Welfare and Long-term care in the East and West: Cross-national inequalities

Purpose - This paper provides an overview of the inequalities between three countries England, the Netherlands and Taiwan in relation to the welfare and long-term care of older people. It compares the positive and negative distinctions between the respective countries and their systems. Design/methodology/approach - This paper discusses and analyses data from public sources and literature and measures the similarities and differences between demographic and social issues, the cultural and political differences shaping policy objectives, economic constraints and long-term care services. Findings - All three countries face similar pressure in long-term care provision of ageing populations, funding limitations and shrinking numbers of carers. None of the countries studied completely conforms to Esping-Andersens ideal types; instead they seem to constitute hybrids. The care system in the Dutch social democratic-conservative welfare regime seems to provide wider support for older people who need care, the English liberal-social democratic welfare regime comes second and Taiwanese conservative-liberal welfare regime comes third. Overall, some converse trends of the long-term care systems indicate a narrowing of the gap in responsibility between state, family and individuals in the East and the West. Research limitations/implications - The difficulties in comparing national and even international databases are well known as they are not always strictly comparable. Therefore I have indicated specific anomalies where they occur. While such indicators need to be treated with care, nevertheless they supply us with a basic understanding of social, political and economic circumstances. Practical implications - The paper contributes suggestions to further research in the area of elements and structures of care systems support and the failure to provide ongoing quality of long-term care and reflects on the implications for the global market of care-workers and the extensive use of migrant workers in the field. Originality/value - The paper provides a detailed consideration of the wide-ranging issues that impact on older peoples care provision in England, the Netherlands and Taiwan.