Cash Versus Services: ‘Worlds of Welfare’ and the Decommodification of Cash Benefits and Health Care Services

Abstract

Welfare state models have focused almost exclusively on the study of cash benefits, and typologies established on this limited basis have been used to generalise about all forms of welfare state provision. This ignores the fact that welfare states are also about the actual delivery of services and/or that countries vary in terms of the relative emphasis that they place upon cash benefits and welfare state services. This article explores the cash and services mix in, and between, welfare states with reference to recent welfare state typologies, most notably Esping-Andersen's decommodification-centred ‘worlds of welfare’. It compares the decommodification levels of the main cash benefits with the main area of service provision: health care. The resulting analysis suggests that when services are added into the comparative analysis of welfare state regimes there are five welfare state clusters: Social Democratic, Liberal, Conservative, and sub-groups within both the Liberal and Conservative regimes. The article concludes that, in order to maintain integrity or generalisability, future welfare state typologies need to reflect more adequately the role of services in welfare state provision.