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Personalized budgets and direct payments

Conference Sofia May 2007

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Aspects

•First ideas and first reactions

•Payment and bottlenecks

•Positions and discussions

•Stake-holders views

•Accepted models

•Perspectives

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First ideas and first reactions• Panacea• Threat• Black economy• Grandma in the coal-shed• Unemployment• Overspending• Cost-reduction

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Payments and bottlenecks(1)

• Services paid by governments• Part of social security• Based on: bed, place• Three parties: user, provider, third

paying• Own contribution• Limited or no influence

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Payment and bottlenecks (2)• Paradigm changes to be cashed

• Specialised services

• Differentiation

• One bed: 15 users

• Increasing special needs

• Governments stepping back

• Market-orientation

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positions

• No patronizing

• Jetzt entscheide ich selbst

• I am the boss

• Wie betaalt bepaalt

• The might is the right

• Avoir c’s pouvoir

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Discussions

• No doubt about the paradigm

• Equal rights and participation accepted

• But what about the consequences

• Are we ready for changing the system

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Stake-holders (1)

Service providers:

• We know what is needed

• Mission impossible

• Complicated

• Not a free market

• Users capable?

• Staff?

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Stake-holders (2)

Governement:

• Support service-users

• Market

• Black money

• Employment

• Cost-reduction

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Accepted models

• Own budget

•Voucher system

•In natura

•Payment on the basis of assessment

•Care weight as basis

•Integration budget

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Perspectives• Accepted as consequences of the

paradigm change

• Increasing interest from all stake-holders

• Challenging providers

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Perspectvies

• Inclusive services

• Service providers as specialist

• Special attention for special needs

• Increasing number of participants

• With drawing governments

• More market regulation

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