Multi-level administrative structure and the distribution of social service expenditures: A Nebraska example

During the decade of the 1980s Nebraska restructured its social service (welfare) delivery system. Prior to the change, administrative responsibility for many social service programs was shared between the state and county governments. The restructuring brought the entire program under state administration. A primary reason for this policy change was to eliminate administrative inconsistencies evident in the decentralized structure. This article utilizes 1980 and 1990 data on the distribution of Food Stamp and AFDC program expenditures in Nebraska to analyze the impact of the restructuring on expenditure distribution. The results indicate that expenditures were more equally distributed and that arbitrary decision making was reduced when social service administration was centralized.     

Social Policy in Greece: Rhetoric versus Reform

This paper reviews the major social policy developments in Greece during the 1980s and 1990s, focusing on social security, health and employment policies. It argues that the concept of social policy and the practice of politics have been distorted in this country. Social policy reflects the legacy of a heavily politicized and centralized policy‐making system, an impoverished administrative infrastructure and poorly developed social services. Its emergence is characterized by the pursuit of late and ineffective policies. It lacks continuity, planning and coordination, being oriented towards short‐term political expediency. It is largely insurance‐based, reproducing huge inequalities and institutional arrangements which are behind the times. It provides mainly cash benefits, low‐quality but rather expensive health services and marginal social welfare protection. Moreover, the lack of a minimum income safety net confirms the country's weak culture of universalism and social citizenship. By implication, complex policy and interlocking interest linkages have tarnished the “system” with a reputation for strong resistance to progressive change. At the same time, sources of change such as globalization, demographic developments, new household and family/gender patterns, unstable economic growth, fiscal imperatives, programme maturation, as well as persisting unemployment, changing labour markets and rising health care costs, have produced mounting pressures for welfare reform.     

Human Motivation and Professional Practice: of Knights, Knaves and Social Workers

Efforts to improve the efficiency and responsiveness of public services by harnessing the self‐interest of professionals in state agencies have been widely debated in the recent literature on welfare state reform. In the context of social services, one way in which British policy‐makers have sought to effect such changes has been through the “new community care” of the 1990 NHS and Community Care Act. Key to this is the concept of care management, in which the identification of needs and the provision of services are separated, purportedly with a view to improving advocacy, choice and quality for service users. This paper uses data from a wide‐ranging qualitative study of access to social care for older people to examine the success of the policy in these terms, with specific reference to its attempts to harness the rational self‐interest of professionals. While care management removes one potential conflict of interests by separating commissioning and provision, the responsibility of social care professionals to comply with organizational priorities conflicts with their role of advocacy for their clients, a tension rendered all the more problematic by the perceived inadequacy of funding. Moreover, the bureaucracy of the care management process itself further negates the approach's supposedly client‐centred ethos.     

The Choice Revolution: Privatization of Swedish Welfare Services in the 1990s

During the 1990s, the Swedish welfare state was declared by some to be in a “crisis”, due to both financial strain and loss of political support. Others have argued that the spending cuts and reforms undertaken during this period did slow down the previous increase in social spending, but left the system basically intact. The main argument put forward in this article is that the Swedish welfare state has been and is still undergoing a transforming process whereby it risks losing one of its main characteristics, namely the belief in and institutional support for social egalitarianism. During the 1990s, the public welfare service sector opened up to competing private actors. As a result, the share of private provision grew, both within the health‐care and primary education systems as well as within social service provision. This resulted in a socially segregating dynamic, prompted by the introduction of “consumer choice”. As will be shown in the article, the gradual privatization and market‐orientation of the welfare services undermine previous Swedish notions of a “people's home”, where uniform, high‐quality services are provided by the state to all citizens, regardless of income, social background or cultural orientation.     

From welfare state to welfare society: toward a viable system of welfare in Japan and England

Laratta R. From welfare state to welfare society: toward a viable system of welfare in Japan and England
Int J Soc Welfare 2010: 19: 131–141 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. This article compares the impact that public welfare reforms during the 1980s and 1990s had, and are still having, on the relationship between statutory organisations and the non‐profit sector in two developed countries, England and Japan. The author argues that the failure of these reforms clearly shows that, although non‐profit organisations may not be able to effectively replace the state in the provision of welfare services, they can contribute, working closely with the statutory organisations, to the shaping, financing and delivery of public services in a variety of ways. It is also interesting to note that, while the public welfare reforms of the late 1990s in England produced a shift away from a culture based on privatisation and contracting‐out toward a partnership culture of collaboration between state and non‐profit entities, similar reforms in Japan have resulted instead in an uncertain area of deregulation and privatisation.     

Supplemental home care and topping‐up: A shift from service universalism towards a new and privatised public service model?

How does a public service model based on service universalism react to the introduction of market principles of topping up? In a recent so‐called Free Municipality Scheme (an experimental scheme that allowed for greater operational autonomy locally in an effort to reduce state bureaucracy), a number of Danish municipalities were for the first time ever allowed to compete with for‐profit providers of home care in selling supplemental home care services paid entirely by the user. The take‐home message from this experience is that the introduction of supplemental home care entails challenges and eventually wider implications for the public service model, on an economic, organisational and cultural level. Supplemental services represent a new and potentially powerful combination of market and state logics that eventually redirects away from the universalist welfare state and towards a new and increasingly privatised public service model – a model where the service level is determined by the user's capacity to purchase and pay for services. The introduction of such services therefore implies a change of the potential of the Nordic welfare state to ensure equal access regardless of class and income.     

Informing Debate or Fuelling Dispute? Media Communication of Reconfiguration in Scotland's Rural Maternity Care

Public reaction to the UK's ongoing health sector reform often results in dilution of policy‐makers’ goals. Public participation in health service decision‐making is advocated in policy, but precisely how to do it and what role public opinion should have in formulating reform strategy is ambiguously described. Public opinion is formed through many influences, including media reporting. This paper examines how reconfiguration at a rural maternity unit at Caithness General Hospital in Wick, Scotland, was communicated in national and local media and considers potential implications of media communication on public participation in policy decision‐making. Content analysis of arguments for and against change revealed a high level of reporting of commentators against change in regional newspapers. Qualitative analysis identified emergent themes about how maternity service reconfiguration was portrayed. These included framing opposition between management and local people, and change drivers receiving superficial coverage. Findings suggest that media portrayal of the public role in change may promote an adversarial rather than a participative stance. More finely tuned understanding of the relationship between the reporting of change and public reaction should be attained as this could affect how planned social policy evolves into actual practice.     

Organizational Restructuring in European Health Systems: The Role of Primary Care

The main goal of this paper is to review the strategies developed across European health care systems during the 1990s to improve coordination among health care providers. A second goal is to provide some analytical insights in two fields. On the one hand, we attempt to clarify the relationships between pro‐coordination strategies and organizational change in health care. Our main conclusion is that the specific features of health care impede the operation of either market or hierarchical coordination mechanisms. These can, however, be selectively successful if applied as levers to promote the role and impact of the pro‐cooperative coordination strategies which are ultimately required to foster adequate inter‐professional and inter‐organizational coordination. On the other hand, we try to cast some light on the ongoing debate on convergence versus path dependency within the broader field of welfare state reform. Evidence on pro‐coordination reforms in health care apparently supports some insights from previous work on the centrality of the socio‐political structure to account for varying patterns of selective path dependency across countries. In particular, the informal power resources of specialist physicians vis‐à‐vis primary care professionals and the state are critical to explain the different rhythm and fate of pro‐coordination reforms across Europe. Against received wisdom, the evidence examined suggests that selective path dependency might apparently be compatible with a general trend towards convergence understood as hybridization.     

The retrenchment of public pension provision in the liberal world of welfare during the age of austerity—and its unexpected reversal, 1980–2017

Pension system adaption during the “age of austerity” since 1980 is expected to vary between industrialized countries broadly in line with their membership of conservative, liberal, or social democratic worlds of welfare. Empirical testing on the liberal world focuses on the later period and differs in its conclusions. This paper is based on a systematic study of the scale, nature, and trajectory of change in six liberal pension systems between 1980 and 2017 using expenditure, economic, demographic, and social rights data. These data are analysed using a framework developed through critical engagement with Pierson's three welfare state change criteria and the welfare state “dependent variable problem.” The paper finds a significant retrenchment of public pension provision in most liberal welfare states after 1980 but largely during the first half of the period. This has been partly reversed in most countries since the mid‐1990s, though the scale of this reversal varies between countries. The recent rise of the state in liberal systems has been noted by some commentators, but to be properly understood, the paper argues, it must be considered in the context of the significant retrenchment, which preceded it. There is a scope especially for research on the broader social context of recent reforms, particularly how middle‐income groups were affected by retrenchment and how recent reforms have mitigated this.     

Resources and strategies of interest groups and industry representatives involved in federal forest policy

This study analyzes the resources and strategies of public interest groups and industry representatives involved in federal forest policy in the state of Oregon during the early 1990s. While many studies have examined the role of interest groups in the policy process, few have compared empirically the resources available and strategies pursued by industry representatives and public interest groups in a particular policy domain. Utilizing survey data from 133 business representatives and 326 public interest groups involved in federal forest policy, the study argues that public interest group influence derives primarily from the ability to mobilize human resources; the financial resources of these groups tend to be modest. Industry and industry-supported groups, in contrast, possess considerable financial power while enjoying less support from the public. Consequently, industry interests tend to focus their efforts on more traditional forms of influence such as the persistent lobbying of natural resource agencies and elected officials. Public interest groups, in contrast, tend to devote considerable efforts to building public support in urban core areas to build the capacity to pressure governmental decision-makers.     

Public Satisfaction with the Health System and Popular Support for State Involvement in an East Asian Welfare Regime: Health Policy Legitimacy of Hong Kong

The legitimacy of social policies has gained increasing attention in the past decade, against the backdrop of fiscal austerity and retrenchment in many nations. Policy legitimacy encompasses public preferences for the underlying principles of policies and the actual outcomes as perceived by citizens. Scholarly knowledge concerning the legitimacy of health policy – a major element of modern social policy architecture – is, unfortunately, limited. This article seeks to extend the scholarly debates on health policy legitimacy from the West to Hong Kong, a member of the East Asian welfare state cluster. A bi‐dimensional definition of health policy legitimacy – encompassing both public satisfaction with the health system and the normative expectation as to the extent of state involvement in health care – is adopted. Based on analysis of data collected from a telephone survey of adult Hong Kong citizens between late 2014 and early 2015, the findings of this study demonstrate a fairly high level of satisfaction with the territory's health system, but popular support for government responsibility presents a clear residual characteristic. The study also tests the self‐interest thesis and the ideology thesis – major theoretical frameworks for explaining social policy legitimacy – in the Hong Kong context. Egalitarian ideology and trust in government are closely related to both public satisfaction with the system and popular support for governmental provision of care. However, the self‐interest thesis receives partial support. The findings are interpreted in the context of Hong Kong's health system arrangements, while implications for the territory's ongoing health policy reform are discussed.     

转型期公共行政模式的变迁--由管制行政到服务行政

从计划经济到市场经济的转型所带来的社会变革,对公共行政的理念、规则乃至职能的履行模式都产生了深刻影响。在世界范围内,公共行政的变革以及科学发展观的本质要求也在推动公共行政模式由管制行政走向服务行政。由管制行政向服务行政的转变,意味着要转变行政理念、扩大行政主体以及变革管理方式。在为管制行政向服务行政变迁提供制度以及组织保障的同时,也要警惕行政对民众权利的侵犯、政府对应有职责的放弃等服务行政“异化”现象的发生。     

Is Sweden Being Torn Apart? Privatization and Old and New Patterns of Welfare State Support

This article examines the potential impact of institutional change on popular welfare support. The encompassing welfare state of Sweden provides an interesting case where the privatization of social service delivery has been widespread over the last decades. We use survey data from five rounds of the Swedish Welfare State Survey (1992, 1997, 2002, 2006 and 2010) in order to study how public preferences for the financing and organization of welfare services have changed over time. Based on a theory describing an ideal‐typical pattern of public support for an encompassing welfare model, we derive three types of public preferences: support for a pure state model, a pure market model and a mixed model (welfare services are funded by taxes but provided by private firms). We begin by tracking the development of these ideal‐typical attitude patterns between 1992 and 2010. We then investigate how preference patterns vary across municipalities displaying different degrees of privatization of social service delivery. Our results show that welfare support among Swedes over the last decades is better characterized as dynamic rather than stable. Swedes seem to take an overall more ideologically based position on the role of the welfare state over time. The share of respondents expressing such ideologically based preferences has increased from 54 per cent in 1992 to 78 per cent in 2010. This change is principally manifested in increased support for the state and mixed models. This trend seems to be parallel to the increasing share of private welfare service providers over the last decade. We also find a link between the municipal degree of privatization and support for our three ideal‐typical welfare models. Public support for a mixed welfare model and, to some extent, a market model, is comparatively stronger in municipalities where welfare services to a large extent are carried out by private actors. Conversely, data shows that public support for the traditional Swedish state model is more widespread in municipalities having a low degree of welfare services privatization. Lastly, we discuss some theoretical implications of our findings.     

"扩权强县"与地区公共产品供给研究

提供更多的以公共产品为主的公共服务是转型期政府的主要责任和职能,政府为减少行政成本提高行政效率的层级改革同样应考虑公共产品的供给。"扩权强县"是近年来在我国部分省区为促进县域经济发展采取的一种分权措施,这种以扩大县(市)地方政府权力为手段,以提高行政效率,推动地区经济发展为目标的改革,对我国当前地区公共产品的供给产生了一定影响。     

GAUGING NEW ZEALAND'S SUCCESS AT POVERTY REDUCTION IN THE NEW MILLENIUM

This paper presents the results of the New Zealand Poverty Measurement Project's analysis of the effects of the 1990s social reforms in New Zealand on the incidence and severity of poverty, and assesses the impact of five social and economic policies introduced by the Labour‐led coalition governments since 1999: New Zealand superannuation, income‐related rents on state houses, active labour market policies for an employment‐rich economy, the Primary Health Care Strategy and the planned income support policy to reduce child poverty. Superannuation is assessed as both adequate and sustainable, rents for state houses are found to be affordable, and GDP growth and employment have increased incrementally as unemployment and benefit numbers have decreased. The Primary Health Care Strategy is an innovative initiative that will increase affordable access to general practitioners, but it and the proposed child assistance initiatives are too new to be adequately assessed. Of the challenges that remain, policy priorities should centre on housing alternatives, including home ownership for low‐income households not in state houses; income support for poor households, particularly those with children; and multi‐sector development of education and training aimed at lifting economic and social capacity.     

Social health insurance development in Mongolia: Opportunities and challenges in moving towards Universal Health Coverage

Mongolia achieved high population coverage under mandatory health insurance relatively quickly. This fact was viewed by policy‐ and decision‐makers as a central issue for health financing reform in Mongolia. Health insurance brought many new features for health service planning, provision, funding and resource management. Based on initial achievements, health insurance came to be strategically considered as the vehicle for achieving universal coverage. The article analyses developments in Mongolia's health insurance over the last decade along with the core policy dimensions of Universal Health Coverage. It examines various reform approaches and the numerous amendments to laws that have been implemented during this period and discusses new opportunities as well as challenges. The analytical review and findings discussed suggest that Mongolia has a need for evidence‐based policy decisions and informed political support, with health insurance backed by robust institutional and administrative capacities. More generally, it also emphasizes that health policy goals and objectives can be attained by strengthening and making transparent and publicly‐accountable all health system financing functions and arrangements. The policy analysis, experiences, lessons and proposed strategies presented with regard to Mongolia intend to stimulate wider discussions on health insurance development as well as promote continuing focused research on specific aspects of health insurance and public financing reform.     

Youth, unemployment and political marginalisation

The article investigates the impact of being unemployed on political marginalisation among young people. Are unemployed youth politically marginalised compared with employed youth? Is the impact of unemployment on political marginalisation related to the development of the welfare state? Based on Marshall’s concept of social citizenry, and Esping‐Andersen’s theory of decommodification politics, the impact of unemployment on political marginalisation was expected to be least in the most‐developed welfare states. In these countries, welfare policies were expected to counteract marginalisation among the unemployed. The analyses were based on the Eurobarometer survey Young Europeans from 1990. Three aspects of political marginalisation were investigated: political confidence, political interest and political extremism. Unemployed youth express less confidence in politics, they talk less about politics and they more frequently support revolutionary political ideas, compared with employed youth. The greatest difference in political confidence between unemployed and employed is found in Great Britain, while Italy represents a deviant case where the unemployed have more confidence than the employed. The development of the welfare state does not appear to be a crucial factor for political confidence among the unemployed.     

Public health care in the balance: exploring popular support for health care systems in the European Union

Which factors explain intra‐ and inter‐country variations in levels of public support for national health care systems within the European Union, and why? We propose that public opinion towards public health care is dependent on (1) the type of welfare state regime to which the various European welfare states belong, (2) typical features of the national care system and (3) individual social and demographic characteristics, which are related to self‐interest or morality oriented motives. To assess the explanatory power of these factors, data from the Eurobarometer survey series are analysed. Support for public health care appears to be particularly positively related to social‐democratic attributes of welfare states, whereas support drops with increasing degrees of liberalism and conservatism. Further, support for public health care proves to be associated with wider coverage and public funding of national care services. We also find higher levels of support in countries with scarce social services for children and the elderly, and larger proportions of female (part‐time) employment. Lastly, with respect to individual characteristics, we find remarkably little evidence for self‐interest oriented motives affecting the preference for solidary health care arrangements.     

Gray Peril or Loyal Support? The Effects of the Elderly on Educational Expenditures*

Objectives. Do large concentrations of elderly represent a “gray peril” to maintaining adequate educational expenditures? The gray peril hypothesis is based on an assumption of instrumental self‐interest in political behavior. In contrast, we argue that loyalty to community schools competes with economic self‐interest and that older citizens are heterogeneous in their preferences. Methods. We test these arguments and their implications for public school finance using a data set of more than 9,000 school districts. Results. The data show that longstanding older residents represent a source of support for educational expenditures while elderly migrants lower spending. Further, this divide among the elderly and their impact on policy outputs depends on how states finance local public education and on aspects of state and local tax policy. Conclusions. Elderly concentrations are a financial asset for a school district unless the senior community includes a large number of new arrivals. The design of tax policy can have enormous impact on the depth of political cleavages and their ultimate impact on public policy. The results are consistent with the idea that loyalty—an emotional bond between residents and their community's institutions—competes with and often trumps instrumental self interest.     

宗教与美国公共政策

美国宪法实行＂政教＂分离原则,禁止教会干预国家政务,但事实上,宗教组织在美国政治体制中如同利益集团一样运作,以各种方式参与和影响公共政策的制定,以确保自己的宗教利益。鉴于美国宗教组织在教义信仰和组织结构上呈多元化,它们对公共政策的影响方式和程度也各自相异,主要取决于历史传统、教义信条、内部团结力量、外部反对力量、战略地位和时代精神等因素。