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Winds of Change: from public toprivate, from collective to
individual.
Aaron ReevesInternational Inequalities Institute
London School of Economics and Political ScienceEmail: [email protected]: @aaronsreeves
November 2, 2017
‘WHERE BETTER TARGETINGCAN BE ACHIEVED, OR FROMWHICH THE PUBLIC SECTORCAN WITHDRAW ALTOGETHER’
Shifting away from the public sector
-10 -5 0 5 10 15 20
Percentage point change in public health spendingas proportion of all health spending
NetherlandsChile
SwitzerlandLatvia
GermanyUnited States
NorwayFinland
BelgiumItaly
IcelandLuxembourg
DenmarkAustriaPolandCanadaFrance
United KingdomSpain
EstoniaSloveniaHungarySweden
IsraelGreece
PortugalCzech Republic
IrelandSlovak Republic
Source: OECD
Financing, provision, and decision
0
10
20
30
40
50
Prop
ortio
n of
all
expe
nditu
re (%
)
1979 1995 2007
Pure Public Mixed PublicMixed Private Pure Private
Source: Hills, J. 2011. "The Changing Architecture of the UK Welfare State." Oxford Review of Economic Policy 27(4).
POLICY DRIFT
Policy drift
‘Shifting social context’ and ‘changing risks’
‘Deliberate efforts by political actors to prevent therecalibration of social programs’
Hacker J., 2004, Privatizing Risk without Privatizing the Welfare State: The Hidden Politics of Social Policy Retrenchmentin the United States, American Political Science Review.
Policy drift and the minimum wage
USA
Belgium
5000
10000
15000
20000
25000
1975 1980 1985 1990 1995 2000 2005 2010 2015
Year
Nat
iona
l min
imum
wag
e(A
djus
ted
for
infl
atio
n, P
PP,
201
4 U
SD
)
Source: OECD
Policy drift and the UK NHS
Largest ever
sustained reduction
in NHS spending
as a % of GDP
0
1
2
3
4
5
6
7
8
9
1980 1985 1990 1995 2000 2005 2010 2015 2020
Year
Exp
endi
ture
on
UK
Nat
iona
l Hea
lth
Ser
vice
(% o
f G
DP
)
OUT-SOURCING