Long-term Care Policies in Central Eastern Europe: Between Decentralization and Europeanization

In the past two decades, welfare systems in Central Eastern European countries have gone through major transformations. An important element of these transformations is a territorial redistribution of responsibilities and roles, both towards regional and local levels and towards the European level. While there is a growing body of literature on these changes for welfare policies in general and for specific welfare state sectors, the study of transformation of long-term care in Central Eastern Europe still is in a very early stage. This contribution therefore attempts to analyse the development of long-term care policies in Central Eastern Europe with a particular focus on decentralization and Europeanization. The study builds on two comparative projects on long-term care and long-term care policies in this European region.

In Central Eastern Europe, long-term care did not play any prominent role in social policy debates in the 1990s and into the 2000s. But, various changes in the regulatory context, not least the decentralization of social assistance towards regional and local levels, had important implications for the provision and funding of long-term care. Europeanization has played some role from the 1990s, but became substantially more important with EU accession, including the implications of free mobility principles and the Open Method of Coordination. In the discussion, the contribution examines processes of Europeanization and decentralization for current long-term care reforms and future pathways in this European region.