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Two Centuries of Solidarity German, Belgian and Dutch social health insurance 1770-2008

Two Centuries of Solidarity German, Belgian and Dutch social health insurance 1770-2008

K.P. Companje
R.H.M. Hendriks
K.F.E. Veraghtert
B.E.M. Widdershoven
Copyright Date: 2009
Pages: 400
https://www.jstor.org/stable/j.ctt6wp5qh
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  • Book Info
    Two Centuries of Solidarity German, Belgian and Dutch social health insurance 1770-2008
    Book Description:

    Today, health insurance is a key component in the system of social security in most European Union countries. In many of these countries, modern health-insurance funds and healthcare insurers play an essential role in implementing the public health-insurance system. Many of these health-insurance funds have a long and fascinating history, of which clear traces can be seen today in the organisation and structure of health insurance, as well as health-insurance funds and insurers.In Two centuries of solidarity, the authors compare the systems of health insurance, health-insurance funds and healthcare insurers in Germany, Belgium and the Netherlands. Given the similar political, economic and social development that these countries have undergone in the past 60 years and the availability of a qualitatively high level of health care, one might expect a high degree of similarity between these countries' healthcare insurance systems. However, the dissimilarities are surprising. In fact, these differences are currently becoming ever more apparent between systems in general, and the structure and operation of the health insurance funds and health care insurers in particular. The differences include the compulsory nature of insurance, the extent of coverage, premiums, entrepreneurship, competition, and the degree of private insurance.Many of these national singularities can be understood and explained only by considering the historical background of the health insurance systems, the insurers, and their evolution over the past two centuries. This study adopts an institutional and political perspective towards a further understanding of the development of health insurance, and of how this ultimately determined the specific nature of the healthcare insurers and funds and the way they currently operate in Germany, Belgium and the Netherlands.

    eISBN: 978-90-485-2128-9
    Subjects: History, Sociology

Table of Contents

  1. Front Matter
    (pp. None)
  2. PREFACE
    (pp. i-ii)
    E. Boer and W. Annard
  3. Table of Contents
    (pp. 1-6)
  4. ACRONYMS AND ABBREVIATIONS
    (pp. 7-10)
  5. TRANSLATIONS
    (pp. 11-20)
  6. INTRODUCTION
    (pp. 21-28)

    The health and medical-expenses insurances funded from premiums in countries such as the Netherlands, Belgium, Germany, Hungary and Poland are an important part of modern-day social security within the European Community, in addition to the care systems financed from tax revenue, as in England, Spain, Italy and the Scandinavian countries.¹ The insurance institutions in the various countries insure millions of people, receive and pay out billions of euros each year, and are major employers.

    Modern health-insurance funds and health-insurance companies are an essential link in this gigantic and complex whole. Many outsiders – as well as people who live and work...

  7. Chapter I GUILDS AND HEALTH-INSURANCE FUNDS: SOLIDARITY DURING THE ANCIEN RÉGIME
    (pp. 29-38)

    Health-insurance funds as they exist today in the Netherlands, as well as in Belgium and Germany, clearly date back to the age of the guilds, which played a key role in the economic, social and political life of towns and cities from the Middle Ages until the system was abolished at the end of the eighteenth and the beginning of the nineteenth century. The guilds operated as organisations that, with the permission of the local authority, members of a particular profession were obliged to join. The main aim of a guild was to promote the economic interests of its members...

  8. Chapter II THE END OF THE GUILD SYSTEM, 1789–1820
    (pp. 39-44)

    During the eighteenth century, the corporative social order in Europe was a subject of debate among state philosophers. As early as 1776, comptroller-general of France Turgot made an unsuccessful attempt to abolish all corporations and guilds and bring an end to their privileges and freedoms. His reforms met with strong resistance and he was dismissed from office. A draft edict was drawn up in the Austrian Netherlands in 1786 to abolish the guilds, but these reform attempts were equally unsuccessful. The forces of democratic patriotism in the Republic of the United Provinces were not strong enough, and were defeated by...

  9. Chapter III THE BIRTH OF MODERN HEALTH-INSURANCE FUNDS
    (pp. 45-62)

    The abolition of the guilds was naturally a direct threat to the social safety net provided by guild and apprentices’ funds in the Netherlands. However, political revolution did not diminish the need for solidarity and mutual support among the members of individual professions. New forms of solidarity soon emerged, under all manner of titles. These new organisations often built on the traditions of the craft guilds, in particular the journeymen’s and apprentices’ associations. In some cases, the new organisations were actually a direct continuation of guilds, which were attempting to survive entirely or partly in secret and preserve their structures...

  10. Chapter IV HEALTH INSURANCE AS A GOVERNMENTAL RESPONSIBILITY, 1850–1914
    (pp. 63-124)

    Between 1849 and 1853, 226 Prussian municipalities made it mandatory for employees to sign up with a health-insurance fund. Apparently the government was dissatisfied with the low rate of growth. In 1854 theUnterstützungskassengesetz(Relief Fund Act) was enacted, which greatly strengthened the Prussian government’s hold on health insurance. Through this law, local governments were also given the right to establish a fund and to oblige labourers, journeymen and apprentices to sign up for it. The law bolstered the government’s supervision of the health-insurance system.¹ It enabled local governments to keep the voluntary health-insurance funds from using contributions and general...

  11. Chapter V WAR, PEACE, WAR, 1914–1945
    (pp. 125-194)

    The passage of war, the misery, the termination and the consequences of the First World War were very dissimilar for Germany, Belgium and the Netherlands. Germany, one of the most powerful countries of Europe in 1914, emerged from the war as an economically broken and humiliated land and would be politically frustrated for years to come in its search for a new path. Belgium, as a neutral country, was swept into the war by the German invasion of 4 August 1914. For four years, most of the country was occupied by German troops, administered as a war zone and ransacked...

  12. Chapter VI GROWTH AND ITS LIMITS, 1945–2000
    (pp. 195-286)

    In many respects, May 1945 wasStunde Nullfor Germany. The whole country was occupied and was politically, economically and morally in ruins. The occupying powers divided Germany into four zones (Soviet Union, Great Britain, United States and France). Agreements relating to the occupation had already been made before the end of the war, and were elaborated during the conferences at Yalta and Potsdam in February and July-August 1945. Each zone was governed by a commander-in-chief who held absolute and independent authority.¹ Despite the partition into zones, the express objective was that Germany would one day be governed as a...

  13. Chapter VII SOCIAL HEALTH INSURANCE AND NEOLIBERAL REGULATED MARKET COMPETITION, 2000–2008
    (pp. 287-348)

    In the period 2001–2007, social security and health care remained linked to each other through four social health insurances:Pflegeversicherung(long-term care insurance) as a limited contribution to the costs of nursing and disability,Unfallversicherung(accident insurance) for occupational health risks andGesetzlicheandPrivate Krankenversicherungen,compulsory and private insurance for income risk and costs incurred through illness.

    As in the Netherlands and Belgium, the political and social debate on the reform of the health-insurance system was in full swing from 1997 onwards. In theBundesrepublik,as in the Netherlands, the debate focused on government regulations, market forces and...

  14. Chapter VIII THE ART OF MUTUAL UNDERSTANDING: ONE CONCEPT IN THREE COUNTRIES
    (pp. 349-374)

    This research was planned as a comparative study of the structure and operation of the Belgian, German and Dutch national health-insurance systems. As J. van Langendonck emphasised in his talk at the 22nd Flemish Academic Economic Congress in 1995, it is very difficult to make an international comparison of social-security systems. If the researcher relies mainly on statistical information, such a comparative study is downright dangerous. Apparent similarities or differences in the figures are so strongly influenced by the differences in the national systems (range of application, risks covered, form of services, terms and conditions, administration) and by how the...

  15. TABLES AND CHARTS
    (pp. 375-376)
  16. BIBLIOGRAFIE
    (pp. 377-393)