Stratification in Changing Swedish Sickness Insurance
| Published date | 01 December 2015 |
| Author | Nadja Grees |
| Date | 01 December 2015 |
| DOI | 10.1177/138826271501700404 |
| Subject Matter | Article |
European Jour nal of Social Sec urity, Volume 17 (2015), No. 4 453
STRATIFICATION IN CHANGING
SWEDISHSICKNESS INSURANCE
N G*
Abstract
is paper proposes an analytical approach to capturing gradual in stitutional change
in mature welfare states. e approach takes account of both public and occupational
provisions of income security and investigates di erences between diverse groups in
the labour market, various income l evels within such groups, as well as changes over
time. e analytical approach is then applied to the empirical case of Swedish sickness
insuran ce, on which n ew data cove ring the la st 30 years h ave been coll ected. e results
show that sickness insurance as a whole still o ers generous replacement rates but
that there has been an institutional shi in the provision of income protection. e
earlier system of universal public provision that was closely related to former income
has developed into a system where this is the case only for certain groups in the labour
market while the rest are dependent on collectively negotiated solutions. Accordingly,
the traditional Swedish institutional model in which an all- encompassing public system
promotes equality of status has been transformed over time. In the absence of an
adequate analytical approach this is a fact that has not been fully recognised in earlier
welfare state research.
Keywords: occupational welfare; sickness insurance; social policy analysis;
strati cation; Sweden
1. INTRODUCTION
It is a well-known fact that t he contemporary welfare state faces a number of cha llenges
in the form of new social, economic and demographic conditions and perhaps also
changed political priorities. In response to such chal lenges and developments, the
welfare state is likely to cha nge.
Despite the fact that we assume t hat welfare states e volve over time, the classical
approach to social policy focu ses on the rise and development of instit utional struct ures
* Department of G overnment, Uppsala University, Box 514, SE-751 20 Uppsala, Sweden, phone : +46
76 820 4338, e-mail: nadja .grees@statsvet.uu. se.
Nadja Grees
454 Intersentia
and outcomes of the welfare state. In what way the mature welfare state is likely to
develop further or cha nge is not fully captured in the traditional strand of welfare
literature. Nor has this be en its aim. However, when the aim is to capture whether, and
if so how, a speci c welfare system adjusts to the contemporar y social, economic and
political chal lenges it may face, a di erent and more elaborated analytica l approach
from the ones that have been used ea rlier is needed.
Such an approach needs to go fur ther than the customary empirical focus on
the public side of provision and should also include the increasingly important
occupational side of social policy. Likewise, the requisite analytical approach has to
go beyond the tendency to treat the populat ion as a homogeneous mass that enjoys
the right s of the social s ecurity syste m on an equal basi s and, according ly, move away
from calculations based on the average production worker. Last but not least, the
analytical approach has to be able to identify and theoretically expla in institutional
change over time, even when it is neither abrupt nor exogenously generated.
Public sickness insu rance in Sweden has gone through a number of changes over
the last decades, decreasing the generosity of the system, but whet her or not this
has had any implications for the institutional structu re of the system as a whole is
still an open question. Accordingly it is sti ll unknown whether, and if so to what
degree, occupational insu rance lls the insura nce gap created by a less inclusive
public insurance system. Since the regulat ion of occupational insurance di ers
between labour market groups and by income levels, such an insura nce gap is likely
to di er between groups in society. If it is possible to discern distinct insurance gaps
by category, this will have implications for strati cation in Swedish society. If this
is the case, it is at odds for a countr y like Sweden with classical theoretica l welfare
state research. Such a system would be expected to deliberately attempt to eli minate
di erentials between population groups, i n order to achieve equality of treatment and
broad solidarity.
I argue that the application of the suggested analy tical approach to the Swedish
case o ers an opport unity to answer the question guiding t his study: how do public
and occupational domains within sickness insurance interact with one another?
More precisely, this study deals wit h the degree to which Swedish public sick ness
insurance and col lectively negotiated occupational sick ness insurance, individually
and taken together, replace former income. It also dea ls with the degree to which
income protection (in terms of replacement rates) during periods of sickne ss, depends
on labour market group and income level. By answering these questions, this study
will provides insig hts into how a mature welfare state may develop institutional ly in
response to contemporary challenges .
is article ma kes two contributions to the eld of welfare state research. First,
it demonstrates that a di erent and more elaborate analytical approach is needed
to capture the gradua l institutional development of a mature welfa re state. Such an
approach takes account not only of public but also occ upational provision of income
security, and investigates di erences between diverse g roups in the labour market
To continue reading
Request your trial