Restructuring The German Welfare State Health Care Policy And Reform In Germany

Seminar paper from the year 2005 in the subject Sociology - Political Sociology, Majorities, Minorities, grade: A, University of Dalarna (Political Sociology), course: Restructuring the Welfare State, language: English, abstract: As health care is among the most personal issues, this is one reason why it is also among the most politically discussed as cost containment has become a priority of health care policy. Health care has consumed a large and growing portion of social spending in all advanced industrialised societies, particularly in the last decade. This cost explosion coincided with the global economic slowdown and worries about the fiscal viability of the welfare state. Reasons for escalating health care costs are, although to varying degrees, common to Western countries. The health care sector provides fertile ground for technological innovations that may prolong life but at considerable expense. Moreover, once these discoveries are made, it is extremely difficult for insurers or governments to limit their provision, as patients demand access to these treatments. Furthermore, the aging population of Western countries has direct consequences for health care because older persons are more likely to be in need of cost intensive treatment and/or care due to acute illness or chronic conditions. At the same time, birth rates are no longer balanced with increasing longevity, so that there will be fewer working age persons in the future to bear the financial requirements for elderly care. Governments and employers claimed that health care costs posed immediate and longterm problems and began to search for ways to address them. The ‘new politics of the welfare state’ – Pierson’s (1996) famous concept, which deals with welfare state reform in the face of changing demographic and tougher economic conditions – has also modified the position of diverse welfare state stakeholders. The actions and preferences of payers and the state are determined by the prevailing health care system as well as by the political system and whether it provides them an opportunity to influence health policies.

This pathbreaking book investigates welfare state change in the area of health care- a field widely neglected by comparative welfare state research. While some work on health care expenditure exists, health care rights have not been systematically studied since social rights have exclusively focused on entitlement to cash benefits. Addressing this research gap, Böhm analyses in what way the social right to health care has been modified in the course of general welfare state transformation since the late 1970s. Taking England and Germany as examples, she assesses how health care reforms conducted under the conditions of constrained budgets, demographic ageing, and rapid medical progress, have altered access to and generosity of public health care systems over the past 35 years. The book’s findings significantly increase our understanding of social rights and reveals fundamental differences of approach: while Germany provides absolute and enforceable rights to health care for each (entitled) individual, English social health care rights are directed towards the population as a whole and contingent upon the availability of resources, i.e. they are not absolute and not enforceable. This distinction between individual and collective social rights will be an important contribution to the theory of social rights given its applicability to other types of social rights and its usefulness in tracing changes in social rights over time.

This is the first in-depth comparison of the UK and Germany as two large, but highly distinct, European welfare states. This analysis provides a systematic comparison of policy change across each country in three core areas: unemployment support, pensions, and family policy.

Argues that the high level of unemployment in Germany not only creates a major challenge for the German welfare state, but is to a good extent caused by the way the country's welfare system is designed. This book reviews the public debate on labour market reforms, and discusses the first set of reforms that have been enacted.

The welfare state has been developed first and in its largest extent in North-Western Europe, in Germany, Great Britain, the Netherlands, and Sweden. It is also in these countries where the crisis and financial problems of the welfare state are felt first. The need for restructuring the welfare state is a challenge of a supra-national, European and international scale. The book analyses the different welfare states in Germany, Great Britain, the Netherlands, and Sweden with outlooks to Eastern Europe and Japan and examines the proposals for reforming and restructuring the welfare state in Europe. The book offers a unique combination of empirical and philosophical-ethical analysis of the welfare state.

What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).

This volume presents a thought provoking analysis of key welfare state issues engaging policy makers across the globe. It provides a unique and comprehensive evaluation of the state of welfare states- developed and developing. It maps the diversity of welfare regimes across the world and brings to fore the particularities and nuances that characterise them. The book also focuses on the on-going reforms and makes a powerful case for the increased relevance of the welfare state in a globalizing era.

As countries confront new health care challenges in the 21st century, their health care systems reflect the problems and political settlements of an earlier age. Meeting these new challenges requires reform of existing health care system arrangements while reconciling the goals of equitable access to quality care at an affordable price. This book compares health care reforms in industrialized nations and the Global South to uncover the similarities and differences in their problems and solutions. It examines the struggle over the Affordable Care Act and its alternatives in the United States, major health care reforms in Germany in the new century, and South Africa's efforts to combat AIDS and construct a comprehensive health care system for all. These particular reforms reflect the underlying configuration of politics in each country.