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Blanca Deusdad, Sagit Lev, Charles Pace and Sue Vella

De-institutionalisation of care for older people in Mediterranean countries has not been sufficiently analysed, in terms of policy discourse and implementation. The aim of this chapter is to study and compare both aspects within a cluster of three different Mediterranean countries: Israel, Malta and Spain. Although these countries differ in their historical, geographic and demographic features, they share a number of features. The traditional provision of care by the family has decreased as women’s employment rates have risen and family sizes have shrunk. Despite attempts to counter this through various ‘ageing in place’ policies, in none of the three countries have such attempts managed to fully offset undue institutionalisation due to the lack of family or financial resources, let alone enable the return of older persons from institutions to the community. Despite differences, enough similarities exist to propose a Mediterranean variant of LTC for older persons. This is characterised by ongoing reliance on family care even in the face of rising female employment; by underdeveloped or under-resourced community services; and by growth in private care services including recourse to migrant care labour. These features have implications for older adults who lack family support or financial means, and for the sustainability of care policies in the face of rapid demographic ageing.

Open access

Teppo Kröger and Angela Bagnato

Provisions and patterns of care for older people have recently undergone significant change all over Europe. This chapter maps the general directions of change in long-term care in different parts of Europe during the early twenty-first century, based on information reported in working papers produced by national teams in the course of the COST Action IS1102. The chapter covers 11 European countries, representing the Nordic countries (with Denmark, Finland, Iceland), Central/ Central-Eastern Europe (with the Czech Republic, Germany, Slovakia) and the Mediterranean region (Greece, Italy, Malta, Spain), plus the United Kingdom. Data-driven reading of the working papers helped identify five key dimensions of policy developments: (1) decentralized care–centralized care; (2) social care–health care; (3) outsourcing–in-house provision of care; (4) home-based care–institutional care; and (5) formal care–informal care. The chapter reports recent and ongoing change along each of these dimensions in different parts of Europe. It concludes that the main directions of change are: from the central state to the local level, from public provision to for-profit services, from institutional care to home care, and from formal care to informal family care. Altogether, these developments imply that governments in Europe seem in general to be trying to reduce their responsibilities for care of their older populations.

Open access

Peter Raeymaeckers, Bettina Leibetseder, Robert Fluder, Erika Gubrium and Danielle Dierckx

In this chapter we focus on social assistance services, such as housing, childcare, counselling and other types of benefits, that are provided to people receiving a guaranteed subsistence income from the state, defined here as social assistance beneficiaries. These services are delivered by social workers in public agencies, often collaborating with other public and non-profit service providers at the local level. We specifically address how these social assistance services have been affected by the so-called ‘activation turn’ in social assistance. We present evidence on the horizontal division of labour between local government actors and a variety of service organisations (public, non-profit and private) and how this division of labour is affected by activation policies in four European cities: Graz in Austria, Antwerp in Belgium, Berne in Switzerland and Oslo in Norway. At the end of the chapter we reflect on the consequences of the activation turn in terms of increasing pressure on local actors. We hypothesise that the latter are increasingly ‘creaming the crop’ by creating a selection mechanism that favours the ‘best’ clients, those who are able to make the transition towards the labour market, over the ‘worst’ clients, those who are not able to find a job.

Open access

Three dimensions of generational justice

Justice, Institutions and Outcomes

Simon Birnbaum, Tommy Ferrarini, Kenneth Nelson and Joakim Palme

In the chapter the authors develop a justice-based argument for why it matters whether the generational welfare contract is balanced and provide equally comprehensive social protection against different age-related social risks. This establishes a normative starting point for the authors’ empirical investigations on how welfare states affect different age groups. Building on the prudential lifespan account of justice between age groups, one set of considerations focuses on how to facilitate stable intergenerational cooperation to enhance life prospects of all successive generations as they move through the different stages of life. A second source of arguments is the ideal of relational equality, bringing attention to inequalities between people in different life stages, especially with respect to goods that matter to their relative power and social status. Finally, a third layer of considerations is derived from justice between non-contemporaries and the requirements of just savings for future generations.

Open access

Profiling the generational welfare contract

Justice, Institutions and Outcomes

Simon Birnbaum, Tommy Ferrarini, Kenneth Nelson and Joakim Palme

In this chapter the authors empirically investigate the generational structure of social citizenship in 18 OECD countries, using new comparative data on income replacement in social insurance directed at three different age-related social risks: childhood, working age and old age. For the period 1980–2010, they identify different types of generational welfare contracts and analyse how they are related to levels of income replacement. Greater balance in the generational structure of social citizenship seems to improve the overall comprehensiveness of the system as well as levels of income replacement in social insurance for each separate age-related social risk; thus supporting their hypothesis of positive-sum solutions in generational politics. While the authors find a general development towards greater balance in the generational structure of social citizenship, as levels of income replacement in social insurance over time have become more evenly distributed across age-related risks, cross-country differences remain substantial.

Open access

Politics of generational welfare contracts

Justice, Institutions and Outcomes

Simon Birnbaum, Tommy Ferrarini, Kenneth Nelson and Joakim Palme

The chapter analyses the political foundations of the generational welfare contract and the patterning of age-related social citizenship rights by focusing on partisan politics. The authors argue that positive-sum solutions in generational politics are more likely to arise in countries where specialized age-related claims for welfare are incorporated into class politics by the presence of strong left parties. The analyses provide support to such class-political and party-oriented explanations. For the period 1960–2010, confessional parties also had a certain influence on the generational structure of social citizenship, and the degree to which income replacement in major social insurance schemes is balanced across age-related social risks. However, this relationship disappeared for the most recent period 1980–2010, which is characterized foremost by expansion of modern family benefits where countries dominated by confessional parties are lagging. Central structural factors – such as the old-age dependency ratio – lack explanatory value for the generational structure of social citizenship.

Open access

The generational welfare contract on the agenda

Justice, Institutions and Outcomes

Simon Birnbaum, Tommy Ferrarini, Kenneth Nelson and Joakim Palme

In the final chapter, the authors return to the issues raised in the first three chapters of the book, and discuss their theoretical expectations in light of the empirical results. Population ageing raises concerns about the feasibility of strategies that rely on comprehensive welfare states for serving different goals and standards of well-being and social justice. One reason is that changes in the age structure will strongly increase demands for intergenerational redistribution. What does a welfare-enhancing, equitable and sustainable generational welfare state contract look like in this context? How can the welfare state serve generational justice over time and how should different strategies in the development of social policy be evaluated? The authors reiterate their analytical framework and briefly summarize the main findings. They discuss the possibilities of establishing and sustaining a just generational welfare contract. Finally, they address ventures for further research.

Open access

The Generational Welfare Contract

Justice, Institutions and Outcomes

Simon Birnbaum, Tommy Ferrarini, Kenneth Nelson and Joakim Palme

This groundbreaking book brings together perspectives from political philosophy and comparative social policy to discuss generational justice. Contributing new insights about the preconditions for designing sustainable, inclusive policies for all of society, the authors expose the possibilities of supporting egalitarian principles in an aging society through balanced generational welfare contracts.
Open access

The generational welfare contract

Justice, Institutions and Outcomes

Simon Birnbaum, Tommy Ferrarini, Kenneth Nelson and Joakim Palme

The chapter puts forwards the hypothesis that it is possible to find positive-sum solutions for the distribution of social citizenship rights across age-related risks. Four ideal-typical generational welfare contracts are outlined. Three of those are unbalanced, where social rights are tilted in favor of one particular target group: children, working age or old age. Unbalanced generational welfare contracts favoring old age are often assumed to foment generational conflict. The fourth ideal-typical category is the balanced generational welfare contract, where the structure of social citizenship rights treats all age-related risks more equally. Balanced generational welfare contracts provide fertile conditions for the formation of common generational interests. The authors expect welfare states that respond more evenly to the needs of each age-related social risk to improve conditions for coalition building, thus providing more favorable conditions for raising the overall generosity of social protection – to the benefit of all age groups.

Open access

Contracts for trust

Justice, Institutions and Outcomes

Simon Birnbaum, Tommy Ferrarini, Kenneth Nelson and Joakim Palme

In the chapter the authors move the analytical spotlight to social and political trust. Whereas social trust is often considered important in shaping social ties between citizens, political trust is more related to the perceived legitimacy of the state and its institutions. Both facets of trust and their relationships to different generational welfare contracts contribute important pieces to the puzzle of understanding how generational politics can receive broad popular support, as well as to how just welfare state institutions can be promoted and maintained for the sustainable future. The authors observed clear relationships between type of generational welfare contract and both forms of trust, lending further empirical evidence for the presence of positive-sum solutions in generational politics. Balanced generational welfare contracts are related to higher levels of political and social trust. Differences in political trust between age-related risk groups also tend to be smaller in countries with balanced generational welfare contracts.