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Health Care Systems – Shaped by the Welfare State? : the impact of the characteristics of the welfare state on health care systems, using the example of Germany, Sweden, and the United Kingdom

Mewes, Janne Charlotte (2009) Health Care Systems – Shaped by the Welfare State? : the impact of the characteristics of the welfare state on health care systems, using the example of Germany, Sweden, and the United Kingdom.

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Abstract:Health care systems in Europe differ substantially between countries, although one could expect that many aspects of life are harmonized within the European Union. In order to find out what has caused the health care systems to be so different the hypothesis “health care systems are shaped by the characteristics of the welfare state to a high degree” is tested in this research. To do so the health care systems of Germany, Sweden and the United Kingdom (UK) are analysed. Welfare states can be classified into different models. There are corporatist, social democratic and liberal welfare states. Germany is an archetype of the corporatist welfare state regime, Sweden of the social democratic welfare state regime, and the UK of the liberal welfare state regime. In this research it was analysed to what degree the characteristics de-commodification, stratification, generosity, accessibility, and a focus on individual responsibility are present in the welfare state regimes and in the health care systems. This has been measured in relation to the EU-15 average. Over the corporatist welfare states it can be said that they are known for upholding existing hierarchies and differences in status. Provisions are related to prior work performance. This is what has been found in the German health care system as well. The type of health insurance that one can obtain (public or private) depends on status. The health care that people receive does not differ much, but accessibility is slightly better for people who have a private insurance. In German health care, as well as in the corporatist welfare state, people who need provisions are assumed to have had bad luck. The degree of stratification is lower in heath care than in the welfare state. The characteristics of the social democratic welfare state and the Swedish Health Care System are almost the same. Just as the social democratic welfare state the Swedish health care system is built on universalism, equal access for everyone and high provisions. Only the degree of stratification is different in health care. In health care it is slightly higher than in the welfare state. The provisions of the welfare state do not create inequalities in society. In liberal welfare states provisions are not related to work, but are financed through taxation. The provisions are low and uphold the existing structure of society. This is the same in the UK health care system. The accessibility to health care is good, except of very long waiting lists. In the liberal welfare state the access to provisions is means-tested, which leads to access only for those who really are in need. It is someone´s individual responsibility to get (back) into a situation where no support of the state is needed. The outcome of the research is that the characteristics match almost perfectly. In the UK all characteristics match, in Germany and Sweden four out of five. On the basis of these findings the hypothesis is accepted. This means that health care systems are shaped by the welfare state to a high degree. The consequence of this is that all knowledge about the welfare state can be applied to the health care system.
Item Type:Essay (Bachelor)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences BSc (56553)
Link to this item:https://purl.utwente.nl/essays/60522
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