Journal of European Social Policy current issue

The importance of socio-economic and political losses and gains in welfare state reform

Vis, B. — Fri, 06 Nov 2009 02:39:00 PST

When do governments pursue unpopular reform, such as cutting benefits? And when do they engage in not-unpopular reform, such as activation? Current approaches in welfare state research cannot systematically explain the cross-government variation in the two types of reform. Based on insights from prospect theory, a psychological theory of choice under risk, this article complements existing theories by arguing that losses and gains matter crucially for welfare state reform. A fs/QCA analysis of labour market reforms pursued by 23 Danish, German, Dutch and British Cabinets between 1979 and 2005 corroborates this hypothesis. Specifically, it shows that an improving political position (a gain) is the necessary condition for not-unpopular reform while for unpopular reform it is a deteriorating socio-economic situation (a loss). This finding helps account for the puzzling cross-government variation in different types of welfare state reform.

Blaming Europe? Exploring the variable impact of national public service dissatisfaction on EU trust

Kumlin, S. — Fri, 06 Nov 2009 02:39:00 PST

European Social Survey data suggest that dissatisfaction with national public services has direct negative effects on EU trust in most EU15 countries, but also that there is significant country variation in their actual magnitude. Two-thirds of this variation can be explained jointly by two macro factors: the effect is stronger in larger welfare states where elites and citizens may perceive EU-induced obstacles for welfare state expansion. Likewise, it is stronger in political systems where the most Eurosceptic parties have tended to be the most welfare state-supporting ones. Under such conditions, it is more probable that citizens receive political cues conducive to a negative effect of dissatisfaction on EU trust.

Hybrid inclusion -- the new consumerism of Danish welfare services

Hojlund, H. — Fri, 06 Nov 2009 02:39:00 PST

Over the last decade, fundamental changes have occurred in Denmark with regard to welfare structures. These changes have taken place in the sectors of social care and health where decision-making structures have been reformed to become more consumer-oriented. This article examines elderly-care services specifically in order to explore how changes in decision making have altered structures of inclusion. The analysis is based on systems theory, which allows an exploration of how each of three decision-making systems has particular conditions for participation and inclusion. The article argues that inclusion has assumed a hybrid form.

Mapping European healthcare systems: a comparative analysis of financing, service provision and access to healthcare

Wendt, C. — Fri, 06 Nov 2009 02:39:00 PST

Healthcare systems have been institutionalized to provide healthcare for those in need. Therefore, comparisons should focus in particular on differences in healthcare provision and on how access to healthcare services is regulated. This article presents a typology of healthcare systems which simultaneously takes into account data on expenditures, financing, provision and access to healthcare in 15 European countries. On this basis, three types of healthcare system have been constructed using statistical cluster analysis: a health service provision-oriented type that is characterized by a high number of service providers and free access for patients to medical doctors; a universal coverage — controlled access type where healthcare provision has the status of a social citizenship right and equal access to healthcare is of higher importance than free access and freedom of choice; and a low budget — restricted access type where financial resources for healthcare are limited and patients’ access to healthcare is restricted by high private out-of-pocket payments and the regulation that patients have to sign up on a general practitioner’s list for a longer period of time.

Exploring the pathways of inequality in health, health care access and financing in decentralized Spain

Costa-Font, J., Gil, J. — Fri, 06 Nov 2009 02:39:00 PST

The regional organization of the Spanish national health system offers a ‘unique field’ for exploring the sources of health inequalities as well as for testing the effects of political decentralization on health and healthcare inequalities. Drawing from the results of an empirical analysis where inequalities in three dimensions of health (outcome), healthcare (access) and healthcare payments (financing) are estimated, this article first explores the association between three such inequality dimensions alongside other system and socio-economic controls. Second, we examine whether the first wave of asymmetric healthcare devolution which took place in Spain between (1980—2001) — whereby health policy responsibilities were transferred to a few region states (autonomous communities [ACs]) — correlates with higher inequalities in health, healthcare and health financing. Our findings suggest that inequalities in health and healthcare appear to be driven by income inequalities and inequalities in use but not by inequalities in financing and health expenditure. Region states politically responsible for the organization of healthcare did not exhibit significant differences in health and healthcare inequalities and tend to exhibit a better equity performance.

Digest

Barbier, C., Ghailani, D. — Fri, 06 Nov 2009 02:39:00 PST

Book Review: M. Seeleib-Kaiser (ed.) Welfare State Transformations. Comparative Perspectives. Basingstoke, Palgrave Macmillan, 2008, 280 pp., {pound}50.00 (hbk), ISBN 9780230205789

Goedeme, T. — Fri, 06 Nov 2009 02:39:00 PST

Books Received

Fri, 06 Nov 2009 02:39:00 PST

Acknowledgement of Referees 2009

Fri, 06 Nov 2009 02:39:00 PST