Varieties of welfare markets from a street‐level perspective: Comparing long‐term care services in Germany and Israel

• Published date: 01 March 2023
• Author: Nissim Cohen,Tanja Klenk,Maayan Davidovitz,Sarah Cardaun
• Date: 01 March 2023
• DOI: http://doi.org/10.1111/puar.13549

RESEARCH ARTICLE

Varieties of welfare markets from a street-level perspective:

Comparing long-term care services in Germany and Israel

Nissim Cohen

1

| Tanja Klenk

2

| Maayan Davidovitz

3

| Sarah Cardaun

4

1

The Division of Public Administration and

Policy, University of Haifa, Haifa, Israel

2

Professorship for Public Policy and Public

Administration, Helmut Schmidt University/

University of the Federal Armed Forces

Hamburg, Hamburg, Germany

3

Wagner Graduate School of Public Service, New

York University, New York City, New York, USA

4

Faculty of Economics and Social Sciences,

Helmut Schmidt University/University of the

Federal Armed Forces Hamburg, Hamburg,

Germany

Correspondence

Maayan Davidovitz, Wagner Graduate School of

Public Service, New York University, New York

City, NY, USA.

Email: maayandavidovitz@gmail.com

Funding information

German-Israel Foundation for Scientific

Research & Development, Grant/Award Number:

I-1414-119.4/2017

Abstract

How does the marketization of social service provision impact the practices of

street-level bureaucrats (SLBs) towards their clients? To explore this question, we

compare the markets for ambulatory long-term care for the elderly in Germany

and Israel, which differ in the latitude of choice offered to clients and the intensity

of state regulation. Based on 52 qualitative interviews with SLBs and managers of

care providers, our study shows that in both countries, institutional contexts play a

significant role in shaping street-level bureaucracy practices. We found that SLBs

and managers in Israel engage in entrepreneurial behavior, whereas their German

counterparts adopt administrative practices. By identifying these tendencies as

responses to the respective welfare market characteristics, the article makes an

important contribution to the field of comparative SLB research and furthers our

understanding of the broader implications of the marketization of welfare services.

Evidence for practice

•This comparative study of long-term care providers in marketized institutional

settings shows that different types of welfare markets impact the practices of

street-level bureaucrats (SLBs) towards clients differently.

•The findings from our qualitative interviews provide evidence that consumer-

driven markets (Israel) encourage both SLBs and their managers to engage in

entrepreneurial behavior. In contrast, our interviewees working in a state-driven

market (Germany) do not behave entrepreneurially but have a strong focus on

administrative practices.

•State-driven markets do not necessarily lead to “moving away from”or “against

clients.”In fact, home care nurses and their managers in both countries use their

own resources and “move towards clients”due to professional considerations

and—in the Israeli case—business orientation.

INTRODUCTION

Relationships and exchanges of street-level bureaucrats

(SLBs) with clients are the focus of many implementation

studies. Scholars use various approaches to discuss how

these interactions shape public service production. Given

SLBs’considerable discretion in their day-to-day practices

(Dias & Maynard-Moody, 2007; Lipsky, 2010, p. 3), they are

the actors who decide de facto how to distribute social

(Gofen, 2014) and personal (Lavee, 2021) resources to cli-

ents. Usually, the literature highlights the role of street-

level bureaucracy perceptions (Lavee & Strier, 2019) and

their attitudes towards clients (Keulemans & Van de

Walle, 2020) in understanding their behavior.

SLB practices are always embedded in a context

(Hupe, 2019). In recent decades, however, New Public

Management (NPM) reforms, including the introduction

of quasi-markets, have radically altered this context.

These reforms have changed both the work environments

Nissim Cohen, Tanja Klenk, Maayan Davidovitz and Sarah Cardaun contributed

equally to this article.

Received: 2 August 2021 Revised: 13 July 2022 Accepted: 31 July 2022

DOI: 10.1111/puar.13549

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribu tion and reproduction in any medium, provided the

original work is properly cited.

© 2022 The Authors. Public Administration Review published by Wiley Periodicals LLC on behalf of American Society for Public Administration.

Public Admin Rev. 2023;83:419–428. wileyonlinelibrary.com/journal/puar 419