Toward Global Welfare State Convergence?: Family Policy and Health Care in Sweden, Canada and the United States

Accounts of the welfare state and the dynamics governing its development have been pivotal and highly contentious in the social policy literature over the past few decades. Since the 1980s, research has suggested that, as a result of domestic pressures and strains and/or the impact of globalization, welfare states were declining in tandem. However, most of these studies were quantitative, focusing upon 18 or more advanced capitalist nations and, in their search to uncover broad cross-national trends, utilized narrow welfare state indicators. This study investigates the extent to which the social democratic welfare state in Sweden, the social liberal welfare state in Canada, and the liberal welfare state in the United States have converged. It takes a qualitative approach, examining the character of the income security and social service programs in two broad policy domains--family policy and health care--and concludes that the welfare states in the three nations remain distinct, while acknowledging some broadly similar trends and new developments. Keywords: convergence, globalization, policy domains, programmatic and structural change, crisis, family policy, health care policy, income security/maintenance, social services Introduction Accounts of the welfare state and the dynamics governing its development have been pivotal and highly contentious in the social policy literature over the past few decades. In the 1980s numerous studies from across the political spectrum declared that they were everywhere in crisis, beset by new unremitting pressures and constraints which would ultimately lead to their demise. Subsequent research, however, disputed these bleak accounts of inevitable cross-national convergence, highlighting significant variation in the face of widespread and broadly similar cutbacks and reforms (cf. e.g., Alber, 1988; Mishra 1984; O'Connor, 1973). Since the 1990s the focus has shifted toward the impact of global integration, but the debate has been very similar. Studies describing or predicting a cross-national race-to-the-bottom suggested that increasingly permeable borders in the spheres of commerce, production and finance have set increasingly stringent limits on state autonomy and national policy options, whatever the nature of domestic public opinion or political stripe of incumbent governments (Clayton and Pontusson, 1998; Fulcher, 1994; Gilbert, 2002; Goodman and Pauly, 1993; Mishra, 1999). But the conclusions of these studies have also been challenged. Some researchers were skeptical of the globalization thesis itself, noting that most developed welfare states have often been found in nations, such as the Nordic lands, with the most open borders because comprehensive networks of social policies can greatly minimize economic uncertainty and socio-political instability (Cameron, 1978; Garrett and Mitchell 2001; Rodrik,1998). Others largely accepted the idea of a downward pressure exerted by economic integration but argued that the forces of globalization are refracted through very different conditions, institutions, and historical traditions across nations, rendering welfare states more or less vulnerable to these forces and preventing any form of meaningful convergence (cf. Bradley et al., 2005; Castles, 2004; Huber and Stephens, 2001: Navarro et al., 2004; Olsen, 2002; Swank, 2002). Despite their varying conclusions, most studies addressing the fate of welfare states to date have been quantitative, utilizing large aggregate data sets and narrow welfare-state indicators amenable to statistical analysis, such as levels of social expenditures as a percentage of GDP, replacement rate levels for major transfer programs, or public employment as a percentage of total employment. Although they have proven invaluable, these studies are limited by their restricted range of indicators. As often pointed out, a higher level of social welfare spending in a nation does not necessarily indicate greater welfare commitment; rather, it might simply reflect greater need spurred by higher levels of unemployment, population aging, or increases in the costs of program delivery. …