America's welfare state has come under a new line of attack in recent years. This critique, particularly common on the progressive left, contends that social-services managers and staff provide too much support to the working poor and other, relatively better-off cohorts by focusing on their most promising clients while avoiding the hardest cases. "Creaming," or "cream-skimming," as the practice is sometimes called, is viewed as a major cause of why so many difficult cases continue to go unaddressed despite massive social-welfare spending, compounding the welfare state's reputation for incompetence and leaving the neediest Americans behind.
In fact, for some on the left, creaming is in a sense the distinctive problem with social services in America. When moderate cases are served in an entirely different and separate manner from the hardest cases, progressives suspect that this inequality is rooted in service providers' desire to have an easier job or to improve their outcome metrics. It is therefore imperative, in their view, that governments take measures to ensure a more equitable distribution of the most difficult cases among service providers.
Stephen Eide is a senior fellow at the Manhattan Institute and contributing editor of City Journal.
Photo by mihailomilovanovic/iStock