Principles and practice of social security payments for care

Abstract

This article examines the dimensions which determine whether national social security systems make payments towards the costs of long‐term care needs and whether they do so where these needs are met within the family; what kinds of payments are made and to whom; and what levels these payments are set at. The article is based on empirical material from five European Union countries (the United Kingdom, Ireland, France, Italy and Germany). We argue that differences between countries along three dimensions account for most of the diversity between national systems in this field. These dimensions are the allocation of responsibilities and powers to local versus central levels of government; assumptions of to whom long‐term care represents a “risk”; national principles of subsidiarity and the relationship between the family and the State. This is, however, a field undergoing change (albeit mostly incrementalist and ad hoc) in the face of the demands placed on social welfare systems by growing levels of disability (related to the growth of elderly populations) and demands from women's movements and disability movements for recognition of their needs within social welfare systems.