Choice and opportunity on the welfare care market: An experimental evaluation of decision‐making in a context of individual funding policy

Abstract

Individual funding schemes are increasingly implemented to organize public welfare services and can be considered as a prime example of the marketization of social care. Clients receive a budget and can “shop” on the welfare market. Current knowledge about the impact of individual funding schemes on choice opportunities for people with an intellectual disability is inconclusive. We conducted a vignette experiment in the context of the Flemish (Belgian) individual funding scheme for people with a disability, using 610 close relatives of people with an intellectual disability as subjects. The respondents were presented with hypothetical situations in which they had to express their intention to change current care provision into care via personal assistance. We find that dissatisfaction with services and having a supportive network increases the intention to change care. Professional support from the incumbent provider does not have a significant impact. We conclude that the promise of choice, as assumed with marketized public services, is likely to be fulfilled only under particular conditions. This entails risks in terms of equal opportunities for clients receiving public services in the context of welfare markets.

The Fate of Social Modernity

“…Over the last decades, this view has gained prominence in the debate on the regulation of human service sectors. It features the claim that competing providers and a public 'commissioning' of services are in the best interest of (some) users (Le Grand 2007;Sturgess 2018;Dursin et al 2021). This line of reasoning also undergirds the idea of a 'moral marketplace' (Singh 2018) populated by both people who donate to competing charitable projects and private companies which seek to attract users by committing themselves to 'Corporate Social Responsibility' and related benevolent activities.…”