When is Choice Possible in Social Security?
| Author | Bent Greve |
| DOI | 10.1177/138826270300500404 |
| Published date | 01 December 2003 |
| Date | 01 December 2003 |
| Subject Matter | Article |
WHEN IS CHOICE POSSIBLE IN SOCIAL SECURITY?
Bent Greve*
Abstract
In recent years, the provision of public services has been reformed in many
European welfare states. Inspired by ‘Public Choice’ and ‘New Public Management’
thinking, changes have emphasised competition, user involvement, and more
efficient service delivery. Quasi-markets and vouchers have often been central
elements in these developments.
The provision of services – public or private – can be regarded as an alternative to
the provision of support in cash. Thus, the choice between income transfers and
service delivery e.g. in relation to care of the elderly or of children, will have a
(quantitative and qualitative) effect on the ways in which society supports the
provision of care.
This article describes these changes and analyses new modes of delivery (which are
often associated with ‘marketisation’). It discusses when choice is possible for service
users and whether, given the need for greater efficiency, it can be combined with use
of the market-mechanism. It specifically analyse the use of vouchers and the
conditions under which vouchers can contribute to achieving the combination of
increased empowerment of users and greater efficiency without having a
detrimental impact on access to services or the distribution of welfare. Vouchers
are employed as a means of ascertaining whether, and under what conditions,
choice is possible. In this sense greater use of free choice is construed as being positive
if it can combine increased empowerment and greater efficiency without any
negative distributional impact.
The paper concentrates on elements of choice within the social services, emphasising
variations between different service areas. It concludes by attempting to emphasise
the aspects that decision-makers must be aware of when increasing the extent of
choice offered to the users of public services.
European Journal of Social Security, Volume 5 (2003), No. 4 323
* Professor in Welfare State Analysis, Department of Social Sciences, Roskilde Universitetscen-
ter, Postboks 260, 4000 Roskilde University, Denmark. E-mail: bgr@ruc.dk
324 Intersentia
1. INTRODUCTION
The market is often regarded as the optimal means of distributing goods
and services in society. In a large number of cases, the market is perceived as
being both efficient and proficient at insuring the optimisation of resources
in society. At the same time, it ensures that a sufficient supply of goods is
available to consumers at the best possible price.
However, it is not clear that this is the case with the provision of services
within the public sector. It is therefore not clear whether the market can
ensure that the individual has the greatest amount of choice within the
public sector. The pivotal point of the analysis presented below is an account
of the conditions under which choice – understood here as free choice – is
possible within delivery of services whether by private or public provider.
This must be seen in light of the fact that marketisation has become a central
theme in a number of national welfare system reforms. These reforms were
originally proposed on the basis of an analysis put forward by thinkers
associated with the New Right (Kelley, 1997; Clarke et al., 2000), but, in
recent years a greater utilisation of the market has also been advocated by
those associated with the so-called ‘Third Way’ (Giddens, 1998). Criticism of
the welfare state, including its legitimacy problems, has also been used as an
argument for an increased decentralisation of the welfare state and need for
the greater empowerment of users (Offe, 1984). In general, over the course
of the 1980s, increasing attention was directed to the need for users to be
given greater influence and for bureaucracy to be reduced (Blomqvist and
Rothstein, 2000).
As Cutler and Waine (2000) point out, reforms to the welfare state have
pointed to the conflict between «improved performance measurement and
performance management; between promoting access to health care and
the private finance initiative». Their analysis can be extended from health
care to care in general.
This paper focuses on the service dimension of the welfare state. It discusses
the conditions that have to be fulfilled if choice is to be a genuine possibility,
as seen from the perspective of the individual. Two other themes that could
have been discussed are therefore omitted: first, the paper largely ignores
the societal perspective, including possible societal expenses associated with
a high degree of free choice. Second, it largely ignores the subject of
transfers, including the individual’s opportunity to choose between various
providers of social security. However, a number of issues in the analysis
below have an affinity with choice between different social security schemes.
This is especially so in relation to being able to survey and assess the supply
of pension schemes and to the choice between different suppliers. Parts of
Bent Greve
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