Long-term Care Policies in Europe. Between Fiscal and Social Sustainability

Over the past two decades, many European countries have established more comprehensive long-term care policies. But this expansionary trend was accompanied by cost containment and retrenchment. This contribution discusses these developments in European long-term care policies from a sustainability perspective. Sustainability requires that current practices do not harm the opportunities of future generations. This is usually discussed in terms of financial sustainability, the question whether we can afford policies in the future. Many reports point at a growing financial burden for welfare states, which has become a major driver of cost-containment or even retrenchment policies across Europe. But these debates usually ignore the social consequences for future generations. It will be shown that cost containment measures can put the coverage of care needs, the provision of care work, and equitable access to long-term care at risk. If the sustainable development concept is taken seriously, the economic and social dimensions need to be more closely connected in long-term care policies.