National Intentions and Local Welfare Markets: A Comparative Analysis of Market Tools to Support Older Adults in France and Québec

Abstract

This homecare policy study compares the creation and enactment of a managed market (Quebec) and a consumer-driven market (France) in urban and rural areas. Market tools are ill-suited for rural environments, as policymakers have an urban setting in mind. Consequently, market tool preferences have modest relevance in rural settings, with implementers facing multiple hurdles to develop and sustain markets. This comparative study demonstrates that the deployment of market tools actually results in heightened pressures on not-for-profit organizations to fill a growing number of service gaps and to adapt market instruments and mechanisms.