Health in the Welfare State
Purpose: To introduce and compare the different types of welfare state and the role of
health policy in them.
1. Learn what welfare states are and why the Canadian welfare state emerged.
2. Introduce theories developed to understand different characteristics of welfare
states and the influences that shaped their development.
3. Consider the influence of different types of welfare states on health expenditure
and health outcomes.
4. Explore challenges to the welfare state.
• Defining the “welfare state”- state where the government plays a role in the social
well being of its citizens: public responsibility for people who can’t provide for
themselves and the equitable distribution of wealth
• Some degrees it’s an intervention state
• Types of intervention: healthcare, education, training,
employment insurance, pensions, social assistance
• The Canadian welfare state- governments spend through economic downturn-
with this spending you can manage inflation and spending, employment
o Residual-institutional- dichotomous typology- give a less developed
welfare state- benefits are lower; (lose your job you won’t get as much
money), not a universal or comprehensive state- directs it to those who
needs it the most
Comes with it means testing
Residual approach is a reactive approach- how can we cope with
situations when they happen
Institutional approach- social investment- welfare state program is
an entitlement program- you’re entitled to it by virtue of
Institutional welfare state- is about pr