Policy and Regulation of Long-Term Care – Exploration of an Uncultivated Field

Abstract

The article deals with the scarcely examined question as to how welfare state policy and regulation are related to the quantity and quality of long-term care services. The analysis carried out here supports evidence of a positive influence of social democratic welfare state regimes on the public spending and supply rates of care services. Beside that and a path dependent development recently also a trend towards the convergence of welfare state regimes began, mostly with the conservative regimes catching up. In general there is a trend towards strengthening home care and regulated markets with private for profit suppliers. The importance of regulation and supervision by the state is emphasized through comparative studies from the USA, showing the positive influence of the intensity of controls on the quality of care services. However, despite supervision, (similar to Europe) the number of serious deficiencies remains high and defects often occur without effective consequences. As background it should be emphasized that there is no sufficient, decisive long-term care policy – also in the USA, where relatively strong age-related organizations are reported. Nevertheless, the political background and effects of welfare state regulation in its various forms remain unclear. In this respect, more research into care policy and the effects of welfare state regulation on the quality of care services is necessary.