Universality and Choice in Health and Education

Abstract

As the discussion in Chapter 3 highlighted, in developing policies for looking after the aged and the unemployed, welfare states display a balance between obligation and entitlement. In this chapter, I show how the values pair of universality and choice structures decision-making in health and education. Hospitals and health care centres provide services that safeguard life and promote well-being, while schools prepare the next generation for work and citizenship. In meeting these goals, similar policy problems emerge: the nature of the relationship between the public and private sectors; the extent to which citizens may choose between providers; and the degree to which equality of access and equality of opportunity are underwritten by the state. ‘Universality’ (equal provision and open access for all) and ‘choice’ (provision based on personal preference) describe the two key values shaping the relationship between the citizen and the state in both these sectors.