The Interaction of Culture, Institutions and Actors in Explaining Cross-National Differences in Care Policy Marketization

Many European welfare states strengthened market principles in their institutions and policies in the 1990s and 2000s. This institutional change was in part based on change in the cultural basis of welfare states in which market-liberal ideas have gained importance. In the new cultural basis of welfare state policies, the market-liberal ideas interacted partly in contradiction with other cultural ideas, such as social solidarity, gender equality, and mutual support between family members. The market-liberal ideas and the market-oriented policies were moreover contested among different groups of actors. It must be considered that different actors had in part also different interests vis-à-vis the marketization. Policy towards long-term care for seniors was a main policy field in which market principles were introduced. The paper aims to answer the question: What is the role of cultural change for the explanation of cross-national differences in the forms of marketization in care policy? As theoretical basis we use the theoretical approach to the interaction of cultural change and institutional change in welfare states by Pfau-Effinger (2005, 2008). We will apply the method of process tracing in order to analyze the role of cultural ideas in the historical processes, contradictions and conflicts that have led to welfare state reforms which strengthened market principles in care policies. The study will be based on a comparative cross-national study for three European countries in the context of the DFG project CAPOFAM.