Comparative Political Economy of Long-Term Care for Elderly People: Political Logic of Universalistic Social Care Policy Development

Despite there being common socio-demographic pressures across advanced industrialized countries, the public elder care programmes therein tend to vary. While the current literature on social care devotes itself to describing the care arrangements of each country and pigeonholing welfare/gender regime types, it does not sufficiently address this empirical puzzle. This study looks to specify the causal relationship between political institutions and public long-term care programmes. It argues that countries with personal-vote-oriented electoral systems and/or fragmented party systems have difficulties in developing universalistic public elder care programmes, whereas countries with party-vote-oriented electoral systems and cohesive party systems are likely to develop generous elder care programmes. For whilst the former types of political institutions prioritize patronage-based, particularistic benefits, the latter types encourage political actors to appeal to broader constituencies through universalistic welfare programmes. This study tests this claim by examining pooled time-series and cross-section data of advanced democracies, from 1980 until 2001. The empirical results suggest that politicians' reliance on personal votes and the fragmentation of ruling coalitions impede the expansion of public spending for elder care.