12. Increasing Consumer Choice and the Reconstitution of Risk in Mature Welfare States
Conveners: Waltraud Schelkle, Christa van Wijnbergen
Frericks Patricia (University of Hamburg , DE), Maier Robert (Utrecht University, NL)
Marketizing social protection in European welfare states and the mismatch of institutional constellations to construct the ‘social citizen'
Costa-i-Font Joan, Schelkle Waltraud and van Wijnbergen Christa ( London School of Economics, UK )
Choice and the reconstitution of communities of risk in European welfare reforms: the case of long term care
Pesenti Luca (Regional Observatory on Social Exclusion, Milan, IT) and Bonini Roberta (Catholic University of Milan, IT)
Freedom of choice in welfare services: an analysis from the Italian case
Heinz Rothgang, Robert Arnold, Braun Bernard, Greβ Stefan, Wasem Jürgen (University Bremen, DE)
Choice among health funds: Why do the insured hesitate to switch funds?
Distributed papers
Powell Martin (University of Birmingham, UK) and Greener Ian (Durham University, UK)
The Welfare State in the Affluent Society: the Dog that Did Not Bark?
The goal of providing more choice to patients, clients, and beneficiaries of social services has figured prominently in welfare reforms of OECD countries over the last two decades. It typically means a differentiated offer of services in return for stricter control and part-privatization of costs. Traditionally the solidaristic bargain underpinning European welfare states revolved around the twin objectives of equity and insurance. But whereas much of the retrenchment literature to date has focused on the income distributive effects of dwindling resources to explain changes in mature welfare states, it may well be that more profound changes in welfare arrangements are being driven by the introduction of ‘consumer choice’ and an accompanied reconstitution of risk.
‘Consumer choice’ typically comes at the cost of higher risk of adverse selection and ‘cream skimming’ for clients and providers respectively. The economic promise is that such risk-taking will be rewarded by greater consumer satisfaction, more willingness to pay and thus higher income generation in welfare markets. The political hope is to find new stakeholders for a social safety net that supplements the dwindling bases of support from traditional corporatist actors. However, if neither the economic promises nor the political hopes materialise, a real tradeoff emerges between consumer choice and social security.
Thus, increasing consumer choice on welfare services and providers raises a number of questions on the future of the welfare state. How does the institutionalisation of consumer choice affect access to and governance of welfare services? Is the choice agenda an explicit challenge to solidaristic welfare citizenship or, paradoxically, can it safeguard public services by providing the basis for a new political consensus? To what extent is the choice agenda motivated by expenditure retrenchment or quality enhancement? How does increasing consumer choice affect the balance between public and private financing and provision of welfare services? We welcome proposals that address these or any other questions relating to the introduction of consumer choice and the reconstitution of risk in mature welfare states.
Waltraud Schelkle
European Institute
London School of Economics
Houghton Street, London WC2A 2AE – UK
Tel.: +44 20 7905 6942
w.schelkle@lse.ac.uk |
Christa van Wijnbergen
European Institute
London School of Economics
Houghton Street, London WC2A 2AE – UK
Tel.: +44 20 7905 7492
c.van-wijnbergen@lse.ac.uk |
|
