Solidarity in Health and Social Care in Europe

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The rich easily will get out of the system as they can afford to pay for their owb healthcare, but this will certainly reduce the public funds available to be spent on treatment. Earlier on, a spokesperson had said that the government plans to expand the range of free health services rather than to narrow them.

European Welfare Solidarity in Focus: High Support for European Social Safety Net - EuVisions

Work is underway on separating private from public health care, with current plans including passing new legislation as well as changing the means of financing and organising the system. However, a critical assessment of the state of the health care system indicates a lack of progress. Based on its parliamentary majority, the government would have had a historical chance to come up with a crucial and necessary reform. Ruud Meulen. While equity may be a term for which most people have a quite similar and clear-cut understanding, solidarity is a less familiar notion that is subject to divergent interpretations and reflections.

In general, the idea of solidarity is associated with mutual respect, personal support and commitment to a common cause. These interpretations come to the fore when Europeans in large-scale surveys are questioned about their understandings of this idea of solidarity.

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Their verbal answers to these kind of questions reflect notions as 'belonging together', 'mutual understanding', 'support of the weak and needy benevolence ', 'shared responsibility' and commitment to the common good. To explain these notions, solidarity is often juxtaposed against individualistic and even egoistic behaviour or contrasted with the alleged self-centred individualism that is often superficially associated with the cultural habits, societal norms and liberal values of the United States.

For example, the plain evidence that forty-five millions of inhabitants of the United States lack any sort of health care insurance is for many Europeans, especially on the leftist stance, writing on the wall. In contrast to the alleged irresponsibility and lack of concern that is generally associated with this kind of individualism, Europeans proudly refer to the notion of solidarity and how it shaped their national health and social care systems.

How ill- defined solidarity often is, the basic understanding is that everyone is assumed to make a fair financial contribution to a collectively organised insurance system that guarantees equal access to health and social care for all members of society. This equally applies to other systems of social protection, which are operating in Europeans welfare states, such as social insurance systems covering the financial risks of unemployment and work related illness and disability, as well as old age insurance systems and pension schemes. While European are boosting their safety net for the risks of bad health and forced idleness, however, there is increasing uncertainty about whether solidarity still is or can be a guiding principle in the shaping of care R.

Arts, and R. Muffels eds. Printed in the Netherlands. This uncertainty is particularly slumbering in the area of health care and social policy, in which solidarity has acquired a particular meaning that goes beyond solely transferring income or in kind benefits to protect the vulnerable and needy in society.

In the domain of health and social care, solidarity is first and foremost understood as a moral value and social attitude regarding those in need of support. Solidarity with vulnerable groups in modern societies, in particular the chronically ill, the handicapped, the political refugees and the frail elderly, is taken as an expression of personal concern and responsibility by the care giver, no matter whether she or he is a professional care-worker, a relative or a friend.

The wider support for solidarity on the level of informal care practices may explain the extraordinary position of the care system within European welfare states. While protection systems of social and economic kind have been put increasingly under pressure, health care has not to the same extent been subject to such strains. However, there are concerns that health care systems may share the same fate as such protection systems. Its development into encompassing systems of universal coverage has put into question the acceptability and sustainability of nowadays configurations of care arrangements in society especially with a view to the increasing demands for expensive treatments, due to the ageing of the population and the changing and more demanding attitudes of the clients.

Such concerns are therefore footed in societal developments, each potentially threatening solidarity.

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The ageing of the population of the European societies has resulted in a change of morbidity patterns and gave rise to an increased demand for care services, particularly in the field of long-term care. This process, which can be observed in most parts of the Western world, is reinforced by a change in attitudes among patients toward more self-awareness and self-assertiveness with respect to the demand for high-quality health care services. Instead of the humble, authority-sensitive attitude of patients in the past, the modern patient considers him or herself to be a client who is very well informed about the treatment opportunities and the types of advanced services that are available.

This 'consumerism', reinforced by the growing popularity and spread of the Internet, is becoming more current among the next elder generations who are expected to claim a higher quality of services than in the past, particularly in the field of diagnostics. Moreover, as medical knowledge and technological opportunities are rising, the costs of medical interventions that are based on high-cost medical technologies will increasingly put pressure on the health care budget. One reason for this pressure emanates from the creation of the European Monetary Union, which has forced national governments to comply with strict measures regarding the level of public funding, the government deficit and public expenditures.


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The gap between the demand and supply of care, partly caused by these unification measures, has resulted in an increasing shortage of care services in all European countries, particularly in the public health care system. The shortage of services is particularly notable in the area of long-term care and care services for the elderly. The relative scarcity of health care services is putting solidarity within society under heavy strains.

An increasing part of the Dutch population shares the opinion that not everyone should be entitled to the same medical treatments, particularly if these treatments are extremely expensive. The scarcity of resources puts strains in particular on the solidarity between generations, that is the willingness of the younger age groups to contribute to the expenditures required to meet the needs of the older generations. WHO global strategy on integrated people-centred health services Placing people and communities at the centre of health services. Barbazza E, Tello J. A review of health governance: definitions, dimensions and tools to govern.

Health Policy. Improving health system efficiency as a means of moving towards universal coverage. The world health report Health systems financing: the path to universal coverage. Corruption and the provision of health care and education services.

Bibliographic Information

Accessed March 15, World Health Organization. Good Governance for Medicines: Model Framework. World Health Assembly. Sustainable health financing structures and universal coverage. Framework for assessing governance in the health system in developing countries: gateway to good governance. Published Adelaide Statement on Health in All Policies - moving towards a shared governance for health and well-being.

Free Solidarity In Health And Social Care In Europe

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Martin McKee - Divided we fall? Securing the future of solidarity in Europe - Forte Talks 2016

DOI: Health Policy Ethics. Norheim OF.



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