4.7 Article

Do standard classifications still represent European welfare typologies? Novel evidence from studies on health and social care

Journal

SOCIAL SCIENCE & MEDICINE
Volume 281, Issue -, Pages -

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.socscimed.2021.114086

Keywords

Classification; Meta-analysis; Health policy; Social policy; Public policy; Welfare regime; Public economics

Funding

  1. Economic and Social Research Council (ESRC) [ES/S01523X/1]
  2. ESRC [ES/S01523X/1] Funding Source: UKRI

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The study found that healthcare and social care policies are characterized by the coexistence and overlap of multiple regimes, resulting in a hybridization of the original welfare taxonomy. Additionally, country classifications differ substantially between healthcare and social care, indicating a lack of coherence in welfare system rationales across policy areas.
Due to the profound changes that have characterised welfare systems, the representativeness of standard welfare classifications such as Esping-Andersen's Three Worlds of Welfare (TWW) have been questioned. In response to concerns that welfare services do not share a common rationale across policy areas, new typologies focused on sub-areas of welfare provision have been introduced. Still, there is little evidence on whether such policy-specific typologies are (i) consistent with the standard TWW classifications; and (ii) consistent across policy areas. We reviewed 22 recent studies which identified welfare typologies in 12 European countries focusing on economically relevant areas such as healthcare and social care. We build novel indices of welfare similarity to measure the extent to which welfare systems have been grouped together in previous studies. Our findings are twofold: first, healthcare and social care policies are characterised by the coexistence and overlap of multiple regimes, i.e., a hybridisation of the original TWW taxonomy. Second, countries classifications are substantially different between healthcare and social care, which highlights the lack of coherence in welfare systems rationales across policy areas. Our findings suggest that comparative analyses of welfare systems should narrow their focus on policy-specific areas, which may prove more informative than general classifications of welfare states.

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