Conclusion: Revisiting the Public-Private Dichotomy

Abstract

The public-private dichotomy is a controversial analytical device used by experts and policymakers to designate responsibilities for social policy. It is prominently referred to in debates over the futures of both health care and pension policies. This volume shows that lines separating public from private social provisions can be hard to draw, not only in the United States but in other countries as well. The volume calls into question the utility of a strict analytical separation between public and private policies while suggesting that its application to health and pension policies is problematic. This is true largely because, due to major institutional and political variations, the public-private dichotomy takes a different meaning from one country to another—or even from one policy area to another within the same country. Adopting a simplistic understanding of the public-private dichotomy is inappropriate because it may thwart democratic efforts to reform and improve existing social policy systems by obscuring their inherent complexity.