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Int J Health Serv ; 32(2): 255-77, 2002.
Article in English | MEDLINE | ID: mdl-12067031

ABSTRACT

Accounts of the future of the welfare state are often presented in crisis terms. Some commentators identify globalization as a force that has already led to a major retreat by the state and is likely to lead to further downsizing of the public sector. Others see the future burden of an aging population as creating huge public expenditure pressures that can be countered only by increased parsimony in most areas of spending. Although both crisis scenarios contain elements of truth, analysis of recent public expenditure trends shows that both are substantially exaggerated as general representations of likely developments over the next two or three decades. However, unnoticed by most commentators, a real, longer-term crisis is beginning to make itself felt. This crisis arises, in part, from the demographic impact of a cultural transformation in the labor market, in progress for several decades. Extreme scenarios of possible consequences over the next 50 to 100 years include population implosion, mass migration, increasingly dangerous eruptions of right-wing populism, and, possibly, territorial conflict between developed and underdeveloped nations. This is not a crisis of the welfare state but rather a crisis for which the welfare state may be an essential part of the answer. The only way Western societies can lessen the future impact of the ongoing cultural transformation of the labor market is through the redesign of welfare state institutions to confront these new challenges.


Subject(s)
Employment/trends , International Cooperation , Population Dynamics , Public Sector/trends , Social Welfare/trends , Socialism/trends , Aged , Birth Rate/trends , Conflict of Interest , Developed Countries/economics , Developing Countries/economics , Emigration and Immigration , Female , Financing, Government/trends , Forecasting , Humans , Models, Statistical , Politics , Social Welfare/economics , Socialism/economics
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