Welfare Nationalism in Catalonia: the Interplay of National Identity and Welfare State Development in the Catalan Healthcare System
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WELFARE NATIONALISM IN CATALONIA: THE INTERPLAY OF NATIONAL IDENTITY AND WELFARE STATE DEVELOPMENT IN THE CATALAN HEALTHCARE SYSTEM © 2018 By Francisco Hernández A thesis presented in partial fulfillment of the requirements for completion Of the Bachelor of Arts degree in International Studies at the Croft Institute for International Studies The University of Mississippi University, Mississippi University, Mississippi May 2018 Approved: __________________________________ Advisor: Dr. Miguel Centellas __________________________________ Reader: Dr. William Schenck __________________________________ Reader: Dr. Joshua First Hernández ii Table of Contents 1. Introduction: Sub-State Nationalism—The Reformulation of an Old Debate ....................3 Research design ........................................................................................................................5 2. Literature Review: National Imaginaries and Social Policy ..................................................8 A brief history of Catalan nationalism .............................................................................................8 Theoretical framework of nationalism ............................................................................................10 The welfare state (and healthcare) as imbedded in the nation ..........................................................12 Table 1. Summary of relevant models of welfare states .......................................................... 17 3. Qualitative Analysis: Nationalism and Health Policy After Franco ...................................19 Nationalist Demands and Autonomy in Healthcare Policy after the Dictatorship ............................21 The Idiosyncrasies of Catalan Healthcare: In between Two Worlds of Welfare ...............................24 4. Quantitative Analysis: The Exceptionalism of Catalan Healthcare in Public Opinion ....31 Table 2. Descriptive statistics of dependent variable and independent variables .....................32 Dependent variable: Support for pro-independence parties ..........................................................33 Attitudes about Catalan healthcare system: Variables ...................................................................33 Demographic variables ..............................................................................................................35 Catalan identity variables ...........................................................................................................36 Table 3. Regression results and analysis .............................................................................37 5. Conclusion: Reinforcing Nationalism through social policy in Catalonia..........................41 Bibliography .................................................................................................................................45 Chapter 1 Introduction: Sub-State Nationalism: Reformulations of an Old Debate I imagine Catalonia becoming the Mediterranean Denmark. –Artur Mas (2017)1 The problem [with importing the Nordic model] is that Catalonia has very few Swedes. –Josep Pla (Autobiographical notes, 1979)2 The recent upsurge of the Catalan independence movement has reignited the debates on European nationalism. As the right of self-determination collides with the national unity recognized in the Spanish Constitution of 1978, scholars and political leaders disagree on the legal, democratic, and moral arguments about Catalonia and its future. Catalan nationalism poses one of the most serious challenges to the current geographical divisions of Europe, and it has become a bête noire of both the Spanish government and the European Union. However, for many in the Spanish region the struggle for independence has become the most decisive factor in electoral decisions and its consequences have entered the daily lives and interactions of every 1 Artur Mas was the President of the Catalan regional government from 2010 to 2015, when he became the first leader from the center-right coalition CiU to advocate for a referendum on the issue of independence from Spain. This quote is from an interview conducted at Harvard University in 2017. 2 Pla (1897-1981) was a celebrated Catalan journalist and author who experienced an extensive and complicated relationship with the political events of 20th century Spain. He lived through the Spanish 2nd Republic (1931-1939), the Spanish Civil War (1936-1939), the subsequent dictatorship of Francisco Franco, and the democratic transition (1975-1981). While he was a proud advocate of the Catalan language and culture, his mild opposition of the dictatorship and his disagreements with Catalan nationalists have earned him a somewhat mixed reputation. This quote, which will be revisited, was a response to a Catalan nationalist leader of the democratic period who referred to Nordic welfare states as an inspiration for Catalonia. Hernández 2 individual. Therefore, to better understand this political movement, it is crucial to shift some of the scholarly focus towards the roots of Catalan separatism and its socioeconomic context. In a late-capitalist European society like Spain, the provision of social policy represents one of the most powerful resources for the state. On the one hand, social policies can mitigate the impacts of economic cycles and commodification, while on the other hand, political or elite interests can shape welfare provisions to consolidate support for the state and the economic system. While these two tendencies are not mutually exclusive, specific contingencies to each state—of the historical, institutional, political, and economic kinds—typically lead to systematic trends, or path dependence, and clustering of types of welfare states (Castles & Obinger, 2008). In the more specific context of Catalonia, a series of endogenous historical and cultural elements interact with the institution of the welfare state, offering a more complex view of the common association of one nation with its corresponding welfare state. In fact, the Catalan regional government gained a significant amount of legislative independence in matters of social policy—in healthcare and education in particular—after the democratic transition, which allows for an inspection of the interplay between sub-state nationalism and welfare state building. For the purpose of this work, the realms of healthcare policy and institutions are particularly representative of the welfare state, as they constitute the mechanism for a society and a nation to provide care for its members. The question becomes: How does the public provision of healthcare by a sub-state territory—especially one with cultural devices such as a distinct language and a collective identity— contribute to the shaping of national imaginaries? In other words, how does the existence of a quasi-autonomous regional healthcare system affect how Catalans define themselves as a nation? Hernández 3 Research design The case of Catalonia offers an ideal environment for the observation of the interplay of nationalism and welfare state development because of the region’s emerging nationalist movement and relatively late processes of democratization and welfare state formation. Endogenous cultural elements of language and common historical ties— such as the repression of the Franco regime, and the shared experience of obtaining autonomy after the democratic transition— emphasize the distinctiveness of the region from the rest of Spain. The evolution of the welfare state in Catalonia also offers the image of a process differentiated from that of other Spanish regions due to the pseudo-federal administrative nature of democratic Spain and the particular demands for autonomy in Catalonia recognized in the Statutes of Autonomy of 1979 and 2006—laws recognizing the exceptional status of Catalonia as a historical nation within Spain and granting a degree of political and legislative autonomy from Spain. The comparison with Scotland—another sub-state territory with a tradition of nationalism and a vibrant independence movement—will become relevant at moments, particularly as it relates to McEwen’s concept of “State Welfare Nationalism” (2002). This author divides factors influencing popular support for Scottish autonomy from the UK along the three main categories: welfare expectations from the Scottish Parliament as opposed to the British Parliament, cultural identity, and desire for self-determination. As these three factors also represent important considerations in the Catalan case, it will be relevant to draw comparisons when necessary. In order to analyze the relationship between public perceptions of a distinctive health system in Catalonia vis-à-vis Spain and support for independence, this work employs a qualitative and a quantitative section. The qualitative section draws from primary sources in campaign manifestos, and other publications by some of the most important political parties and Hernández 4 actors in Catalonia in the last quarter of the 20th century—covering the building processes of both regional democratic institutions and the welfare state. The manifestos selected are from 1980, 1984, 1988, and 1992 because those years encompass most of the legislative and institutional progress in health policy in Catalonia. The purpose of this qualitative analysis is to trace the development of health policy under a regional government with newly acquired autonomy, distinct regional institutions and legacies from the dictatorship, yet with a degree