Salvatore Picconi

Ltc Between First and Second Welfare. The Home Care Premium Scheme: Social Innovation or Italian Style Welfare?

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Abstract

The aging of the Italian population and a rise in the chronic states of illness primarily among the elderly, call for re-thinking policies for long-term care. So far, the main focus has been on strategies of retrenchment in public expenditure using a mix of new resources and new actors from outside the scope of the public welfare system. This article investigates the potential of a new supplementary welfare plan for non-self-sufficient subjects: the Home Care Premium (HCP). This occupational welfare plan only covers public employees and their families, and is now managed by the Italian National Institute of Social Security (INPS). Initially, the article focuses on the concept of dependency as a social risk and the Italian long-term care model, specifically the role of the INPS. Then it presents quantitative data on the HCP program, with reference to the distribution of benefits by geographical area, sex and age. The evidence shows that a disproportionate amount of the benefits goes to Southern Italy, and the author highlights the factors that could explain this outcome. The last section discusses the ambiguities of the program which introduces a number of interesting innovations while also reinforcing the Italian welfare states' distributive distorsions.

Keywords

  • Social Risk
  • Long-Term Care
  • Impoverishment
  • Supplementary Welfare
  • LTC Insurance

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