Aging and social welfare in transition: the case of the United States

In the United States at the end of the twentieth century, government policies regarding elderly people appear to be in transition. In part this reflects the traditional American ambivalence between radical individualism and collective assistance - especially in the form of tax-supported public welfare provided through government agencies - for those unable to earn or save for their own support. But in part this reflects new concerns about the growth of welfare "entitlements" for elderly people and the presumed "generational inequity" of public support for the aged at the expense of funds for children and young families. We review 1) the changing demography of the United States elderly population, 2) the complex and ambivalent history of welfare policy in the United States and 3) the evidence for tensions and conflicts between older and younger Americans in the context of politicized "generational inequity" debates, with special attention to changing government health care policies. We conclude that in American society, particularly in terms of federal assistance to the aged, there is considerable public support for current policy measures, and - contrary to the predictions of many - it is not likely that there will be dramatic policy changes in the near future.     

State socialism and the welfare state: a critique of two conventional paradigms

The post–war development of industrialised nations has been led by the idea of a welfare state. On the other hand, research on current and former communist states is still dominated by an age–old notion of 'state socialism'. This article provides a critical assessment of the two conventional paradigms by reviewing their implications within the historical and international contexts. By tracing its ideological roots and contrasting with the changing reality, it is argued that state socialism was misused in representing Marxist guidelines and is outdated in characterising the reforming socialist societies. By emphasising the experience of developing nations the article further challenges the welfare state as the paradigm for studying the general direction of a modern society. Attention is drawn to the study of a general public policy, and the economic state model is revisited for conceptualising the experience of a non–welfare state nation such as China.     

Care earnings in the United States and 24 European countries: The role of social policy and labour market institutions

Care occupations are gendered and remain relatively poorly paid, particularly in the United States. Prior research on the ‘care penalty’ primarily points to individual, relational, and market-valuation factors in explaining the relative earnings of care workers. This study integrates these explanations with a comparative institutional perspective. Using higher-quality data and methods than previous comparative research in the field—that is, harmonized micro-data from the Current Population Survey and EU-SILC from 2005 to 2016, country and year fixed effects models, and a counterfactual analysis—we find that national variance in labour market and welfare state institutions explains most of the difference in the relative earnings of reproductive care workers between the United States and European countries. Higher rates of collective bargaining coverage, stronger employment protection and welfare state spending contribute to higher relative earnings for reproductive care occupations, and lower relative earnings for high-status nurturant care occupations. Differences in the relative earnings of care workers appear to be mostly a construct of social policy and labour market institutions rather than individual, relational, and market-valuation factors.     

Work, welfare and the attack on the welfare state: the mixing of politics and policy

This article considers the current ideological and political attack against the floor of benefits for poor families in the United States. It examines a number of punitive approaches to the treatment of families on welfare that were developed in the United States in the late 1980s and the 1990s and contends that such policies will not effectively deter the dysfunctional behavior of some of the poor. Rather these policy developments reflect an attack on current national policies of developing an income maintenance floor that seeks to economically sustain poor families, albeit often inadequately. The article contends that current welfare proposals by conservatives and social liberals are not satisfactory for dealing with the problems of the welfare poor and offers suggestions for dealing with these deficits. It also notes that criticisms of welfare state protection for the poor raised in the United States are much more categorical than those raised in Sweden.     

The construction of the medical insurance system in the Republic of Korea, 1963–1989

The task of bringing a whole population into medical insurance coverage is a challenging one for a country's health policy makers. The outcomes of health policy differ significantly from one country to another depending on each state's socio-economic and political background. Health policy in Korea is to a great extent incremental in character and the consequence of a variety of causal events. This is why it has been difficult to apply the established social welfare theories to the Korean case. In any event, the Korean national medical insurance system, constructed between 1963 and 1989, reveals some similarity to that in Japan, i.e., compartmentalization of financial and administrative units as well as inequality in contributions and benefits. The system also reflects Korea's traditional Confucian value which emphasizes mutual dependence between family members.     

Traces of Norwegian influence in the development of social services in Minnesota, USA, 1890–1920

This article explores areas where Norwegian Americans contributed to the burgeoning social welfare system being established in Minnesota from 1890 to 1920. The array of services developed was due in part to the belief among native-born Americans that immigrant groups should establish their own helping networks and care for themselves. The Lutheran Church played a central part in this development by initiating and sponsoring new undertakings. Issues discussed during this period are found to be still central among both immigrant groups and 'natives' today. Concerns regarding mother tongue, religion, integration in schools and use of existing welfare systems continue to stir up 'natives' and 'settlers' alike.     

One hundred years of money,welfare and death: mortality,economic growth and the development of the welfare state in 17 OECD countries 1900–2000

Kangas O. One hundred years of money, welfare and death: mortality, economic growth and the development of the welfare state in 17 OECD countries 1900–2000 Int J Soc Welfare 2010: ??: ??–??© 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. The article focuses on the role played by the welfare state vis‐à‐vis GDP in the increase of life expectancy in 17 OECD countries 1900–2000. The article shows that money matters, war kills and the welfare state is good for health. There is a curvilinear relationship between prosperity and longevity: after a certain level, the marginal utility of an extra dollar levels off. In the longer run, growth is a necessary but not sufficient condition. The welfare state plays its role, too. Bigger is better, be it with regard to social spending or the generosity or coverage of social protection. For the life expectancy of a population to increase, it is better to have broader coverage or universal access to care than to have more generous benefits, which are channelled to a limited circle of citizens. It is better to give adequately to all than lavishly to too few.     

Welfarism and the multidimensionality of welfare state legitimacy: Evidence from The Netherlands, 2006

Oorschot W van, Meuleman B. Welfarism and the multidimensionality of welfare state legitimacy: evidence from The Netherlands, 2006 Is it possible that citizens who support a substantial role for government in the provision of welfare are, at the same time, critical about specific aspects of such provision? Based on confirmatory factor analyses, and using a 2006 Dutch survey, this study shows that welfare state legitimacy is indeed multidimensional, i.e. that opinions tend to cluster together in several dimensions referring to various aspects of the welfare state. There is partial evidence for the existence of a single, underlying welfarism dimension which consists basically of views regarding the range of governmental responsibility, as well as of the idea that these governmental provisions do not have unfavourable repercussions in economic or moral spheres. However, the separate dimensions cannot be reduced entirely to this overall welfarism dimension. This is illustrated by the finding that the various attitude dimensions are affected differently by socio‐structural position and ideological dispositions.     

The welfare state as a context for children's development: a study of the effects of unemployment and unemployment protection on reading literacy scores

Data were analysed from the Organization for Economic Cooperation and Development (OECD) Program for International Student Assessment (PISA) to examine whether the relationship between parental unemployment status and child reading literacy is modified by the level of unemployment protection provided by the nation. The sample consisted of 61,946 children, nested in 3,918 schools among 17 market economies. The results of multi-level analyses indicated that, after controlling for a range of individual, family and school covariates, children with unemployed fathers in all countries had significantly lower reading literacy scores than those of employed fathers (β = −8.84, SE = 2.01). The contextual effect of unemployment protection was not significant after accounting for fathers' employment status (β = −18.63, SE = 16.26). However, there was a significant negative interaction between unemployment protection and fathers' unemployment, yielding the unexpected suggestion that, in countries with higher levels of unemployment protection, children with unemployed fathers fare worse, both in relation to children with unemployed fathers in lower protection countries, and in comparison with children with employed fathers (β = −26.96, SE = 8.08). Possible explanations are advanced for this result, including the potential for a 'discouraged child effect' arising from the potential association between unemployment protection and higher local unemployment rates (though unemployment rates at the national level were not significant).     

After New Labour: political and policy consequences of welfare state reforms in the United Kingdom and Australia

ABSTRACT

Growing global integration, combined with the collapse of Soviet Communism, created major challenges for centre-left politics in the democratic world. This article considers two transformative Labour Party-led experiments that refurbished the welfare states of Australia and the United Kingdom, respectively. In Australia, this includes the Hawke–Keating (1983–1996) and Rudd–Gillard (2007–2013) Governments, and in the United Kingdom, the ‘New Labour’ Blair–Brown Governments (1997–2010). We present a comparative political economy of these welfare reforms, one that draws on both the policy transfer and policy diffusion literatures. By the 1980s, both parties faced three problems related to national economic decline, the ideological challenge to Keynesianism, and the decline of the traditional working-class electorate. We argue both parties developed common electoral and governing strategies aimed at winning support for a market-driven social-democratic program. Policy simultaneously compensated voters for market inequalities and deepened market relations. Focusing on how labour governments managed post-industrial change, responded to inequalities, advanced quasi-markets, and negotiated with union partners, we argue these experiments produced increasingly contradictory results that left both parties electorally and ideologically depleted. Despite important similarities, we note differences – starting points, discrete events and institutional variations have mattered to reform paths and their consequences.     

Divergence in the development of public health insurance in Japan and the Republic of Korea: A multiple‐payer versus a single‐payer system

Japan and the Republic of Korea achieved universal health insurance coverage for their populations in 1961 and 1989, respectively. At present, Japan continues to operate a multiple‐payer social health insurance system, while the Republic of Korea has moved to an integrated single‐payer national health insurance structure. This article analyzes the influence of political economy in shaping the policy divergence found between these two Bismarckian health insurance systems. Issues addressed include differences in political power, the policy influence of business, the extent to which regional autonomy has developed and regional traits have been preserved, the level of political democratization, the form of political leadership, and the scale of development of the health insurance system. The article offers policy lessons derived from the two countries' experiences.     

Expanding social health protection in Cambodia: An assessment of the current coverage potential and gaps,and social equity considerations

The Royal Government of Cambodia recently launched its National Social Protection Policy framework to strengthen and expand social security and assistance. To inform social health protection policy, we examine socio-economic survey data and administrative coverage data to assess the coverage potential of existing coverage mechanisms and current gaps; and compare equitable contribution rates. Over 53 per cent of the population currently has no social health protection coverage mechanism, and about 16 per cent of the population who do have access to a mechanism are not yet enrolled. Current expansion efforts focus on the formal employee scheme, primarily benefiting individuals from higher income households. In addition, recent coverage expansion to some informal workers leaves significant gaps, particularly among the informal sector. We find out-of-pocket health care expenditure to be an excessive share of income among lower wealth quintile individuals and conclude they are financially vulnerable. Finally, we illustrate that an equitable approach to individual, monthly health care contributions among the lower three quintiles has a severely limited potential for revenue generation, and collection costs could exceed the amount collected. Therefore, we recommend that vulnerable groups should be exempted from contribution payments as social health protection is expanded.