Attitudes Towards Welfare State Institutions: New Perspectives for the Comparative Welfare State Analysis
Research question/goal:
Welfare states are facing increasing external and internal pressures which are especially related to the processes of globalisation and demographic change. While the responsibilities of the welfare state have increased, the financial scope for social policy intervention has been limited. In the current context of permanent austerity social policy reforms go beyond simple cost containment measures and welfare states are more and more confronted with structural changes - a process that eventually will affect the legitimacy of the welfare state.
By comparing 15 member states of the European Union it has been analyzed whether certain relations between welfare state institutions and patterns of orientation can be identified. Since institutions that integrate the total population are perceived in a different way than those that are targeted at specific periods of the life course or at certain socioeconomic groups, the project focuses on different welfare state institutions: first, health care systems, second, family policy measures, and third, social policy measures against poverty are included in the comparative analysis.
According to our analyses, attitudes on minimum income protection systems depend on the generosity of benefits and unemployment. In situations of high unemployment and low benefit levels, the public is in favour of these systems and demands increased state intervention. When unemployment is lower, support also drops and high benefit levels may polarize public opinion.
In the field of family policy, attitudes are related to the type and generosity of existing policies for families. In countries with generous support for the dual-earner model of the family, the level of satisfaction is highest and families perceive fewer difficulties combining work and family life. In most countries, irrespective of the institutional context, the financially better off were more satisfied and perceived fewer difficulties to combine work- and family life.
Almost everywhere in Europe, there is high public support for state responsibility in healthcare. Satisfaction with the healthcare system, in contrast, is more strongly related to specific institutional arrangements. In healthcare systems with lower levels of expenditure and general practitioners and higher co-payments, the overall level of satisfaction is lower. In contrast, healthcare systems with a long tradition of comprehensive coverage regardless of occupation or income seem to generate rather homogenous attitudinal patterns. Countries with high levels of expenditure, high density of general practitioners and free choice of doctors, finally, show the highest levels of satisfaction but also more pronounced differences between social classes.
Publications
Books
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(2014): Public attitudes towards family policies in Europe : linking institutional context and public opinion. 240. Wiesbaden, Springer VS. More
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(2011): Welfare States and Public Opinion. Perceptions of Healthcare Systems, Family Policy and Benefits for the Unemployed and Poor in Europe. 224. Cheltenham, UK, and Northampton, MA, USA, Edward Elgar. More
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(2009): Krankenversicherung oder Gesundheitsversorgung? Gesundheitssysteme im Vergleich - 2. überarbeitete Auflage. 344. Wiesbaden, VS Verlag. More
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(2003): Krankenversicherung oder Gesundheitsversorgung? Gesundheitssysteme im Vergleich. 369. Wiesbaden, Westdeutscher Verlag. More
Edited Books
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(2005): Das Weber-Paradigma. Studien zur Weiterentwicklung von Max Webers Forschungsprogramm. 406. Tübingen, Mohr Siebeck. More
Book Chapters
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(2011): Gesundheitssysteme im internationalen Vergleich. 471-485. Wiesbaden, VS Verlag für Sozialwissenschaften. More
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(2009): Grundprinzipien der sozialen Sicherheit und Gleichheit im Wohlfahrtsstaat. 135-146. Baden-Baden, Nomos. More
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(2008): New governance, Institutionenwandel und Vertrauen im Gesundheitssystem – Vertrauensverlust oder neue Formen der Vertrauensbildung?. 4443-4445. Frankfurt, Campus. More
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(2006): Wandel von Staatlichkeit in den Gesundheitssystemen von OECD-Ländern. 309-355. Frankfurt am Main, Suhrkamp. More
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(2006): Der Gesundheitssystemvergleich: Konzepte und Perspektiven. 270-297. Wiesbaden, VS-Verlag. More
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(2004): 19. Satisfaction with Health Care Systems. A Comparison of EU Countries. 311-331. Dordrecht, Kluwer Academic Publishers. More
Journal Articles
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(2012): The World Health Report 2008 - Primary health care: How wide is the gap between its agenda and implementation in 12 high-income health systems?. Healthcare Policy, 7, 3, 38-58. More
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(2011): Comparative studies and the politics of modern medical care. Political Studies Review, 9, 2, 254-256. More
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(2011): Medicine and user involvement within European healthcare: a typology for European comparative research. International Journal of Clinical Practice, 65, 12, 1218-1220. More
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(2011): Cost barriers reduce confidence in receiving medical care when seriously ill. International Journal of Clinical Practice, 65, 11, 1115-1117. More
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(2010): Translating monetary inputs into health care provision: A comparative analysis of the impact of different modes of public Policy. Journal of Comparative Policy Analysis, 12, 1-2, 11-31. More
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(2010): How do Europeans perceive their healthcare system? Patterns of satisfaction and preference for state involvement in the field of healthcare. European Sociological Review, 26, 2, 177-192. More
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(2010): The power of ideas – can Obama’s healthcare reforms change the U.S. health system?. The International Journal of Clinical Practice, 64, 4, 423-425. More
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(2010): Bereichsbesprechung: Gesundheit und Gesundheitssystem. Soziologische Revue, 33, 2, 230-242. More
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(2009): Healthcare system types: a conceptual framework for comparison. Social Policy & Administration, 43, 1, 70-90. More
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(2009): Letter from America: the political economics of US healthcare reform. Journal of the Royal Society of Medicine, 102, 4, 129-133. More
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(2009): Public Opinion on State Responsibility for Minimum Income Protection: A Comparison of 14 European Countries. Acta Sociologica, 52, 2, 117-134. More
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(2009): Mapping European healthcare systems. A comparative analysis of financing, service provision, and access to healthcare. Journal of European Social Policy, 19, 5, 432-445. More
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(2008): Einstellungen zu wohlfahrtsstaatlichen Institutionen in Europa - Wie werden Gesundheitssysteme von den Bürgerinnen und Bürger wahrgenommen?. Zeitschrift für Sozialreform, 54, 2, 115-140. More
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(2006): Gesundheitssysteme im internationalen Vergleich. Ein Überblick über den Forschungsstand. Das Gesundheitswesen, 593-599. More
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(2005): The Changing Role of the State in Healthcare Systems. European Review, 13, Supp.No.1, 187-212. More
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(2004): Social Austerity versus Structural Reform in European Health Systems: A Four-Country Comparison of Health Reforms. International Journal of Health Services, 34, 3, 415-433. More
Presentations
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(2011): Conceptual Frameworks for Comparing Healthcare Politics and Policy. [Healthcare systems: change and outcomes. Ideas, institutions, actors, and reform, Amsterdam, 10/11/2011 - 11/11/2011]. More
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(2011): Conceptual Frameworks for Comparing Healthcare Politics and Policy. [The European Health Policy Group Meeting, London, 21/09/2011 - 22/09/2011]. More
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(2011): Changing Types of Healthcare Systems. [RC 19/ISA annual conference on "Production, Reproduction, and Protection in the Welfare State", Seoul, 24/08/2011 - 26/08/2011]. More
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(2010): The role of experts in the German healthcare system. [Conference on the Politics of Ideas and the Politics of Representation: The Case of Health Policy, Rothermere American Institute, Oxford University, 10/11/2010 - 11/11/2010]. More
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(2010): Welfare States and Public Opinion in 15 European Countries. [ESPAnet Conference 2010, Budapest, 01/09/2010 - 03/09/2010]. More
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(2010): Framework for Comparing and Researching Health Policy Regimes. [COST ACTION TRAINING SCHOOL: Enhancing the Role of Medicine in the Management of European Health Systems, Lyon, 21/10/2010 - 21/10/2010]. More
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(2010): Ideas and Institutional Change in Healthcare Systems. [Equalsoc Institutional Change Workshop, MZES, 24/11/2010 - 25/11/2010]. More
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(2009): Challenges and reform options in health care systems: what can America learn from European countries?. [The American Council on Germany and the European Union Center of Excellence, University of Wisconsin, Madison, 27/01/2009 - 27/01/2009]. More
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(2009): Ideas and institutions in the field of health care. [Visiting Scholars Seminar, Minda de Gunzburg Center for European Studies, Harvard University, 31/03/2009 - 31/03/2009]. More
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(2009): Confidence in receiving medical care in seven countries. [Harkness Program of Health Policy and Practice, final conference, New York, 10/06/2009 - 11/06/2009]. More
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(2009): Regulating access to health care providers and inequalities of utilization in European countries. [Academy Health Annual Research Meeting, Chicago, 27/06/2009 - 29/06/2009]. More
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(2009): Family policy in Europe: institutional change and its meaning for families (with Agnes Blome, WZB Berlin). [TRALEG (EQUALSOC) Institutional Change Project Meeting, Amsterdam, 17/06/2009 - 18/06/2009]. More
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(2009): Ideas and Institutions: Protection for the unemployed and poor in Europe. [EQUALSOC INCDIS Workshop, Dublin, 09/11/2009 - 10/11/2009]. More
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(2008): Reconciliation of work and family in Europe. First evidence on childcare arrangements from the European Social Survey. [EQUALSOC Midterm Conference, WZB, Berlin, 10/04/2008 - 11/04/2008]. More
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(2008): How European Families Care: Patterns of Use and Attitudes towards Child Care. [Seminar at Centre for Comparative Welfare Studies: Theoretical understandings of welfare attitudes, Aalborg University, Aalborg, 02/09/2008 - 02/09/2008]. More
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(2008): Minimum income schemes and attitudes towards redistribution. [EQUALSOC/TRALEG Workshop: Welfare State Institutions and Welfare State Outcomes, Mannheim, 05/03/2008 - 07/03/2008]. More
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(2008): Regulating patients’ access and the utilization of healthcare services in European countries. [The European Health Policy Group's Sixteenth Meeting: Access, Choice and Equity, Dublin, 16/04/2008 - 17/04/2008]. More
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(2008): Attitudes towards family policy in Europe. [EQUALSOC/TRALEG Workshop: Welfare State Institutions and Welfare State Outcomes, MZES, Mannheim, 05/03/2008 - 07/03/2008]. More
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(2008): Mapping European Minimum Income Schemes. [EQUALSOC Midterm Conference, WZB, Berlin, 10/04/2008 - 11/04/2008]. More
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(2008): Who has access to health care in Europe?. [Invitation of The Health of Nations Study Group, Center for European Studies, Harvard University, 20/11/2008 - 20/11/2008]. More
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(2007): Translating Monetary Inputs into Health care Services - The Influence of Different Modes of Public Policy in a Comparative Perspective. [4th ICPA Forum Workshop: Comparative Healthcare Policies, Yale University, 25/04/2007 - 28/04/2007]. More
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(2007): Attitudes Towards Welfare State Institutions. [Fourteenth International Research Seminar on 'Issues in Social Security' - 'Social Security, Happiness and Well-Being'. The Foundation for International Studies of Social Security (FISS), Sigtuna, 14/06/2007 - 16/06/2007]. More
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(2007): State Interventions against Poverty: Public Perceptions in Europe. [RECwowe/ESPAnet Summer School 'Europe, Welfare and Work', Edinburgh, 19/06/2007 - 29/06/2007]. More
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(2007): Patterns of Trust in Health Care Institutions. [Annual Conference of Research Committee 19 of the International Sociological Association "Social Policy in a globalizing world: developing a north-south dialogue”, Florence, 05/08/2007 - 07/08/2007]. More
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(2006): Bedingungen für einen Institutionenwandel - Das Beispiel des Gesundheitssystems (Ad-hoc-Gruppe: Zur Natur der Behinderung. Klassifikationen der Gesundheit, Behinderung und Funktionsfähigkeit. [33. Kongress der Deutschen Gesellschaft für Soziologie, Universität Kassel, 08/10/2006 - 12/10/2006]. More
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(2006): Nimmt das Vertrauen in Institutionen der Gesundheitsversorgung ab? Ein internationaler Vergleich. [33. Kongress der Deutschen Gesellschaft für Soziologie, Universität Kassel, 08/10/2006 - 12/10/2006]. More
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(2006): Changing Health Care Systems in a Changing World. [XVI World Congress of Sociology, Durban, 22/07/2006 - 28/07/2006]. More
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(2006): Attitudes towards Welfare State Institutions. [XVI World Congress of Sociology, Durban, 22/07/2006 - 28/07/2006]. More
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(2005): Discussant of the presentation by Herbert Obinger: Outcomes of Policy Reforms. [Governance of Welfare State Reform, Universität Bremen, 15/12/2005 - 16/12/2005]. More
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(2005): Health Care Systems, Social Inequality, and Health. [Japanese-German Frontiers of Science Symposia, Tokio, 01/11/2005 - 04/11/2005]. More
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(2005): Ideas, Actors and Institutions in Health Care Systems. [2005 ESPAnet Conference, Fribourg, 21/09/2005 - 23/09/2005]. More
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(2005): Die neue soziale Frage. Ausgrenzung, Teilhabe und Umverteilung. [Gerechtigkeits-Kongress. Wissenschaftliche Tagung der Heinrich-Böll-Stiftung, Stuttgart, 17/11/2005 - 18/11/2005]. More
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(2005): Reasons for high levels of satisfaction and trust. [Health Care Systems between Centralisation and Decentralisation, Universität Bielefeld, 11/05/2005 - 11/05/2005]. More
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(2005): Trust in Just Health Care Systems?. [GSSS Conference on Social Justice, Bremen, 09/03/2005 - 11/03/2005]. More
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(2004): Regulation, financing and service provision in OECD health care systems. [Annual Conference of Research Committee 19 of the International Sociological Association “Welfare state restructuring: processes and social outcomes”, Paris, 01/09/2004 - 03/09/2004]. More
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(2004): Convergence or Divergence in OECD Health Care Systems. [Eleventh International Research Seminar on “Issues in Social Security” – “International cooperation in social security: How to cope with globalisation”. The Foundation for International Studies of Social Security (FISS), Sigtuna, 18/06/2004 - 20/06/2004]. More
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(2004): Ansätzes des Gesundheitssystemvergleichs. [Graduiertenprogramm der Fakultät für Gesundheitswissenschaften, Universität Bielefeld, 07/07/2004 - 07/07/2004]. More
Reports
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(2007): Der Wandel des Interventionsstaates. 50. Bremen, Universität Bremen, Sonderforschungsbereich 597. More
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(2007): Gesundheitssystemtypen im Vergleich. Konzeptionelle Überlegungen zur vergleichenden Analyse von Gesundheitssystemen. 61. Universität Bremen. More
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(2005): The self-regulatory German health care system between growing competition and state hierarchy. 32. Bremen, SFB 597, Universität Bremen. More
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(2004): Convergence or Divergence of OECD Health Care Systems?. 9. Bremen, SFB 597, Universität Bremen. More
MZES Working Papers
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(2006): Modes of Regulation and their Effects on Financing and Service Provision in OECD Health Care Systems. 95, Mannheim, MZES. More
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