Childcare and Long-Term Care Policies. Evolution and Pro-Market Conditioning

With the aim of contribute to the debate on the reformulation of the welfare State, this article analyzes the evolution of public policies for childcare and elderly and long-term care in three different welfares regimes -Sweden, France and Spain-for the last decades. To determine how and to what extent these policies have been developed in terms of coverage, cost and formal care work, and what new tensions on the social organization of care have emerged, we use international bibliographic databases, and reports and databases from the three selected countries, the European Union and OECD. The results of this study show that childcare and long-term care policies have developed in the context of competing discourses on free choice, social investment, managerialization or new public management, leading to both an expansion of coverage and cost containment. The balance between these two forces has been different in each country. Sweden has achieved to maintain a public universal model with high costs and coverage, even though it is introducing economic principles and cash-for-care schemes. France promoted a pro market model, which allowed increase coverage through cash-for-care benefits, but it has failed to prevent the increase in total costs, so that recently it introduced cuts and means-tested benefits. Finally, Spain has implemented a low-cost model that has been able to increase coverage mainly due to the predominance of cash-for-care benefits. Besides, the severe fiscal consolidation implemented with the European management of the financial and economic crisis is leading to serious cutbacks in the provision of public services for care.