Retreating State? Political Economy of Welfare Regime Change in Turkey

2010 ◽  
Vol 2 (2) ◽  
pp. 152-184 ◽  
Author(s):  
Mine Eder
Keyword(s):  
Health Care ◽  
Social Insurance ◽  
Social Assistance ◽  
State Power ◽  
Cumulative Effect ◽  
Health Care Expenditures ◽  
Welfare States ◽  
The State ◽  
Welfare Regime ◽  
Welfare Provision

AbstractInformed by the debates on the transformation of welfare states in advanced industrial economies, this article evaluates the changing role of the state in welfare provision in Turkey. Turkey's welfare state has long been limited and inegalitarian. Strong family ties coupled with indirect and informal channels of welfare (ranging from agricultural subsidies to informal housing—both costly but politically expedient) have compensated for the welfare vacuum. At first glance, Turkey's welfare reform that emerged from the 2000-2001 fiscal crisis appears like a classic case of moving towards a minimalist, 'neoliberal' welfare regime—with increasingly privatized health care and private social insurance. The state retreats via the subcontracting of welfare provision to private actors, growing involvement of charity organizations, and increasing public-private cooperation in education, health, and anti-poverty schemes. Yet, there is also evidence of the expansion of state power. The newly empowered 'General Directorate of Social Assistance and Solidarity (SYDGM)' manages an ever-increasing budget for social assistance, the number of mean-tested health insurance (Green Card) holders explodes, health care expenditures rise substantially, and municipalities become important liaisons for channeling private money and donations for antipoverty purposes. The cumulative effect is an 'institutional welfare-mix' that has actually mutated so as to compensate for the absence of the earlier, politically attractive but fiscally unsustainable welfare conduits. The result has so far been the creation of immense room for political patronage, the expansion of state power, and no significant improvement of welfare governance.

scholarly journals Social innovation as a policy response to restructure the welfare state

2021 ◽  
Vol 11 (5) ◽  
pp. 269-276
Author(s):  
Doğa Başar Sariipek ◽  
Gökçe Cerev ◽  
Bora Yenihan
Keyword(s):  
Welfare State ◽  
Social Protection ◽  
Social Innovation ◽  
Welfare States ◽  
The State ◽  
Welfare Provision ◽  
Civil Society Organisations ◽  
Leading Role ◽  
Social Risks ◽  
The Welfare State

The focus of this paper is the interaction between social innovation and restructuring welfare state. Modern welfare states have been reconfiguring their welfare mixes through social innovation. This includes a productive integration of formal and informal actors with support and leading role of the state. This collaboration becomes significantly important since it means the integration of not only the actors, but also their capabilities and resources in today’s world where new social risks and new social challenges have emerged and no actor can overcome these by its own. Therefore, social innovation is a useful tool in the new role sharing within the welfare mix in order to reach higher levels of satisfaction and success in welfare provision. The main point here is that this is not a zero-sum competition; gaining more power of the actors other than the state – the market, civil society organisations and the family – does not necessarily mean that the state lost its leading role and power. This is rather a new type of cooperation among actors and their capabilities as well as their resources in welfare provision. In this sense, social innovation may contribute well to the debates over the financial crisis of the welfare state since it may lead to the more wisely use of existing resources of welfare actors. Thanks to social innovative programs, not only the NGOs, but also market forces as well as citizens are more active to access welfare provisions and social protection in the broadest sense. Thus, social innovative strategies are definitely a solid step taken towards “enabling” or “active” welfare state.

scholarly journals ORGANIZATIONAL AND ECONOMIC FUNDAMENTALS OF DEVELOPMENT OF SPORTS TOURISM IN THE SYSTEM OF MANAGEMENT OF SPORTS AND HEALTH ACTIVITIES

2020 ◽  
Vol 5 (5) ◽  
pp. 79
Author(s):  
Olena Melikh ◽  
Inna Irtyshcheva ◽  
Konstantin Bogatyrev
Keyword(s):  
Health Care ◽  
Physical Education ◽  
Life Expectancy ◽  
Health Care Expenditures ◽  
The State ◽  
Physical Culture ◽  
Average Life Expectancy ◽  
Life Expectancy At Birth ◽  
Current State

The article highlights the approaches to the development of sports and health activities and sports tourism in various spheres of society. It is proved that the current standard of quality of life in Ukraine is characterized as not satisfactory. Many factors affect the quality of life: lifestyle, genetic and environmental factors. However, one of the main issues remains the underfunding of development. The work investigates the state of financial support for health care, which is closely related to the level of low healthy life expectancy. It is determined that in modern conditions physical culture and sports are a necessary element of life of every Ukrainian. It is justified that grant programs are the main financial source for the development of physical culture and sports. It is proved that the state and non-state policy of development of physical education and sports should be built on creation of the corresponding concept for the next five years, which will include the appropriate strategy and program of development of physical culture and sports. The purpose of the article is a study of the peculiarities of organizing sports and health activities in different spheres of society and mechanisms of financing physical culture and sports in Ukraine. To achieve this goal, the following tasks are solved: to reveal the role and importance of organizing sports and health activities in different spheres of society; to conduct an analysis of the current state of financing of health care, physical education and sports; outline strategic guidelines for improving state and non-governmental policies on financial provision for physical education and sports. Subject and object of study. The subject of the research is theoretical and practical aspects of organization of sports and health activities in different spheres of society. The object of the research is the process of managing sports and health activities in different spheres of society. Research methods. For a comprehensive study of the necessary information the basic methods of information research in management were used. In the study of the current state of financing the health care, physical education and sports the methods of statics and dynamics were used. The dynamic method was used to analyze health care expenditures in percentage terms to GDP and total expenditures, average life expectancy at birth in Ukraine, transition from one equilibrium state to another for the period from 1995 to 2017. The static method involved a comparison of the amount of annual funding from the State Targeted Social Program for the Development of Physical Culture and Sports and the actually allocated funds. An economic model of the dynamics of health care expenditures in percentage terms to GDP and total expenditures, average life expectancy at birth in Ukraine in the form of a graph is constructed.

scholarly journals THE STATE OFFINANCIAL SECURITYOFTHE HEALTHCARE SECTORIN UKRAINE

2017 ◽  
pp. 156-165
Author(s):  
Liudmyla PARKHETA
Keyword(s):  
Health Care ◽  
Financial Support ◽  
Health Sector ◽  
Health Care Expenditures ◽  
The State ◽  
Financial Resources ◽  
Effective Control ◽  
Current State ◽  
Financing Health Care ◽  
Care System

Introduction. Organization ofeffective functioning and development ofhealth care system in the conditions of limited financial resources is the most important task ofthe authorities at all levels. Therefore, the question ofassessing the current state ofhealth and identifying the main problems of financing health care institutions relevant is more than ever. Purpose. The purpose of the article is to analyze the current state of financial securement ofhealth care in Ukraine. To identify the main problems ofthe development ofthe health sector and to develop recommendations for improving existing and finding new sources of financial support forthe health care system. Results. The results of the analysis show that in recent years, despite an annual increase in health care expenditures, their share in the budget structure is reduced by redistribution to finance other activities ofthe state. The financial support ofhealth care at the state level is extremely insufficient. Apart from the problem of financing health expenditures, attention is drawn to the problem of inefficient and inappropriate use of available resources by the network ofhealth care facilities, which in many cases does not correspond to the real needs ofthe population. Conclusion. It is concluded that the problems of financing health care are largely solved by the introduction of insurance medicine, which ensures not only the ability to receive proper medical care by the population of Ukraine, but also provides effective control by insurance organizations to the rational use of financial resources of the health care sector.

Assessing Welfare State Change: The German Social Insurance State between Reciprocity and Solidarity

2003 ◽  
Vol 23 (3) ◽  
pp. 325-347 ◽  
Author(s):  
Sigrid Leitner ◽  
Stephan Lessenich
Keyword(s):  
Welfare State ◽  
Social Exchange ◽  
Social Insurance ◽  
Welfare States ◽  
Welfare Regime ◽  
State Change ◽  
Analytic Framework ◽  
Social Policy Reform ◽  
National Welfare ◽  
Different Dimensions

The analytic framework used here to study welfare state change builds upon the distinction of two fundamentally opposed logics of social exchange: the logic of reciprocity and of solidarity. The approach enables to assess the complexity and ambivalence of policy change in advanced welfare states. Using recent social policy reform in Germany as an illustration of the analytical capacity of our approach, it is shown that change can be detected in two different dimensions. One type of change is in the overall mix between reciprocity-based insurance and solidarity-based assistance programmes which makes up the specific profile of a national welfare regime. Another type is in the balance between elements of reciprocity and solidarity within social insurance schemes. This approach can be replicated with any of the developed welfare states of the OECD world.

Three Welfare Models and Current Chinese Social Assistance: Confucian Justifications, Variable Applications

2015 ◽  
Vol 74 (4) ◽  
pp. 977-999 ◽  
Author(s):  
Dorothy J. Solinger
Keyword(s):  
Health Care ◽  
Financial Aid ◽  
Social Assistance ◽  
Political Elite ◽  
Social Citizenship ◽  
Assistance Program ◽  
Citizenship Rights ◽  
Welfare Provision ◽  
The Third ◽  
The Poor

To situate today's social assistance program conceptually and historically, this paper presents three ideal-typical stances states may adopt in welfare provision, especially for indigent populations: (1) extend assistance to accord with social citizenship rights—or to fulfill the Confucian concept of the rite of benevolence; (2) offer subsidies to attain support or to pacify anger and silence demands from the poor; or (3) grant benefits (education, health care) to enhance the nation's productivity. The intended beneficiaries of these projects are, respectively, individuals, society and the state, and politicians. This categorization can distinguish, in broad-brush fashion, official handouts at diverse historical moments; the models are meant not so much to characterize entire eras as to illustrate differential styles of allocation. Moreover, each era justifies its practice with reference to Confucian dicta. In this comparative context, today's political elite bestows financial aid—but just a conditional kind—mainly to preempt disturbances and prevent “instability,” in line with the third of the types.

scholarly journals Experience of EU countries in organizing of the circulation and availability of medicines for the population

2021 ◽  
Vol 2 (1) ◽  
pp. 1-15
Author(s):  
Svitlana Zbrozhek
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Social Insurance ◽  
Health Care Systems ◽  
The Elderly ◽  
The State ◽  
Medical Services ◽  
Selling Price ◽  
Social Insurance System ◽  
Eu Countries

Finland's health care system has evolved over the years, with its distinctive features being tax funding, the provision of the vast majority of medicines and medical services by public and municipal authorities. to study the experience of EU countries in the field of health care in the organization of circulation and availability of medicines. To achieve this goal used the methods of regulatory, documentary, comparative and graphical analysis. The increase in the cost of medical care leads to the fact that the state is increasingly thinking about containing costs. The level of co-financing by patients is growing, at the same time measures are being taken to limit the selling price of medicines. The existing system of reference prices promotes the entry of generics into the market and, apparently, this direction will develop. A characteristic feature of the health care and pharmaceutical supply system in the Nordic countries is coordination, which is implemented at different levels and in many forms. The organization of the circulation and accessibility of medicines for the population in Finland is based on covering the costs of medicines through the social insurance system, but with the participation of the state. The priority common aspects of the functioning of the national health care systems of the Scandinavian region remain: coordination between hospitals and definition of their areas of activity; coordination between general services and specialized assistance centers; coordination of the organization of drug circulation and medical care for certain categories of patients (privileged categories, patients with oncological diseases, etc.); coordination of pharmaceutical support and medical services for patients with chronic diseases (diabetes, etc.); coordination of long-term pharmaceutical provision and medical care for the elderly.

scholarly journals Is There Room for Targeting within Universalism? Finnish Social Assistance Recipients as Social Citizens

2020 ◽  
Vol 8 (1) ◽  
pp. 145-154
Author(s):  
Paula Saikkonen ◽  
Minna Ylikännö
Keyword(s):  
Social Services ◽  
Social Insurance ◽  
Public Services ◽  
Social Assistance ◽  
Safety Net ◽  
Welfare States ◽  
Social Citizenship ◽  
Flat Rate ◽  
Income Transfers ◽  
National Register Data

This article focuses on the role of means-tested social assistance in Finland, which is often considered one of the Nordic welfare states described as having a universal welfare model. The article scrutinises the capacity of the final safety net to enhance the social citizenship of social assistance recipients. The Finnish social security system combines social insurance (earnings-related benefits), universal benefits (flat-rate benefits), free or affordable public services, and social assistance as a means-tested and targeted element, and thus it is a discussion on the degree of universalism that best captures the nature of universalism in the Finnish welfare state. Because the final safety net includes public services (especially social work) and income transfers (especially social assistance), its ability to strengthen social citizenship depends on both elements—separately and as a combination—as there may be a simultaneous need for financial aid and services. Whilst national registers provide data on social assistance, there is no national register data on municipal social services, which is why a survey was conducted. In this study, the heterogenic clients supported by the final safety net were described based on an open-ended question in the survey data. Statistics were then used to evaluate the frequency of client groups (capable clients, persistent clients, invisible clients, safety net dropouts). The article concludes that universalism as a social policy principle is challenged by the diversity of the clientele.

scholarly journals Welfare user roles in a conservative welfare state. Are Germans citizens, consumers or co-producers?

2016 ◽  
Vol 32 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Stephan Köppe ◽  
Benjamin Ewert ◽  
Florian Blank
Keyword(s):  
Health Care ◽  
Welfare State ◽  
Empirical Evidence ◽  
Welfare States ◽  
Heuristic Model ◽  
Main Argument ◽  
Pension Insurance ◽  
Market Mechanisms ◽  
Welfare Provision ◽  
Multiple User

Many welfare states have embraced choice and market mechanisms since the 1990s. With respect to welfare users, it has been argued that this led to a change from citizens to consumers. This paper challenges this observation and discusses changes of welfare user roles in the German welfare state. The main argument rests on the assumption that user roles are much more complex and include claimants and co-producers in addition to citizens and consumers. Based on this heuristic model of multiple user roles, empirical evidence for user roles in pension insurance, health care and schools is presented. Indeed, we observe a shift towards consumers in many fields of welfare provision, but German users are still largely addressed as claimants and citizens. Moreover, they are acting as active co-producers, entitled claimants, subversive consumers and needy patients.

Similar Pressures, Different Contexts: Public Attitudes toward Government Intervention for Health Care in 21 Nations

2008 ◽  
Vol 49 (4) ◽  
pp. 385-399 ◽  
Author(s):  
Saeko Kikuzawa ◽  
Sigrun Olafsdottir ◽  
Bernice A. Pescosolido
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Public Attitudes ◽  
National Level ◽  
Health Care Expenditures ◽  
The State ◽  
Cultural Socialization ◽  
Individual Vulnerability ◽  
The Social ◽  
Government Involvement

Health care systems worldwide are experiencing similar pressures such as rising cost, aging populations, and increased burden of disease. While policy makers in all countries face these challenges, their responses must consider local pressures, particularly the implicit social contract between the state, medicine, and insurers. We argue that public attitudes provide a window into the social context in which policy decisions are embedded. Using data from the International Social Survey Programme (ISSP), we compare public attitudes toward government involvement in health care in 21 countries, testing the associations between various nationallevel variables (e.g., health care expenditures, aging of population, health care traditions) and public opinions. Specifically, we posit four national-level hypotheses (“health care traditions,” “expenditure crisis,” “demographic crisis,” “changing disease profile crisis”), one individual-level hypothesis (“individual vulnerability”), and two cross-level hypotheses (“cultural socialization” and “health care need”). Our findings indicate that public attitudes cluster around the historical organization of health care, but also relate to current economic and demographic realities. Individuals in countries adopting the “National Health Service Model” (the state directly provides health care but complete state control is absent) or the “Centralized Model” (the state directly provides health care and has much control) are more supportive of government involvement in health care than those in the “Insurance Model” (the state is limited to maintenance of the system) countries. However, citizens in countries currently spending more on health care and having a greater burden of chronic illness are less supportive. Our results cast doubt on arguments that increased cost will result in a questioning of the contract between the state and citizens in the social provision of health care. We end by discussing implications for recent work in political sociology that highlights the importance of public attitudes.

scholarly journals Job Satisfaction in the Health Care Sector: Empirical Evidence from Medical Care in Greece

2016 ◽  
Vol 5 (1) ◽  
pp. 7 ◽  
Author(s):  
Alexandra Gkliati ◽  
Anna Saiti
Keyword(s):  
Job Satisfaction ◽  
Health Care ◽  
Medical Care ◽  
Health Care Services ◽  
Social Insurance ◽  
Health Care Expenditures ◽  
Health Care Sector ◽  
Public Hospitals ◽  
Care Providers ◽  
Care Services

It is extremely important for employees in every sector of an economy to be satisfied with their work since job satisfaction contributes significantly to improvements in their productiveness and performance. This paper deals with the very sensitive sector of health care in which medical staff provide citizens with health care services. The job satisfaction of these medical care providers is of particular importance when aiming to improve the quality of their services. Literature on job satisfaction among the providers of medical care is limited since researches have focused mainly on users’ satisfaction with the medical care services provided. In an era in which many countries worldwide are facing uncertainty and the social insurance systems are confronted with serious problems as they strive to respond to a number of changes, the Greek health care sector is no exception. With particular reference to the Greek reality, due to the heavy recession that the country has been facing for a number of years, health care expenditures have been cut dramatically and, as a result, the working conditions in public hospitals have been negatively influenced. Based on the above, the purpose of this paper is, through empirical investigation, to examine the levels of job satisfaction among Greek doctors who work in public hospitals and to determine the factors that may influence the satisfaction they gain from their work.

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