Long Term Care, and the Fourth Pillar of the Welfare State

This article analyses the Spanish and especially Catalan public policies for long term care. These policies change the distribution of care between family, state, and market. We have arrived at three main conclusions. Firstly, public policies complement and doesn't substitute the role of the family, which continues to have an important care role. Second, the involvement of the state does not decrease the market role. On the contrary, the market has expanded. Thirdly, public policies have not changed the gender structure. Women remain the principal caretaker and men are hardly ever involved. These policies have been halted because of the economic crisis. The social construction of women as care providers has been reinforced as the result of budget restrictions and diminished social rights.