Susanne Ekman – the system and the toxic debt

We often talk about the solution to pressure on welfare services as a matter of allocating more resources. But according to Susanne Ekman, something more fundamental is at stake: we have built a system of steadily growing expectations that cannot be met.

As an anthropologist and associate professor, she has spent several years studying how forms of governance and expectations shape work in welfare organisations. In her latest book, “Toxic Debt and Depleted Welfare – on the depletion of the public sector and the destructive dynamics of debt”, she puts words to a development she sees across sectors. Later this year, she will publish a new book titled “The Expectations Crisis in the Welfare State”, published by Hans Reitzel.

She describes it as a form of “toxic debt”. A system in which we repeatedly promise improvements — higher quality, faster help, better service — without the financial, and especially the human, resources being able to keep up. The result is that the promises can only be kept alive by making new promises. It begins to resemble a pyramid scheme.

“It is a system in which gold and green forests are promised — but where the reward cannot be delivered.”
– Susanne Ekman

The problem is not that anyone is deliberately trying to create it. Quite the opposite. The dynamic arises because it is difficult to say the opposite: that something must be deprioritised, that something must take longer, that something must be less tailored, that something must involve less change. That the welfare state cannot solve everything. And so we — as politicians, citizens and system — maintain the idea that everything can be done.

The consequence is an overheated system. Expectations grow faster than the system can keep up, creating a persistent experience of inadequacy. At the same time, trust is challenged when promises repeatedly fail to be fulfilled. The bill does not land in one place. It is displaced. And it becomes particularly visible in the meeting between citizens and professionals — where the broken promises have to be explained and handled.

Part of what makes the situation difficult is that prioritisation in practice always involves experiences of loss. And loss, precisely, has become something we struggle to accept as a condition.

“If we do not agree on shared principles for how to distribute the unavoidable losses, it becomes everyone against everyone in an endless attempt to push the losses onto others."
— Susanne Ekman

When loss is no longer understood as something shared, but as something unjust, these very conflicts arise. If that conversation is not taken openly, the problem is pushed downwards in the system to those who are most vulnerable. It ends up as something that must be handled locally and individually — and that makes it harder to make sustainable decisions that feel legitimate.

According to Susanne Ekman, what is needed is the difficult and honest conversation about what is possible in welfare services — and what is not. And not least: what we are willing to give up in order to preserve what matters most.

Read our newsletter about the expectations crisis here.