Federalism in Health and Social Care in Austria

Trukeschitz, Birgit; Schneider, Ulrike; Czypionka, Thomas

doi:10.1057/9781137291875_8

“…The politics of Spanish health policy focus in large part on regional authority in health care, ending with a very substantial regional role, rather than on the basic desirability of a tax-financed system agreed to decades ago. By contrast, in social insurance countries such as Austria, Belgium, and Germany, the autonomy of the social insurance funds has made breaking them up a very tough project (Béland andLecours 2005, 2018;Laible 2013Laible , 2019 and has kept them remarkably low-profile in the territorial politics of other countries, as we argue here and others argue elsewhere (Trukeschitz and Riedler 2019;Mätzke 2013;Mätzke and Stöger 2015).…”

Section: Chapter 4 How Policies and Legacies Mattermentioning

confidence: 61%

“…A broader effect, though, is that territorialization and possible decentralization of the welfare state reach further in countries with tax-funded provision as a key part of their systems; regional governments matter much more and spend much more on health in Australia, Canada, Spain, and the United Kingdom than in Austria, Belgium, or Germany. Within countries, this logic plays out in welfare programs at a fairly detailed level; in the United States, states matter more in Medicaid than in social insurance Medicare (by definition), and the most overt territorial partnerships in Austrian social policy are outside its extensive social welfare areas (Trukeschitz and Riedler 2019). When American health reformers argue about the relative merits of social insurance Medicare and federal-state Medicaid, they are arguing about two quite different programs and models of policy.…”

Section: Programmatic Designmentioning

confidence: 99%

Putting Federalism in Its Place

Greer¹,

Béland²,

Lecours³

et al. 2023

View full text Add to dashboard Cite

supported the project that led to this and the earlier volume, Federalism and Social Policy. Theresa Ramirez and Connie Rockman supported that project with the generosity and competence they always show. Comments from Alan Trench, Janet Laible, and Margitta Mätzke on the initial development of this project were very helpful. Finally, the University of Michigan Press, especially Elizabeth Demers, Kevin Rennells, and Haley Winkle, were the combination of supportive, engaged, tough, and patient that authors always appreciate. CHAPTER 1Why Should We Care about Federalism?In Texarkana there is an unusual building. As its name suggests, the town straddles the border between the U.S. states of Texas and Arkansas. The building stands along the border, half on each side. It is a U.S. federal government building, finished in 1933, that combines post offices and courts. The federal courts serving Texas are on the Texas side, and the federal courts serving Arkansas are on the Arkansas side. A post office, equally divided between the two states, serves both. The street splits to go around the building, with different pavement quality and parking rules on the two sides.That one building in a little-known railroad town is a metaphor for federalism. The states constitute the environment, but the federation constitutes the states. It is a legacy of specific political moments and policy decisions that there is a shared post office, serving the American people, in a unifying federal building that reinforces juridical divides between states in its very design. Perhaps it is telling that it is said (by the town's tourism bureau) to be the second most photographed federal building in the United States. It is of no significant architectural interest-except insofar as its location and its twinned courthouses inscribe federal politics in its stones. Letters mailed there since 1933 have been postmarked with a stamp that marks them as having been mailed in both states: "Texarkana-AR-TX" or "Texarkana, USA."The concrete complexity of a federal building in the American Cotton Belt belies much of what is written about federalism. Much research about the impact of federalism, or any other political or social institution, treats it as a binary variable, present or absent, and then look for its effects. Endless effort has been expended and endless ink spilled in scholarly and popular 1. More specifically, this book focuses primarily on federal countries located in Australasia, North America, and Western Europe, which does not mean the lessons it draws are not applicable to federal countries located outside the Global North, such as Argentina,

show abstract

“…The politics of Spanish health policy focus in large part on regional authority in health care, ending with a very substantial regional role, rather than on the basic desirability of a tax-financed system agreed to decades ago. By contrast, in social insurance countries such as Austria, Belgium, and Germany, the autonomy of the social insurance funds has made breaking them up a very tough project (Béland andLecours 2005, 2018;Laible 2013Laible , 2019 and has kept them remarkably low-profile in the territorial politics of other countries, as we argue here and others argue elsewhere (Trukeschitz and Riedler 2019;Mätzke 2013;Mätzke and Stöger 2015).…”

Section: Chapter 4 How Policies and Legacies Mattermentioning

confidence: 66%

Putting Federalism in Its Place

2023

0

View full text Add to dashboard Cite

supported the project that led to this and the earlier volume, Federalism and Social Policy. Theresa Ramirez and Connie Rockman supported that project with the generosity and competence they always show. Comments from Alan Trench, Janet Laible, and Margitta Mätzke on the initial development of this project were very helpful. Finally, the University of Michigan Press, especially Elizabeth Demers, Kevin Rennells, and Haley Winkle, were the combination of supportive, engaged, tough, and patient that authors always appreciate. CHAPTER 1Why Should We Care about Federalism?In Texarkana there is an unusual building. As its name suggests, the town straddles the border between the U.S. states of Texas and Arkansas. The building stands along the border, half on each side. It is a U.S. federal government building, finished in 1933, that combines post offices and courts. The federal courts serving Texas are on the Texas side, and the federal courts serving Arkansas are on the Arkansas side. A post office, equally divided between the two states, serves both. The street splits to go around the building, with different pavement quality and parking rules on the two sides.That one building in a little-known railroad town is a metaphor for federalism. The states constitute the environment, but the federation constitutes the states. It is a legacy of specific political moments and policy decisions that there is a shared post office, serving the American people, in a unifying federal building that reinforces juridical divides between states in its very design. Perhaps it is telling that it is said (by the town's tourism bureau) to be the second most photographed federal building in the United States. It is of no significant architectural interest-except insofar as its location and its twinned courthouses inscribe federal politics in its stones. Letters mailed there since 1933 have been postmarked with a stamp that marks them as having been mailed in both states: "Texarkana-AR-TX" or "Texarkana, USA."The concrete complexity of a federal building in the American Cotton Belt belies much of what is written about federalism. Much research about the impact of federalism, or any other political or social institution, treats it as a binary variable, present or absent, and then look for its effects. Endless effort has been expended and endless ink spilled in scholarly and popular 1. More specifically, this book focuses primarily on federal countries located in Australasia, North America, and Western Europe, which does not mean the lessons it draws are not applicable to federal countries located outside the Global North, such as Argentina,

show abstract

“…In Austria, healthcare and LTC services are provided by separate institutions, with healthcare being organized and co-funded by the social health insurance system and LTC services being organized at the local level and funded mostly via taxes and private co-payments (Trukeschitz et al, 2013), supported by a nationwide universal LTC cash benefit. A national means-tested cash benefit aims to enable 24-hour care in private households.…”

Section: Characteristics Of Home Care Service Provision In Austria England and Finlandmentioning

confidence: 99%

Investigating factors influencing quality-of-life effects of home care services in Austria, England and Finland: A comparative analysis

Trukeschitz¹,

Hajji²,

Kieninger

³

et al. 2021

Journal of European Social Policy

Self Cite

View full text Add to dashboard Cite

European countries have developed a range of long-term care (LTC) policy responses to support the increasing share of older people. However, little is known about the effectiveness of LTC services and benefits, particularly their impact on older peoples’ quality of life (QoL). This paper investigates the role of personal, care service and environmental characteristics on the effects of home care services on QoL across England, Finland and Austria. We used data from surveys conducted in England, Finland and Austria. In total, 811 older adults were included in the analysis. OLS regression including main effects and country-specific interactions was used to explore variation in gains in long-term care service-related quality-of-life (LTC-QoL). Explanatory variables were derived from the production of welfare framework and comprised home care service user socio-demographics, needs indicators, social support and environmental variables and characteristics of home care service provision. In all three countries, LTC-QoL gains increased with needs, indicating that home care services perform well, with additional gains declining the higher the needs. Also, better process quality contributed to LTC-QoL improvements in all three countries. In addition, the availability of informal care, social contact, financial household situation and living alone, were associated with changes in LTC-QoL only in one or two of the countries. Home care services increased service users’ QoL in all three European countries. The increase in QoL, however, varied across the countries. The results also provide insights into the benefits and limits of home care service provision and areas for future improvements. JEL: I31, I38, J14

show abstract

Federalism in Health and Social Care in Austria

Cited by 5 publications

References 3 publications

Putting Federalism in Its Place

Putting Federalism in Its Place

Putting Federalism in Its Place

Investigating factors influencing quality-of-life effects of home care services in Austria, England and Finland: A comparative analysis

Contact Info

Product

Resources

About