<i>A Comparative Case Study of Care Systems for Frail Elderly People: Germany, Spain, France, Italy, United Kingdom and Sweden</i>

Bihan, Blanche Le; Martin, Claude

doi:10.1111/j.1467-9515.2006.00475.x

Cited by 61 publications

(24 citation statements)

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“…The generosity of the (care or cash) provision and the way in which it is calculated are linked to either each beneficiary's estimated care needs—possibly reduced by an amount paid by the users on the basis of their economic circumstances—or the amount of money that the public authorities are able or willing to pay for the support of dependent people with a certain level of disability. Two different rationales determine the extent to which the costs of care are sustained by the dependents and/or their families and by the state policy (public policy) (Le Bihan and Martin 2006): the “copayment” rationale and the “lump‐sum” rationale.…”

Section: Different Regulationsmentioning

confidence: 99%

Similar and Yet So Different: Cash-for-Care in Six European Countries’ Long-Term Care Policies

2010

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Context:In response to increasing care needs, the reform or development of long-term care (LTC) systems has become a prominent policy issue in all European countries. Cash-for-care schemes-allowances instead of services provided to dependents-represent a key policy aimed at ensuring choice, fostering family care, developing care markets, and containing costs. Methods:A detailed analysis of policy documents and regulations, together with a systematic review of existing studies, was used to investigate the differences among six European countries (Austria, France, Germany, Italy, the Netherlands, and Sweden). The rationale and evolution of their various cash-for-care schemes within the framework of their LTC systems also were explored.Findings: While most of the literature present cash-for-care schemes as a common trend in the reforms that began in the 1990s and often treat them separately from the overarching LTC policies, this article argues that the policy context, timing, and specific regulation of the new schemes have created different visions of care and care work that in turn have given rise to distinct LTC configurations. Conclusions:A new typology of long-term care configurations is proposed based on the inclusiveness of the system, the role of cash-for-care schemes and their specific regulations, as well as the views of informal care and the care work that they require.Keywords: Long-term care, cash-for-care, care work, informal care. Address correspondence to: Since the 1990s, cash-for-care schemes have been a common trend in social policies, particularly in the field of longterm care (LTC). Instead of services, these schemes give people monetary benefits, which they can use to purchase care services.Most of the literature on this topic concerns the common objectives and possible implications of cash-for-care schemes. One of the main ideas behind cash-for-care is "free choice"; that is, disabled (older) people and/or their families may choose among different kinds of care and care providers, thereby giving them both autonomy and control, which disabled people's organizations have sought since the 1970s (Glendinning 2008). The resulting competition among care providers also has enhanced the quality and efficiency of care (Kremer 2006) in accordance with a "new public management" perspective (Ferlie, Lynn, and Pollitt 2007). Another objective is the recognition of (formerly unpaid) informal care, since many cash-for-care schemes allow beneficiaries to compensate or employ their relatives (Ungerson 1997). Finally, cash-for-care schemes can be seen as opportunities to offer LTC policies that are less expensive than traditional services.A closer inspection of cash-for-care schemes in various European countries also reveals some striking differences among them. First, the strict regulation of cash-for-care schemes has strongly influenced the "commodification of care" (Ungerson and Yeandle 2007), as well as the development of specific forms of care work and informal care (Da Roit, Le Bihan, andÖsterle 2008). ...

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Section: Different Regulationsmentioning

confidence: 99%

Similar and Yet So Different: Cash-for-Care in Six European Countries’ Long-Term Care Policies

2010

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“…Italy has shown very little support for the development of formal, state‐provided care (favouring a housewife/carer model), but has developed relatively unregulated care payments, and a concern about migrant labour replacing family care (Da Roit 2010; Pavolini and Ranci 2008). Austria – although having a more strongly social‐democratic commitment to the state provision of welfare and social insurance scheme to cover long‐term care – has a similar ideological and normative commitment to family care being the preferred/default option, and a similarly relatively unregulated use of care payments (Oesterle 2001; Kreimer and Schiffbaenker 2005; Le Bihan and Martin 2006). France has developed a combination of a familiaist regime of predominantly relying on unpaid family care whilst also developing a system of insurance and needs‐based care payments designed to be used in a highly regulated market (Da Roit and Le Bihan 2010).…”

Section: Tensions In Care Policy: Care Regimes and Marketization In Lmentioning

confidence: 99%

Care: A Critical Review of Theory, Policy and Practice

Rummery

Fine

2012

Soc Policy Adm

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‘Care' is a source of critical tension in current social theory, and the policy and practice implications of that tension are evidenced in its current prominence on the political agenda of developed welfare states. This article critically appraises current developments in the theory, policy and practice of care, drawing on interdisciplinary developments in political theory, sociology and social policy. Developing feminist and disability-rights theories, it explores a critical synthesis of conflicting normative and theoretical positions regarding the giving and receiving of care, and of the ethics and justice of care. It examines case studies of current comparative policy developments across a range of different welfare regimes, including the marketization/commodification and de/re-familiaization of care, exploring ideological and normative trends in the design of contemporary policies. It discusses the impact of theory and policy on the practice of care, looking particularly at the issue of long-term care for disabled and older adults. Finally, the authors argue for the development of a citizenship-based approach to care that decouples it from individualistic and paternalistic paradigms that disempower those who give and receive care

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“…The use of the benefit is therefore controlled and it can only be used to finance services identified as necessary by the professionals. Finally, France has adopted a twofold system to finance the care packages (Le Bihan and Martin 2006a). On the one hand, an ‘assistance principle’ is applied: below a fixed income threshold (€669.89) recipients do not contribute at all to the funding of their care packages.…”

Section: Cash‐for‐care Schemes In Italy Austria and Francementioning

confidence: 99%

Long‐term Care Policies in Italy, Austria and France: Variations in Cash‐for‐Care Schemes

2007

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Cash benefit provisions have been at the core of many recent reforms in the long-term care sector in Europe. The respective schemes, however, vary widely in terms of the definition of entitlements, the level of benefits, and the ways in which benefits can be used by recipients. This article investigates cash-for-care schemes in three European social insurance countries. It asks whether the diversity of these schemes indicates different paths or just differences in the pace with which the respective policies address the risk of dependency. A characterization of the three schemes and a discussion of the implications for care work arrangements lead to the conclusion that the context and timing of long-term care reform processes are in fact quite variegated. All three countries have histories of cash schemes and of applying the cash approach to support -and to some extent relieve -traditionally strong family obligations. Differences predominate in terms of linking cash to employment, although some convergence is apparent in the effects on qualifications, working conditions and wages in care work.

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A Comparative Case Study of Care Systems for Frail Elderly People: Germany, Spain, France, Italy, United Kingdom and Sweden

Cited by 61 publications

References 1 publication

Similar and Yet So Different: Cash-for-Care in Six European Countries’ Long-Term Care Policies

Similar and Yet So Different: Cash-for-Care in Six European Countries’ Long-Term Care Policies

Care: A Critical Review of Theory, Policy and Practice

Long‐term Care Policies in Italy, Austria and France: Variations in Cash‐for‐Care Schemes

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