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Nursing homes are where some of the most vulnerable live and work. In too many homes, the conditions of work make it difficult to make care as good as it can be. For the last eight years an international team from Germany, Sweden, Norway, the UK, the US and Canada have been searching for promising practices that treat residents, families and staff with dignity and respect in ways that can also bring joy. While we did find ideas worth sharing, we also saw a disturbing trend toward privatization. Privatization is the process of moving away not only from public delivery and public payment for health services but also from a commitment to shared responsibility, democratic decision-making, and the idea that the public sector operates according to a logic of service to all. This book documents moves toward privatization in the six countries and their consequences for families, staff, residents, and, eventually, us all. None of the countries has escaped pressure from powerful forces in and outside government pushing for privatization in all its forms. However, the wide variations in the extent and nature of privatization indicate privatization is not inevitable and our research shows there are alternatives.
Looking at the theory and practice of privatization in its broadest manifestations, the contributors to this volume scrutinize the combination of public and private initiatives that makes up the present U.S. social sector. As they discuss privatization both in production and delivery of services and in financing, they reveal complexities that have been ignored in recent ideological arguments. This book, while warning about political misuse of privatization, offers an unusually rigorous definition and theory of the concept and presents a number of case studies that show how public and private sectors variously cooperate, compete, or complement one another in social programs--and how various systems have accommodated to the privatization rhetoric that has come to the fore under the Reagan administration. The contributors are Marc Bendick, Jr., Evelyn Z. Brodkin, Arnold Gurin, Alfred J. Kahn, Sheila B. Kamerman, Michael O'Higgins, Martin Rein Richard Rose, Paul Starr, Mitchell Sviridoff, and Dennis Young. Originally published in 1989. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.
This book provides a detailed microeconomic analysis of the impact of various privatizations in different countries in the region. Its central message is that in many cases, contrary to popular belief, society as a whole and in particular the poor have benefited from privatization. The book presents a careful analysis of the various mechanisms through which privatization has an impact on welfare, an analysis that by and large has been missing from the debate. Case studies of water sector privatization in Argentina and Colombia, and also the telecom industry in Peru are included.
Focusing on health care, education, and elderly care, Privatizing Welfare Services draws on extensive research on the consequences of introducing market-based mechanisms to deliver welfare services. Empirical evidence over the last few decades is summarized and condensed to policy lessons. How to balance equity and efficiency is a central theme. The book also addresses the challenges of financing the Swedish model of welfare services as well as the importance of management practices and public opinion. The privatization of service production has occurred despite major political controversy between two competing visions for the welfare state. Successful experiments have spread organically to neighbouring municipalities. What was done well in this process and what were the mistakes? The book addresses the fundamental economic challenges, the trends of the future, and the implications for institutional design.
Through research in the field of social care in six European Countries (France, Germany, Italy, Norway, Spain and the U.K.) the authors of this volume highlight the role of nonprofit and commercial organizations in the new "welfare mix systems" and main social and institutional effects of such new order. This volume in the Nonprofit and Civil Society Studies series is the first attempt to bridge the relevant gap existing between the literature on the welfare state and studies on the nonprofit sector.
Why government outsourcing of public powers is making us less free Many governmental functions today—from the management of prisons and welfare offices to warfare and financial regulation—are outsourced to private entities. Education and health care are funded in part through private philanthropy rather than taxation. Can a privatized government rule legitimately? The Privatized State argues that it cannot. In this boldly provocative book, Chiara Cordelli argues that privatization constitutes a regression to a precivil condition—what philosophers centuries ago called "a state of nature." Developing a compelling case for the democratic state and its administrative apparatus, she shows how privatization reproduces the very same defects that Enlightenment thinkers attributed to the precivil condition, and which only properly constituted political institutions can overcome—defects such as provisional justice, undue dependence, and unfreedom. Cordelli advocates for constitutional limits on privatization and a more democratic system of public administration, and lays out the central responsibilities of private actors in contexts where governance is already extensively privatized. Charting a way forward, she presents a new conceptual account of political representation and novel philosophical theories of democratic authority and legitimate lawmaking. The Privatized State shows how privatization undermines the very reason political institutions exist in the first place, and advocates for a new way of administering public affairs that is more democratic and just.
This provocative report examines the trend toward competitive contracting of government functions. By focusing on four jurisdictions that hired private firms to handle welfare-to-work services, The Welfare Marketplace reveals the ways in which increased contracting with the private and nonprofit sectors is changing the role and capacity of government, threatening accountability and responsiveness to groups with special needs. Encouraging improved performance through market mechanisms creates particular challenges for the nonprofits who must balance their missions with the bottom line. The organization of service delivery to welfare clients has undergone significant restructuring as a result of the 1996 Welfare Reform Act, which encouraged states to contract with outside companies and for the first time allowed them to determine eligibility for welfare benefits. Seeking to assess the impact of this development, M. Bryna Sanger studied the competitive contract environment in San Diego, Milwaukee, New York, and Houston. Interviewing contracters, public officials, opinion leaders, and researchers revealed the comparative advantages of a variety of key players in the multi-sector service industry. Sanger's conclusions paint a complex picture of how competitive contracting arrangements have changed the ways vendors and government agencies serve their clients. While performance and innovation have improved in some cases, all the players are finding that adequate accountability and contract monitoring are more difficult and expensive than anticipated. Both for profits and nonprofits are quickly draining talent and capacity as they compete for experienced executives from government and from each other. Sanger argues that competitive contracting is here to stay, but it will require more—not less—government management and oversight. She urges scholars and practitioners to develop a more nuanced and sophisticated set of expectations about the costs and
This book deals with the quest for a divided welfare state in Sweden. The prime example is the rapid rise of private health insurance, which now constitutes a parallel system characterized by state subsidies for some and not for others. This functions as a kind of reverse means-testing, whereby primarily the upper classes get state support for new types of welfare consumption. Innovatively, Lapidus explains how such a parallel system requires not only direct and statutory state support but also indirect support, for example, from infrastructure built for the public health system. He goes on to examine how semi-private welfare funding is dependent on private provision and how the so-called 'hidden welfare state' gradually erodes the visible and former universal welfare state model, in direct contrast to its own stated goals. Who benefits from privatized welfare? How are the privatization of delivery and the privatization of funding linked? How does this impact public willingness to pay tax? All of these questions and more are discussed in this accessible volume.
Originally published in 1988, this book offers the first comprehensive and critical analysis of the privatisation of public housing in Britain. It outlines the historical background to the growth of public housing and the developing political debatea surrounding its disposal. The main emphasis in the book, however, is on the ways in which privatisation in housing links to other key changes in British society. The long trend for British social housing to become a welfare housing sector is related to evidence of growing social polarisation and segregation. Within this overall context, the book explores the uneven spatial and social consequences of the policy.
This volume represents the most important work to date on one of the pressing policy issues of the moment: the privatization of social security. Although social security is facing enormous fiscal pressure in the face of an aging population, there has been relatively little published on the fundamentals of essential reform through privatization. Privatizing Social Security fills this void by studying the methods and problems involved in shifting from the current system to one based on mandatory saving in individual accounts. "Timely and important. . . . [Privatizing Social Security] presents a forceful case for a radical shift from the existing unfunded, pay-as-you-go single national program to a mandatory funded program with individual savings accounts. . . . An extensive analysis of how a privatized plan would work in the United States is supplemented with the experiences of five other countries that have privatized plans." —Library Journal "[A] high-powered collection of essays by top experts in the field."—Timothy Taylor, Public Interest