How do pension and healthcare systems frame long‐term care policy? Comparison of the Czech Republic and Poland

Abstract

AbstractThis article compares changes in long‐term care (LTC) policies in the Czech Republic and Poland. The article challenges the view that countries from Central and Eastern Europe can be treated as a homogenous group with regard to LTC. To account for the dissimilarity between the countries, the article adopts Ranci and Pavolini's (2015, p. 274) recent recommendation that changes in LTC policies must be analyzed in the context of reforms of traditional and more expensive social policies, such as pensions and healthcare. Using the approach of political institutionalism, the article argues that these two countries' pension and healthcare systems established different opportunity structures and strategic preferences for change in LTC policy. Consequently, the persistent difference between the two countries over the past decade is explained by how their pension and healthcare systems frame LTC policy. The article also finds that “functional equivalents” to social care programs that are instituted either in pensions (i.e., lowering the retirement age, which impacts the supply of informal care) or in healthcare (i.e., increasing the availability of nursing homes) should be included in the analysis of LTC policy development.