To date, social long-term care insurance (SLTCI) systems have been introduced in six countries globally: the Netherlands, Israel, Germany, Japan, Luxembourg and South Korea. Applying an actor-centred, multi-dimensional framework and fuzzy-set analysis, the present article investigates the typical characteristics and variations of these SLTCI schemes at introduction and today. In short, we find that the SLTCI model features dominant social contribution financing, a mix of for- and non-profit providers, and state regulation. In light of the relevance of corporate self-regulation often associated with social insurance systems, the dominance of state regulation is unexpected. The analysis also reveals considerable variance between cases, most notably concerning the extent of private individual actors’ involvement. While geographical proximity of countries does not explain differences between SLTCI systems, “temporal clusters” seem to partly drive the variation of SLTCI actor configurations.

This article provides an overview of the scholarship on healthcare reform in democratic middle-income countries through comparative cases from Indonesia and Thailand. This study identifies the reasons why Thailand has achieved universal healthcare faster than Indonesia and analyses the policy outputs towards universalism resulting from unfolding reforms. Taking a closer look at the causal mechanisms underpinning healthcare developments (clientelistic-based mechanism and limited vertical alliance-based mechanism), we discuss how changes in political economy have enhanced the state’s intervention in the healthcare sector while reproducing the fragmented and stratified nature of the system. Based on coverage, generosity and financial risk protection, Thailand has a higher degree of universalism in comparison with Indonesia. The article suggests that the welfare regime now governing healthcare can be conceptualised as a developmental-universalist state, while noting a less-effective model for Indonesia and a more effective model for Thailand.

This introductory essay situates the papers in this Thematic Section within the background of social policy development in the Western Balkans during the long period of transition following the break-up of former Yugoslavia. We identify three stages of transformation of social protection policies. The first, in the 1990s, was characterised by a continuation of the Yugoslav legacy of social insurance, while many work-based benefits were lost during privatisation. In the second stage, international institutions promoted individualised social protection policies, taken up in some countries but avoided in others. In the third phase, EU influence on social policies accompanied the prolonged EU accession process, with an emphasis on the introduction of work-care policies, early childhood education and the remediation of in-work poverty. The four papers address these issues in greater detail and provide a basis for re-evaluating progress with social protection policies in the Western Balkans in the future.

This paper analyses social protection expenditure, its financing and its correlation with redistribution effects in the European Union (EU) candidate and potential candidate countries from the Western Balkans – Albania, Bosnia and Herzegovina, North Macedonia, Montenegro, Kosovo and Serbia. Although social expenditure in the Western Balkans varies between countries in terms of the extent and functions, in general, it is growing and concentrates on the elderly population. The expenditure is strongly redistributive towards old age, but is less efficient in reducing extensive child and working-age poverty. From an intergenerational perspective, despite various recent improvements, it remains significantly unbalanced compared to the EU. The expenditure reflects the design of social rights that have been shaped by the legacy of socialism and war, local politics, and international organisations perhaps more than by the impact of economic resources and aging.

Many south-east European states made the transition from socialist to market economies. All described here had to reform their pension systems to match the new context in which these operated. The experiences of 10 countries are reviewed – seven of which were once part of Yugoslavia. Some countries’ reforms were more radical than others. Five of them merely adapted the Bismarckian systems they had inherited; four others adopted the “three pillar” model that the World Bank had been propagating. One went further than that. The four who followed World Bank model were often forced to backtrack. Whatever the longer-term benefits, they generated their own shorter-term fiscal problems. Nonetheless, the most radical reformer gives some indications of possible ways forward. The south-eastern European states do not have financial markets that can support capitalised/funded pension systems. Nor do they have the resources to pay proportional pensions that, at the same time, keep retired people out of poverty. The article suggests that their governments should concentrate upon improving economic performance to satisfy longer term aspirations and on ensuring that pensioners are able to live properly if not luxuriously by using tax-financed transfer measures. Provision above this level can be secured through savings plans, but it must be accepted that the investments to secure those savings will have to be made abroad.

This article explores work-care policy development in Western Balkans, focusing on a critical assessment of the potential of the European Union’s policy framework to (re)shape the policies adopted in Western Balkans and boost gender equality in employment and care. Two policy measures at the centre of the European agenda are in focus: parenting leaves and early childhood education and care. The EU’s employment-oriented policy framework has met underdeveloped childcare services network and mother-centred and stratifying leave policies in Western Balkans, providing ample space for improvements regarding gender imbalance in care and employment. While the EU policy framework may provide an important push factor towards introducing gender-equalising policies in Western Balkans, it can also bring minimum adjustments. The EU’s ambiguous work-care policy framework, weak legitimacy of gender equality agenda and weak fiscal capacities in Western Balkans, and uncertainties about EU membership prospects may hamper progress towards more inclusive and gender-equal work-care policies.

Montenegro has the highest in-work poverty (IWP) rates among all ex-Yugoslav countries. Although the IWP rate in Montenegro is significantly below the average poverty rate for the entire population, it has increased substantially since 2013. Despite that, IWP is rarely discussed as an important topic in the media or by policymakers, although some policies do target the working population at risk. This article starts with the identification of factors that affect IWP and differences in IWP of specific population groups between Montenegro and selected ex-Yugoslav countries (Slovenia and Serbia). As low earnings and low wages from employment are the main causes of IWP, the article focuses on the analysis of policies that influence income: minimum wage policy, family policy and tax policy and their influence on IWP of specific population groups. We use SILC data to map trends of IWP, while further analysis is based on desk review and expert interviews. We conclude that the approach to IWP in Montenegro requires more integrated policies that should target population groups most exposed to IWP.