Who has the responsibility to cover needs?

The focus in this chapter is that even if one, based upon objective criteria, has defined a need for a service, this does not clarify whether it is the welfare state, the market or civil society that must provide this service. It also does not clarify the scope of the service that is made available. How to determine which service the individual citizen should have will in some areas be discretionary, while in other areas (for example emergency treatment in a hospital) it is more reminiscent of a social right. The consequences of the differences are explained here, as well as the possible reasons for the variations in who has the responsibility for the service provision. The variations between welfare professionals’ assessment of what is needed, citizens’ wishes, and the possibility of financing one type of service, given that it will reduce what is available for other types of service, is further a core issue to solve. This, combined with the fact that when it comes to discretionary assessments of the need for services, also increases the risk that some people will actually receive more services than others, and thus that a new type of inequality will become a reality in different welfare states. At the same time, it is looked at whether all services must be produced directly by the public sector itself, or whether through income transfers/vouchers it will be possible for citizens to purchase this type of service themselves. This can also include a choice between different providers of services.