Explain the Competing Pressures Which Health Care Systems in Europe Face Today

Topics: Social security, Welfare state, Health care Pages: 6 (2545 words) Published: May 15, 2013
Explain the competing pressures which health care systems in Europe face today. Critically assess and compare how the systems in two countries have responded to these pressures. (2500) According to the WHO commission on macroeconomics and health, investment in health care can be an effective method to improve both economic growth and public health. This is because a healthy nation is not only good in itself; it is also a key factor for economic development and reduction in poverty, which in turn enhances public health. Therefore over the years health care policy has played an ever increasing role in the welfare states across Europe. After the Great Depression, capitalism lost a lot of its popularity. Thus the primacy of politics and communitarianism replaced the ideology of self-interest and reliance on markets to achieve societal goals. Although a lot of countries in Continental Europe made major cutbacks during this time, in Scandinavia there was a renewal and advancement of the welfare state. Ideas such as Keynesianism, social democracy, the ‘Bismarkian welfare state’ became increasingly prevalent in order to help those in society who could not work for one reason or another. During the second half of the 20th century post-materialism changed the way of living for most people and so the increasing need for the welfare state was evident. People started caring about different societal issues which were not as cared for before. The elderly, who were usually the poorest in society, were now cared for and other factors such as; single mothers, increased divorced rates, contraception and increased living age became issues that were undertaken by both state and society as a whole. By 1990 Danish sociologist Gøsta Esping-Andersen, published a book titled ‘The Three Worlds of Welfare Sate Capitalism’ in which he generalisation of the different types of welfare state that exist today. Although it may be a bit outdated for today, many scholars still apply his knowledge in analysing welfare states and his theory of decommodification remains very important till today. In this essay I will explain the competing pressures in which health care systems in Europe face today. After that I will describe the way in which the Swedish and German health care systems function, the pressures they face and the measures taken to overcome these pressures. Finally I will compare the two countries, critically assessing both and then coming to a conclusion. There are three main aims that governments and social policy scholars analyse in order to assess how well a health care system works. These are high quality of provision, cost containment, and equal access. Depending on the type of welfare state, there will be more of a focus on certain aims than others. For example health insurance systems in general, like that of Germany, the supply of health care is usually in surplus. This allows for patient choice and comfort, which ticks the box of quality of provision, but often results in a lot of health spending, and seldom inequality of access. Therefore the extent to which these aims can be fulfilled depends on the policies made by individual nations or the amount of money a particular government is willing to spend of health care. Usually in order to accomplish one or two of these aims, there is usually a compromise made (i.e the third aim will not be accomplished). In order to understand the Swedish welfare state, it is also necessary to understand Sweden history with social democracy. Social democracy is an ideology based on the primacy of politics and communitarianism, therefore ‘a core value is, to put it broadly, equal concern and respect for all members of society’ (p3). From 1932 to 1976, the Swedish Social Democratic Party (SAP) held power continuously and by the time it left office in 1976, it had transformed Swedish society. The party had implemented a policy of folkhemmet (people’s home) during its time power, which was seen as a middle...
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