Introduction of Long-Term Care Systems: The Nascent Diffusion of an Emergent Field of Social Policy

Abstract

The introduction of social protection schemes for long-term cares that is assistance with daily living activities in case of extended impairments, constitutes a comparably recent development. Taking a birds-eye perspective, this chapter explores which international interdependencies and national constellations contributed to the establishment of long-term case systems from 1945 to 2010. In particular, we investigate the relevance of channels of horizontal diffusion, that is, geographic proximity, cultural similarity, and colonial ties, the influence of the European Union as well as domestic factors such as problem pressure and women’s political empowerment.

The Fate of Social Modernity

“…Although unpaid, informal and private forms of caregiving have remained dominant in many European countries, public bodies have begun to develop special support schemes, using tax revenue or collective insurance schemes. This has paved the way for the promise of cared-for dependency becoming incorporated into the architecture of twenty-first century welfare states (Fischer et al 2022). The literature on 'care regimes' (see Bettio et al 2006;Theobald and Luppi 2018) often refers to this movement as defamilialisation and 'commodification' of care provision.…”

“…Overall, however, the trends in this field have been highly dynamic over the last decades, including with respect to structural characteristics of related welfare programmes. The development of domiciliary services has been an international success story compared with the situation in the 1970s and in the late 2010s (Bode 2017a;Halásková et al 2017;Fischer et al 2022). Some countries have seen a strong uptake of formal care supply services, alongside a marked decline of informal arrangements (up to 20 per cent, when measured in care hours, see Barczyk and Kredler 2019).…”