Solidarity in Health and Social Care in Europe

by Meulen, R. H. J. Ter; Arts, Wil; Muffels, Ruud

• ISBN13: 9781402001642
• ISBN10: 1402001649
• Format: Hardcover
• Copyright: 2002-02-01
• Publisher: Springer Verlag

Summary

This volume is written for scholars and analysts in the field of health policy, philosophy of health care, and biomedical ethics, particularly the ethics of resource allocation and the just distribution of scarce resources. The book provides students and scholars with an improved understanding of solidarity as a fundamental value in health care and social care, by comparing it with traditional approaches to justice, fairness, and individual freedom. In addition, the reader is provided with empirical evidence of the socio-cultural views of solidarity, which may contribute to a better understanding of its determinants at the national level. The book has strong applied and policy dimensions. By giving examples of the way solidarity can be institutionalised and practised, the book may make an important contribution to the debate on health care reform and health care policy in Europe as well as the United States.

Table of Contents

Preface and Acknowledgments	xv
List of Figures	xvii
List of Tables	xix
Solidarity, Health and Social Care in Europe Introduction to the Volume	1	(12)
Ruud ter Meulen
Wil Arts
Ruud Muffels
Setting the Scene: the Issue of Solidarity in Modern Society	1	(1)
Concerns for Care Put Solidarity under Strain	2	(4)
Theoretical Perspectives on Solidarity	6	(2)
Content of the Volume	8	(3)
Solidarity as a Public Value: Empirical Issues	9	(1)
Solidarity as a Moral Concept	10	(1)
Bibliography	11	(2)
PART I: SOLIDARITY AS A PUBLIC VALUE: EMPIRICAL ISSUES	13	(264)
Modernisation, Solidarity and Care in Europe the Sociologist's Tale	15	(26)
Wil Arts
Rudi Verburg
Setting the Stage	15	(2)
Modernity, Organised Solidarity, and Individual Responsibility	17	(2)
Solidarity as a Sociological Construct	19	(2)
Solidarity in a Time of Reflexive Modernity	21	(3)
Welfare States	24	(2)
Differences in Organised Solidarity between Welfare States	26	(3)
Modernity and its Threat to Solidarity	29	(2)
The Dimension of Affluence	29	(1)
The Dimension of Structural Differentiation	30	(1)
The Dimension of Generalisation of Values and Norms	31	(1)
Solidarity as a Public Value in European Care Systems	31	(2)
Country Studies	33	(5)
Picking up the Thread of the Volume	38	(1)
Bibliography	38	(3)
Popular Support for Health Care in Europe Review of the Evidence of Cross-National Surveys	41	(36)
Josette Gevers
John Gelissen
Wil Arts
Ruud Muffels
Introduction and Research Question	41	(2)
Solidarity and its Motivational Bases	43	(9)
Welfare State Regimes	45	(1)
Institutional Characteristics of the National Care System	46	(6)
Individual, Social and Ideological Position	52	(1)
Hypotheses	52	(5)
Data, Operationalisation and Methodology	57	(6)
Data	57	(1)
Measures	57	(5)
Method of Analysis	62	(1)
Results	63	(7)
Attitudes towards Public Health Care	63	(2)
Explaining Differences in Attitudes towards Public Health Care	65	(5)
Conclusions and Discussion	70	(3)
Notes	73	(1)
Bibliography	74	(3)
Solidarity and Care in Sweden	77	(30)
Ake Bergmark
Elisabet Lindberg
Mats Thorslund
Introduction	77	(2)
The Swedish Model	79	(1)
The Social Insurance System	80	(2)
The Pension System	81	(1)
Unemployment Benefits	81	(1)
Cash Benefits during Illness and Parental Insurance	82	(1)
The Health Care and Social Services System	82	(4)
Health Care	82	(2)
The Social Services	84	(2)
Geographical Variations	86	(1)
Development over Time	87	(3)
The Non-Profit Sector and Informal Care	90	(2)
Public Opinion	92	(4)
The Public Debate	96	(1)
Swedish Welfare in Transition?	97	(4)
Conclusion	101	(1)
Notes	102	(1)
Bibliography	102	(5)
Solidarity and Care in the United Kingdom	107	(26)
Malcolm Johnson
Lesley Cullen
Introduction	107	(4)
Care Services	111	(9)
The National Health Service - Costs and Care	111	(3)
The Personal Social Services	114	(5)
Informal Care and its Relationship with State Provision	119	(1)
Public Values	120	(4)
Solidarity as a Public Value	120	(4)
Solidarity as a Value in Government Policies	124	(4)
Conclusions	128	(1)
Bibliography	129	(4)
Solidarity and Care in Italy	133	(26)
Christiano Gori
Nicola Pasini
Introduction	133	(1)
Principles and Values	133	(3)
Charity Versus Solidarity	133	(1)
Public Solidarity versus Private Social Solidarity	134	(2)
Social Welfare Policy after World War II	136	(4)
The Health Policy from the Post War Period to the 90s: the Reform Process	136	(3)
Social Care Services: a Residual Part of the Italian Welfare State	139	(1)
The Care System	140	(8)
Health and Social Care Services in the 90s	140	(2)
Funding Health Care	142	(1)
The Provision of Health and Social Services	142	(2)
Exit and Market in Health Care	144	(1)
Towards more Equity in Service Provision?	145	(2)
Summary: a Changing Care System	147	(1)
Citizen's Attitudes	148	(2)
Health Care	148	(1)
Summary: a Complex Attitude	149	(1)
Towards which Welfare?	150	(3)
Health Care	151	(1)
Social Care	152	(1)
Conclusions	153	(1)
Notes	154	(1)
Bibliography	155	(4)
Solidarity and Care in Germany	159	(30)
Adalbert Evers
Martina Klein
Introduction	159	(1)
The Changing Forms of Solidarity in the Historical Development of the Health Care System	159	(4)
Solidarity and Health Care: from Solidaristic Self Help	160	(1)
Towards the Principle of a Welfare State	160	(2)
Solidarity and Social Care: the Late Intrusion of Social Solidarity into the Field of Private Care	162	(1)
Shaped by Different Principles and Values	163	(2)
Similar Principles but Different Levels	165	(8)
Basis Elements of the Health and Care System	165	(1)
Different Levels of Rights and Benefits in the Health System and the Care System	166	(2)
The Social Insurance - A Way to Institutionalise Solidarity	168	(1)
The Provision of Services	168	(1)
East Germany - the Same Institutions but a Different Situation	169	(1)
The Future for Solidarity? Reforms in Health Care During the Past Decade	170	(1)
Renewing Solidarity? the Politics of the New Government	171	(2)
Public Support for Solidarity in East and West Germany	173	(6)
Opinions on the Welfare State and the Principle of Solidarity	174	(1)
Attitudes towards Characteristics and Reforms of the Health Care System	174	(2)
Solidarity as Social Security - Different Degrees of Esteem	176	(1)
Informal and Family Care	177	(1)
Reasons For Solidarity	178	(1)
Conclusion: a High Approval for Both-Solidarity and Individual Responsibility	178	(1)
Where Can We Go from Here? Main Issues in the Public Debate	179	(6)
The System of Solidarity in Front of Changes in Labour Markets, Demography and Families	179	(1)
Defining the Limits of what Solidarity Should Preserve	180	(2)
The Statutory Insurers: Solidaristic Institutions as Market Competitors	182	(1)
Developing Synergies? On the Linkages between Insurance Based and Social Solidarities as well as Family Care	182	(3)
Conclusions: on the Complementarity of Social Solidarities and Citizenship Rights	185	(1)
Notes	186	(1)
Bibliography	186	(3)
Solidarity and Care in Austria	189	(40)
Kai Leichsenring
Gerhard Majce
Sabine Pleschberger
Approaching Dimensions and Levels of `Solidarity' in Health and Social Care Systems	189	(1)
Solidarity and the Political Culture in Austria	190	(3)
The Christian-Democratic Idea of Strengthening `Civil Society'	191	(1)
Solidarity In the Social-Democratic Discourse	192	(1)
The Relative Importance of Solidarity in the Austrian Political Discourse	192	(1)
The Social and Health Care System in Austria	193	(8)
History	193	(1)
Financing and Administration of Health Care	194	(1)
Social Care Services (in Kind Benefits)	195	(2)
Care Benefit Systems (Cash Benefits)	197	(2)
Long-Term Care institutions (Private, Public)	199	(1)
Institutionalised Solidarity in the Austrian Social and Health Care Systems in the Light of Recent Reforms	199	(2)
Solidarity as a Public Value in Austria	201	(15)
Solidarity as a Moral Value	203	(3)
Solidarity with Specific Groups	206	(2)
Solidarity as Expressed in Formal Social Institutions	208	(1)
Health Insurance	209	(2)
Pension Insurance	211	(1)
Reform Perspectives	211	(1)
Solidarity as Expressed in Informal Arrangements and Practical Help (`Micro-Solidarity')	212	(1)
Solidarity Potential and Practical Solidarity in Families and Among Relatives	213	(3)
Conclusions	216	(1)
Notes	217	(1)
Bibliography	218	(3)
Appendix	221	(8)
Solidarity and Care in The Netherlands	229	(26)
Jan van der Made
Ruud ter Meulen
Masja van den Burg
Introduction	229	(2)
Solidarity and the Dutch Formal and Informal Health	231	(11)
Care System	231	(1)
The Dutch Health Insurance System	232	(2)
The Extent of Macro Solidarity	234	(2)
Limits to Equal Access	236	(2)
Micro Solidarity and Informal Care	238	(4)
Public Values	242	(4)
Government, Solidarity and Equal. Access in Recent Years	246	(2)
Concluding Remarks	248	(4)
Notes	252	(1)
Bibliography	252	(3)
Reforms in Health and Social Care in Europe: The Challenge to Policy	255	(22)
Ruud Muffels
Rudi Verburg
Introduction	255	(1)
Reform and Support	256	(2)
Tinkering With the Terms of the Contract	258	(1)
Market Mechanisms and Informal Care	259	(2)
A New Balance in Welfare State Solidarity	261	(1)
Policy Conceptions of the Welfare State	262	(4)
The `Homo Economicus' and the `Homo Ethicus'	266	(1)
The `Social Investment Society'	267	(1)
New Challenges for Welfare State Policies	268	(8)
The Relationship Between Formal and Informal Care	268	(6)
Future Policy Scenarios in Health and Social Care: Looking For a New Balance of Public and Private Interference	274	(2)
Bibliography	276	(1)
PART II: SOLIDARITY AS A MORAL CONCEPT: PHILOSOPHICAL ISSUES	277	(186)
Reconsidering Solidarity by Conceptual Analysis	279	(30)
Rob Houtepen
Ruud ter Meulen
Introduction	279	(3)
The Nature and Content of the Philosophical Contributions	282	(4)
The Red Thread of the Philosophical Part	286	(1)
Rahel Jaeggi	287	(1)
Solidarity and Indifference	287	(1)
Introduction	287	(1)
What Is Solidarity?	288	(4)
Everyday Use of the Concept	289	(3)
Non-Instrumental Cooperation and Ethical Life	292	(5)
Two Models of Cooperation	293	(3)
The Particularity of 'Ethical Life'	296	(1)
Precarious Basis of Solidarity	297	(3)
Being Associated	297	(3)
Solidarity As Empowerment	300	(1)
De-Solidarization, Social Indifference and the `Crystallised' Solidarity of Welfare States	300	(6)
Crystallised Solidarities and Welfare Institutions	305	(1)
Notes	306	(1)
Bibliography	307	(2)
Solidarity, Citizenship and Selective Distributive Justice in Health Care	309	(24)
Nicola Pasini
Massimo Reichlin
Introduction	309	(1)
Traditional, Modern and Present Conceptions of Solidarity	310	(2)
Solidarity: from Tradition to Modern Society and Back Again?	311	(1)
Towards A New Social Citizenship: Problems and Perspectives	312	(6)
Solidarity in an Evolving Model of Citizenship	315	(1)
Can We Speak of a `Selective' Solidarity?	316	(2)
Solidarity In Health Care: Theoretical Reflections	318	(7)
Justice and Solidarity in Health Care Rationing	325	(4)
Notes	329	(1)
Bibliography	330	(3)
Organ Transplantation in Italy: Forced Solidarity?	333	(6)
Massimo Reichlin
The New Act on Organ Transplantation	333	(1)
Two Objections	334	(1)
Discussion	335	(2)
Concluding Remarks	337	(1)
Bibliography	337	(2)
Beyond Justice and Moralism: Modernity and Solidarity in the Health Care System	339	(26)
Rob Houtepen
Ruud ter Meulen
Guy Widdershoven
Introduction	339	(6)
Justice and Solidarity Beyond Liberalism and Communitarianism	340	(2)
Communitarian Notions of Solidarity	342	(2)
Solidarity Beyond the Liberal-Communitarian Split	344	(1)
Solidarity and the Development of the Dutch Welfare State and Health Care Arrangements	345	(6)
Origins of Welfare State Solidarity	345	(2)
Heyday and Crisis of the Welfare State	347	(4)
The Modernist Concept of Solidarity: Criticism and	351	(9)
New Heuristics	351	(1)
Towards A Practically and Culturally Sharpened Concept of Solidarity	351	(2)
Solidarity and Care Ethics	353	(3)
Reflexivity and Citizenship Theory: Solidarity as Required by the Functioning of a Democracy	356	(4)
Conclusion	360	(2)
Bibliography	362	(3)
Personal Budgets for the Elderly:	365	(8)
Rob Houtepen
Ruud ter Meulen
A Case Study in Dutch Solidarity	365	(1)
Targeting the Elderly	365	(1)
The Personal Budget Experiment	366	(3)
Solidarity Beyond Market and Bureaucracy	369	(2)
Bibliography	371	(2)
Solidarity in Universal Welfare - the Case of Sweden	373	(24)
Ake Bergmark
Introduction	373	(1)
Perspectives on Solidarity	374	(4)
Social Solidarity	374	(1)
Individual Solidarity	375	(2)
Intergenerational Solidarity	377	(1)
The Roots of Swedish Welfare	378	(2)
Under a 'Social Democratic Regime' - the Strong State vs. Individual Autonomy	380	(1)
The Non-Universalist Traits	381	(2)
Attachment to Welfare	383	(2)
Solidarity or Self-Interest?	385	(2)
Solidarity - the Concern for Others	387	(3)
Solidarity - Societal Cohesion	390	(2)
Conclusion	392	(1)
Notes	392	(1)
Bibliography	393	(4)
The Historical and Philosophical Background of `Solidarity' in UK Social Welfare	397	(20)
Alastair Campbell
Susan Jones
Introduction	397	(2)
A Historical Sketch	399	(2)
The Modern Era - from Utilitarianidm to the Welfare State	401	(4)
Fifty Years of the Welfare State	405	(6)
A New Consensus on Welfare: Titmuss and Marshall	406	(1)
The Radical Critique of `Welfarism'	407	(2)
The `Third Way'	409	(2)
Conclusion	411	(2)
Notes	413	(1)
Bibliography	413	(4)
A Case Study: The Long Term Care of Older People	417	(6)
Alastair Campbell
Susan Jones
Introduction	417	(4)
The Findings of the Royal Commission	417	(1)
The Commission's Recommendations	418	(2)
The Dissenting View	420	(1)
Conclusion: Solidarity and Long-Term Care of Older People	421	(1)
Note	422	(1)
Bibliography	422	(1)
Which Theories of Solidarity? From the Austrian Case to the European Context	423	(22)
Sonja Puntscher Riekmann
Introduction	423	(4)
Solidarity Discourses in Austria From the Habsburg Empire to the Second Republic: Continuities and Discontinuities	427	(12)
`La Longue Duree' of Theoretical Approaches	427	(3)
The Parties and their Solidarity Concepts	430	(2)
The First Republic: Solidarity and Nation Building	432	(3)
The Second Republic: Continuities and Expansion	435	(1)
The Socialist Discourse	436	(1)
The Christian Discourse	437	(2)
`Liberalism' and Solidarity: the FPO Case	439	(1)
The Greens: Ecology and Solidarity	440	(1)
Future Perspectives	440	(3)
Bibliography	443	(2)
The Comprehensive Long-Term Care Allowance Scheme: The Last Grand Enterprise in Austrian Social Policy?	445	(6)
Sonja Puntscher Riekmann
Introduction	445	(1)
The Political Debate on the Long-Term Care Insurance	445	(4)
The Solidarity Discourse	446	(3)
Conclusion	449	(1)
Notes	449	(1)
Bibliography	449	(2)
Solidarity, Justice, Reflexivity and Participatory Citizenship	451	(12)
Rob Houtepen
Ruud ter Meulen
Conceptual Analysis: from Solidarity to Justice and Back	451	(3)
Threats to Solidarity	454	(2)
Opportunities: Participative Citizenship and Reflexivity	456	(3)
The Full Range of Participative Solidarity and Citizenship	459	(4)
EPILOGUE: THE FUTURE OF SOLIDARISTIC HEALTH AND SOCIAL CARE IN EUROPE	463	(16)
Wil Arts
Ruud Muffels
Ruud ter Meulen
Setting the Stage	463	(1)
Sustained Public Support for the Welfare State	464	(1)
Solidarity and Modernity	464	(8)
Solidarity, an Ambiguous Concept	464	(1)
Reflexive Modernity, Trust and the Risk Society	465	(1)
Trust and Liquid Modernity	466	(1)
Individualisation	467	(3)
Globalisation and Capitalism	470	(2)
Solidarity and European Integration	472	(2)
The European Social Model	472	(1)
Towards a European Network State?	473	(1)
The Future of Health and Social Care Practices in Europe	474	(2)
The European Face of Citizenship and the Future of Health and Social Care	475	(1)
Bibliography	476	(3)
Notes on the Contributors	479	(4)
Index of Subjects	483	(12)
Index of Names	495