The implementation of new technologies and artificial intelligence in welfare should represent an opportunity to reconcile equality in the enforceability of rights with a system made up of skills and services present in the territories which should reduce rather than increase inequalities. “It is the great challenge of the welfare state of the 21st century”. This is the opinion of Elena Amalia Ferioli, professor of Institutions of Public Law at the University of Pisa.
Profess what are the possible applications of AI in welfare?
Digital technology and its applications in artificial intelligence can find ample space
in systems welfare national, with particular reference to the traditional sectors of pension, healthcare and social systems, as well as in labor policies. In these areas, the new technologies present two distinct application profiles: one concerns their use in the management of the public system from a purely organisational, administrative-procedural perspective, with reference, for example, to the monitoring of performance and the related information flows towards the government bodies, for automated decision-making processes, in the selection of public personnel or beneficiaries of services. The other application area concerns the use of ICT in the provision of services and services welfare, being able to innovate the typologies of the same, the methods of taking care of those entitled, the service models. Thus, for example in the healthcare sector, AI can help in the acquisition and reprocessing of information data necessary for the planning and financing of the NHS or be used in the diagnosis of a pathology.
How widespread is artificial intelligence in our welfare system?
The processes of digitalisation and technological updating of welfare Italian appear to be making limited progress when compared with other EU states.
Is Italian and European legislation sufficiently mature? Does it need to be implemented or updated?
From a regulatory point of view, the regulation and standardization of the technological updating of welfare is placed, by its nature, at a crossroads of several systems of distinct rules both in a vertical sense, as they pertain to the different local, state and European regulatory levels, and in a horizontal sense, involving areas of regulation intended to protect multiple interests such as the implementation of social rights – social protection, health, work, assistance, – but also the protection of personal data, in particular digital data, technological innovation and economic development. The result is a complex regulatory framework, with uneven degrees of interpretative and jurisprudential development and consolidation. What emerges clearly, however, in approaching the analysis of the reference regulatory framework, is the important role played by the European Union, whose policies in the matter have stood out for a constant tendency to promote and stimulate technological innovation of the systems welfare national, more recently intensifying its action with specific reference to the creation of the digital single market and the regulation of the production and marketing of robotic and AI devices, following an approach based on protection from the risk that may derive from them.
Taking stock of the use of AI in the welfare system, what are the benefits and what are the critical issues?
Starting from the advantages, ICTs seem to tend to implement the personalization of services and therefore, in themselves, could act in favor of enhancing the centrality of the person in the system of welfare. Furthermore, they can bring greater efficiency and effectiveness to the action of the competent public authorities in the provision of services, improving the administrative management of procedures, increasing the efficiency of interventions and services and therefore decreasing waiting times for beneficiaries. Furthermore, new technologies can increase a person’s control and responsibility in decisions and behaviors that concern their well-being and social security. Think, for example, of the numerous healthcare apps that allow self-monitoring and control of health or rapid intervention by healthcare personnel in the case of fragile, chronic or non-self-sufficient patients. It is no coincidence that the OSM and the literature talk about empowerment of the person. Finally, ICTs are central in the transition towards service models that, at a national level, we have long wanted to implement, such as home care, in coherence with the reflections induced by the pandemic period and the implementation of PNRR funding.
Certainly, however, the profiles described above give us a new vision of beneficiary of welfare as an informed, technologically competent, committed and more responsible person in satisfying his social needs. This forces us to deal with the evolution of human relationships within the services of welfare: virtual assistance, artificial intelligence, remote services are changing human relationships between operators and citizens. How far should this transformation go? Will the centrality of the person really be enhanced by digital data or will it be obscured? The digital divide further increases the social divide? These possible critical issues can be contained or avoided thanks to one governance attentive to the innovation process of welfare state. Personally, on this point I think that Italian legislation, on the basis of the personalist principle recognized in the Constitution, is already capable of directing technology in a guaranteeist sense without forgetting the centrality of the person.
The major critical issues that I see on the horizon are linked on the one hand to the dimension of equality to be guaranteed to all beneficiaries of our welfare state, albeit within the context of a decentralized system on the territory, healthcare and social services, and on the ‘other to the risk of marginalization of the public dimension of ours welfare with respect to the economic interests of private individuals involved in the production, marketing and application of new technologies to services welfare. These profiles deserve reflection by political decision-makers and legislators, also because, above all, the first already constitutes an ancient weakness of our welfare, prior to the introduction of new technologies.
It would therefore be desirable that the implementation of ICT in welfare Italian becomes an opportunity to revisit the tools and mechanisms that allow us to reconcile equality in the implementation and effectiveness of social rights with a system of decentralized competences across the territories, to avoid too uneven diffusion of new technologies at regional and local level increases, rather than decreases, inequalities. It is the great challenge of the welfare state of the 21st century.
Tommaso Nutarelli
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