir a la existencia de cambios sociales, se puede estimar la eficacia de los sistemas de bienestar. Los países que tienen un sistema de bienestar más eficaz a la hora de reducir la pobreza son Hungría y los países nórdicos. Entre los menos eficaces destacan los mediterráneos (Grecia, España e Italia por este orden) y ex socialistas de la Europa oriental.

En los países de la Europa meridional, caracterizados por un bienestar orientado h hacia la familia, gran parte del gasto social se canaliza mediante un sistema de prevención. En estos países, aparte de pensiones y sanidad, pocos recursos disponibles quedan para el gasto en otros programas como el apoyo a las familias y el mercado laboral. Una composición parecida del gasto en bienestar caracteriza a algunos países ex socialistas del Este europeo, como la República Checa, Estonia, Eslovenia y Polonia, que gastan más del 85% del gasto total en pensiones y sanidad.

Tras las primeras dificultades surgidas a finales de los setenta, el sistema de políticas sociales vinculado al modelo del estado de bienestar entró en crisis en todos los países por una serie de factores externos e internos. Los externos están vinculados a la globalización, que además de ser una de las causas de la crisis económica ha acentuado la necesidad de políticas de integración social. También destacan la cesión de soberanía nacional a favor de los organismos políticos y económicos supranacionales o transnacionales, como los de la UE, que establece vínculos explícitos al endeudamiento como forma de financiación de las políticas de bienestar, o la ralentización de la economía mundial. Estos factores han agravado los efectos de problemas internos de los propios estados, como las dificultades para alimentar financieramente una política de bienestar en un contexto de menor productividad, el aumento vertiginoso de la deuda pública, el envejecimiento de la población, el cambio del sistema ocupacional, las nuevas pobrezas y patologías sociales, las exigencias de bienestar, cada vez más complejas y diferenciadas, la mayor fragilidad de los vínculos familiares.

Afirma Chantal Delsol: “Bajo el Estado-providencia los ciudadanos se convierten en ‘clientes’ sin tener en cuenta su aptitud o ineptitud para procurarse bienes y servicios que necesitan. La redistribución se organiza sin tener en cuenta la figura del deudor ni la del acreedor. (…) Hay por tanto que renegociar los derechos crediticios en relación a las nuevas exigencias y posibilidades de nuestro tiempo. Al contrario, bajo un Estado-providencia los derechos sociales, inicialmente ofrecidos en un preciso momento histórico para responderá  las necesidades o reparar las injusticias, tienden a cristalizarse en el Estado. Cuando los frenan se enrocan hasta que la necesidad desaparece, y los derechos se superponen unos sobre otros en sucesivas capas, llegando a veces a generar crueles desigualdades”.

Desde este punto de vista, el replanteamiento de los modelos de bienestar no puede llegar más que partir de una consideración distinta de los sujetos implicados en el proceso de prestación de los diversos servicios.

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