Long-Term Care Italian Policies: A Case of Inertial Institutional Change

The Transformation of Care in European Societies

“…Or, again, the provision of formal care might be more dependent on the presence of severe limitations with daily living activities in Italy -where the threshold of dependency above which one is entitled to receive support is very high -than in countries where access to services and transfers is also granted to those with moderate care needs, such as Germany and Austria (Burau and Dahl, 2013;Costa, 2013;Theobald and Hampel, 2013). For instance, the role of household composition -and thus the presence or absence of a partnershould be more relevant in the familistic welfare systems of the Mediterranean countries than in Denmark -characterised by an universalistic approach to LTC policies.…”

“…Nevertheless, even for the first case, it remains a question whether quality is hollowed out with cuts in staff and opening hours. Cash programmes have also been extended (Italy, Spain), which have, paradoxically, fostered the use of migrant care workers (Costa, 2013;Ibáñez and León, 2014;. While market principles and universalism had been going hand in hand until the 1990s and early 2000s, in the most recent years, however, marketisation of care has been increasingly replaced by processes leading to the privatisation/commodification of care (Meagher and Szebehely, 2013).…”

“…Whereas other latecomer European countries have introduced relevant reforms in public care policies, institutional inertia has been the main characteristic in Italy (Costa, 2012;Da Roit and Sabatinelli, 2013;Ranci and Pavolini, 2012). Welfare policy has long implicitly supported family networks in providing the most vulnerable people with care and services, with comparatively low public provision .…”

Not all that glitters is gold: Long-term care reforms in the last two decades in Europe

“…After a period of experimentation, in 2002, France adopted the 'APA' ('personal allowance for autonomy') (Le Bihan and Martin, 2013). In Italy, no relevant LTC policy changes took place in the last two decades (Costa, 2013). The Czech Republic was the first Central-Eastern European country to establish a new LTC system in 2006 with the promulgation of an Act on Social Services (Barvíková and Oesterle, 2013), which introduced a new care allowance.…”

“…The Czech Republic was the first Central-Eastern European country to establish a new LTC system in 2006 with the promulgation of an Act on Social Services (Barvíková and Oesterle, 2013), which introduced a new care allowance. Another important element which is shared by England and Italy is that, apart from what happened in services, an expansion of social transfers to beneficiaries took place: in both countries, the percentage of older people receiving allowances almost doubled over the last 15-20 years (Beasley, 2010;Costa, 2013). Among them, only Germany adopted a strictly 'social insurance model'; elsewhere, the financing was more mixed and often based on fiscal revenues.…”