Retrenchment and restructuring in an age of austerity: what (if anything) can be learned from the affluent democracies?

Abstract

The article discusses some difficulties of drawing implications from welfare state reform in the Organisation for Economic Co-operation and Development for "middle-income countries", and whose welfare states have been less well institutionalized. It is argued that globalization's role in contemporary social policy dynamics were not unimportant, but social processes occurring within national contexts were probably more important. There is not a single "new politics of the welfare state" but distinct political dynamics in different "regimes" or "configurations", which are characterized by different problem loads and different structures of political opportunity. Different factors are crucial in explaining outcomes in different configurations and there is little reason to expect much convergence in social policy outcomes across regime type. Contemporary welfare state reform is depicted as a process of restructuring rather than dismantling, what can encourage the possibilities for developing coalitions advancing multi-dimensional agendas of welfare state reform.

Social policy development and global financial crisis in the open economies of Botswana and Mauritius

“…For that reason the path dependent effects are likely to be much more limited (Pierson, 2002). This article then offers a hard test to the hypothesis that the effects of globalization on social policies are path dependent -also in developing countries.…”

“…Pierson argues that because the social policy framework is less extensive in the South, the supporters of wide-ranging social provisions are typically much weaker and the social policy system less deeply embedded in domestic social arrangements. For that reason the path dependent effects are likely to be much more limited (Pierson, 2002). This article then offers a hard test to the hypothesis that the effects of globalization on social policies are path dependent – also in developing countries.…”

A atenção primária à saúde nos países da União Européia: configurações e reformas organizacionais na década de 1990

“…Compartilhando contextos econômicos restritivos, com redução do ritmo de crescimento, despesas em saúde crescentes em decorrência da progressiva incorporação de onerosas tecnologias de forma desordenada e sem avaliação adequada 31 e, envelhecimento de suas populações com aumento da prevalência de doenças crô-nicas, governos de diversos países europeus empreenderam reformas em seus sistemas de saúde com propósitos de contenção de gastos desde a década de 1980. Ainda que as estruturas ampliadas de proteção social à saúde não tenham sido desmanteladas, a ênfase na contenção de gastos impressa por governos conservadores levou à introdução de diversas medidas restritivas para racionalização da demanda, e, de mecanismos de mercado, incentivando-se a competição entre prestadores e entre seguros sociais 32,33,34 . Pelo lado da oferta, durante os anos 90, em parte dos países, gradualmente foram implementadas reformas organizacionais que incidiram sobre o setor ambulatorial e incluíram entre seus objetivos promover a coordenação dos serviços prestados entre os diversos pontos da rede assistencial, com fortalecimento dos serviços de atenção primá-ria.…”