Abstract
Long-term care (LTC) is one of the most rapidly developing policy areas in Europe, where significant institutional change and innovation have taken place over the last two decades throughout the continent. In contrast to mainstream policy fields (e.g., pensions, labor market policies, and health care), where attempts to reduce public intervention has been the most common trend (Castles, The Future of the Welfare State: Crisis Myths and Crisis Realities, 2004, Policy and Politics, 33(3), 411–430, 2005; Korpi and Palme, American Political Science Review, 97(3), 425–446, 2003; Pierson, The New Politics of the Welfare State, 2001), LTC has seen a broader scope of transformations, ranging from retrenchment and cost containment to a growth in public financing and an expansion of coverage. In many European countries, LTC policies over the last two decades have been characterized by a recognition of social rights on the one hand and yet increasing social responsibilities on the other (Morel, The Politics of Post-Industrial Welfare States, 2006). This book is aimed at describing these general trends, identifying the factors, which explain these broad developments, highlighting both the main differences between European countries and outlining the main consequences of the various policy developments that have taken place.
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Notes
- 1.
We use here a broad definition of LTC, namely, as “a range of services required by persons with a reduced degree of functional capacity, physical or cognitive, and who are consequently dependent for an extended period of time on help with basic activities of daily living (ADL), such as bathing, dressing, eating, getting in and out of bed or chair, moving around and using the bathroom. This personal care component is frequently provided in combination with help with basic medical services such as help with wound dressing, pain management, medication, health monitoring, prevention, rehabilitation or services of palliative care. LTC services can also be combined with lower-level care related to help with instrumental activities of daily living (IADL), such as help with housework, meals, shopping and transportation” (OECD 2011). This definition, however, fails to consider income scarcity, material deprivation, poverty, and housing distress, factors, which are often related to dependency.
- 2.
This is one of the most widespread explanations of change in the social sciences, based on the idea that institutions tend to be path dependent (once a certain institution is set, due to a series of events, it tends to maintain inertia over time and finishes with reinforcing itself with a lock-in effect); only in the case of relevant external shocks (e.g., relevant economic and political crisis) will institutional change take place (Pierson 2001).
References
Alber, J. (1995). A framework for the comparative study of social services. Journal of European Social Policy, 5(2), 131–149.
Anttonen, A., & Sipila, J. (1996). European social care services: Is it possible to identify models? Journal of European Social Policy, 6(2), 87–100.
Ascoli, U., & Ranci, C. (Eds.). (2002). Dilemmas of the welfare mix. The new structure of welfare in an era of privatization. New York: Springer.
Baumol, W. J. (1996). Children of performing arts, the economic dilemma: The climbing costs of health care and education. Journal of Cultural Economics, 20, 183–206.
Bettio, F., & Plantenga, J. (2004). Comparing care regimes in Europe. Feminist Economics, 10(1), 85–113.
Bonoli, G. (2006). New social risks and the politics of post-industrial social policies. In K. Armingeon & G. Bonoli (Eds.), The politics of post-industrial welfare states. Adapting post-war social policies to new social risks (pp. 3–26). London: Routledge.
Burau, V., Theobald, H., & Blank, R. H. (2007). Governing home care: A cross national comparison. Cheltenham: Elgar.
Capano, G., & Howlett, M. (Eds.). (2009). European and North American policy change. Drivers and dynamics. Oxon: Routledge.
Castles, F. G. (2004). The future of the welfare state: Crisis myths and crisis realities. Oxford: Oxford University Press.
Castles, F. G. (2005). Social expenditure in the 1990s: Data and determinants. Policy and Politics, 33(3), 411–430.
Clasen, J., & Siegel, N. (Eds.). (2007). Investigating welfare state change. Cheltenham: Edgar.
Costa, G., & Ranci, C. (2010). Disability and caregiving: A step toward social vulnerability. In C. Ranci (Ed.). Social vulnerability in Europe. The new configuration of social risks (pp. 159–185). Basingstoke: Macmillan.
Da Roit, B., & Le Bihan, B. (2010). Similar and yet so different: Cash-for-care in six European countries’ long-term care policies. The Milbank Quarterly, 88(3), 286–309.
Dahrendorf, R. (1988). The modern social conflict. An essay on the politics of liberty. Berkeley: University of California Press.
Daly M., & Lewis, J. (1998). Introduction: Conceptualizing social care in the context of welfare state restructuring. In J. Lewis (Ed.), Gender, social care and welfare state restructuring in Europe (pp. 1–24). Aldershot: Ashgate.
Esping-Andersen, G. (1990). The three worlds of welfare capitalism. Princeton: Princeton University Press.
Evers, A., Pijl, M., & Ungerson, C. (Eds.). (1994). Payments for care. A comparative overview. Brookfield: Ashgate.
Ferrera, M. (2005). The boundaries of welfare. European integration and the new spatial politics of social protection. Oxford: Oxford University Press.
Finch, J. (1989). Family obligations and social change. London: Routledge.
Finch, J., & Groves, D. (Eds.). (1983). A labour of love: Women, work and caring. London: Routledge.
Hacker, J. (2004). Privatizing risk without privatizing the welfare state. American Political Science Review, 98(2), 243–260.
Hall, P. (1993). Policy paradigms, social learning, and the state: The case of economic policy-making in Britain. Comparative Politics, 25(3), 275–296.
Hall, P., & Thelen, K. (2009). Institutional change in varieties of capitalism. Socio-Economic Review, 7(1), 7–34.
Heclo, H., & Wildavsky, A. (1974). The private government of public money. Community and policy inside British politics. London: Macmillan.
Jensen, C. (2008). Worlds of welfare services and transfers. Journal of European Social Policy, 18(2), 151–162.
Korpi, W., & Palme, J. (2003). New politics and class politics in the context of austerity and globalization: Welfare state regress in 18 countries, 1975–1995. American Political Science Review, 97(3), 425–446.
Knijn, T., & Ungerson, C. (1997). Introduction: Care work and gender in welfare regimes. Social Politics, 4(3), 323–327.
Lafortune, G., & Balestat, G. (2007). Trends in severe disability among elderly people: Assessing the evidence in 12 OECD countries and the future implications (OECD Health Working Paper No. 26). Paris: OECD.
Lamura, G., Melchiorre, G., Quattrini, S., Balducci, C., Spazzafumo, L., & Barbagallo, M. (2003). Eurofamcare. Giornale di Gerontologia, 52, 5.
Leira, A. (1992). Welfare States and Working Mothers: The Scandinavian Experience. Cambridge: Cambridge University Press.
Leira, A., & Saraceno, C. (2004). Care: Actors, relationships and contexts. The multidimensional concept of care. In B. Hobson, J. Lewis, & B. Siim (Eds.), Contested concepts in gender and social politics (pp. 55–83). London: Elgar.
Lundquist, L. J. (1980). The hare and the tortoise: Clean air policies in the United States and Sweden. Ann Arbor: University of Michigan Press.
Malley, J., & Fernández, J.-L. (2010). Measuring quality in social care services: Theory and practice. Annals of Public and Cooperative Economics, 81(4), 559–582.
March, J. G., & Olsen, J. P. (1989). Rediscovering institutions. New York: Free Press.
Morel, N. (2006). Providing coverage against new social risks in Bismarckian welfare states: The case of long-term care. In K. Armingeon & G. Bonoli (Eds.), The politics of post-industrial welfare states. London: Routledge.
O’Connor, J. S. (1993). Gender, class and citizenship in the comparative analysis of welfare state regimes: Theoretical and methodological issues. The British Journal of Sociology, 43(4), 501–518.
OECD (2011). Help wanted? Providing and paying for long-term care. Paris: OECD.
Österle, A. (2001). Equity choices and long-term-care policies in Europe. London: Ashgate.
Palier, B. (Ed.). (2010). A long good-bye to Bismarck. The politics of welfare reform in continental Europe. Amsterdam: Amsterdam University Press.
Pauly, M. (1990). The rational nonpurchase of long-term-care insurance. Journal of Political Economy, 98(1), 153–168.
Pavolini, E., & Ranci, C. (2008). Restructuring the welfare state: Reforms in long-term care in western European countries. Journal of European Social Policy, 3, 246–259.
Pfau-Effinger, B., Flaquer, L., & Jensen, P. H. (2009). Formal and informal work. The hidden work regime in Europe. London: Ashgate.
Pierson, P. (2001). The new politics of the welfare state. Oxford: Oxford University Press.
Ranci, C. (Ed.). (2010). Social vulnerability in Europe. The new configuration of social risks. Basingstoke: Palgrave.
Rauch, D. (2007). Is there really a Scandinavian social service model? Acta Sociologica, 50, 249–269.
Rostgaard, T. (2002). Caring for children and older people in Europe—A comparison of European policies and practices’. Policy Studies, 23(1), 51–68.
Sabatier, P. (1988). An advocacy coalition framework of policy change and the role of policy-oriented choice. Policy Sciences, 21(1), 56–71.
Saraceno, C. (2008a). Gender and care: Old solutions, new developments? Annual Hirschman Lecture delivered at the European University in Florence, Italy.
Saraceno, C. (Ed.). (2008b). Families, ageing and social policy. Intergenerational solidarity in European welfare states. Cheltenham: Elgar.
Sen, A. (1981). Poverty and famines. Oxford: Clarendon Press.
Simonazzi, A. (2009). Care regimes and national employment models. The Cambridge Journal of Economics, 33(2), 211–232.
Streeck, W., & Thelen, K. (Eds.). (2005). Beyond continuity: Institutional change in advanced political economies. Oxford: Oxford University Press.
Taylor-Gooby, P. (2004). New risks, new welfare. Oxford: Oxford University Press.
Ungerson, C. (1997). Social politics and the commodification of care. Social Politics, 4(3), 362–382.
Ungerson, C., & Yeandle, S. (Eds.). (2007). Cash for care in developed welfare states. Basingstoke: Macmillan.
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Pavolini, E., Ranci, C. (2013). Reforms in Long-Term Care Policies in EuropeAn:Introduction. In: Ranci, C., Pavolini, E. (eds) Reforms in Long-Term Care Policies in Europe. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4502-9_1
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