Abstract
Twelve areas of reflection are presented in this chapter that are related to choices confronting all social health care systems. These are choices that may significantly influence the satisfaction of the population with the health care system. Moreover, these choices may determine to what extent the social health care system of a country proves to be sustainable. A first set of issues concerns the borders of the social health care system and we ask what its territorial scope should be, how the areas of social health care and private health care should be defined, and whether health care should be for all or only for the socially insured. We also address the question of whether limits should be set to the availability of health care, and if so, what they should be. All social health care systems, be they national health systems or social insurance systems, will have to make choices related to in-kind or reimbursement-based benefits, the co-payments by patients and freedom of choice regarding health care providers. We examine the advantages and disadvantages of such systems. All countries struggle with the way in which they finance social health care and ask themselves what the best way to employ and/or pay health care providers is. The responsibilities of the health professional and the patient must be defined. Finally, we discuss the impact of medical liability on social health care schemes.
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Notes
- 1.
This presentation is to a large extent based on my earlier article “Asistencia sanitaria, diez áreas de actuación”, in: Los retos actales de la asistancia sanitaria Española en el context de la Unión Europea, Ediciones Laborum, Murcia, 2016, pp. 951–962.
Bibliography
M. Albrecht and E. Knappe (2002) Soziale Dienste im Europäischen Binnenmarkt: im Spannungsfeld zwischen Sozialen Sicherungssystemen und Freiem Dienstleistungsverkehr (Idstein: Schulz-Kirchner).
K. M. Anderson (2015) Social Policy in the European Union (Basingstoke and New York: Palgrave).
J. Arpe, S. Milio, and A. Stuchlik (eds.) (2015) Social Policy Reforms in the EU: A Cross-National Comparison (SimEurope, London School of Economics, Bertelsmann Stiftung).
U. Becker (ed.) (2010) Security: A General Principle of Social Security Law in Europe (Groningen: Europa Law Publishing).
U. Becker, H. J. Reinhard et al. (2018) Long-Term Care in Europe: A Juridical Approach (Cham: Springer).
J. Berghman (1999) ‘Basic Concepts on Social Security in Europe’ in B. Greve and D. Pieters (eds.) Social Security in an Interdisciplinary Perspective (Antwerpen: Maklu).
J. Berghman (2003) Social Security Policy and Economics (Leuven: Universitaire Pers).
J. Berghman (2013) ‘Prevention: The Cases of Social Security and Healthcare’ in B. Greve (ed.) The Routledge Handbook of the Welfare State (London and New York: Taylor and Francis Group).
J. Berra (2000) La Structure des Systèmes de Sécurité Sociale: Étude de Droit Comparée (Lausanne: Institut de Recherches sur le Droit de la Responsabilité Civile et des Assurances).
A. C. Bianculli (ed.) (2016) Regional Organizations and Social Policy in Europe and Latin America: A Space for Social Citizenship? (Basingstoke and New York: Palgrave Macmillan).
J. Bradshaw (2003) Children and Social Security, XXXII (Farnham: Ashgate).
J. Bradshaw (ed.) (2008) Social Security, Happiness and Well-Being (Antwerp and Cambridge: Intersentia).
L. Bryson (1992) Welfare and the State (London: Macmillan).
B. Cass (1991) ‘Expanding the Concept of Social Justice: Implications for Social Security’ in M. Adler et al. (eds.) Sociology of Social Security (Edinburgh: Edinburgh University Press).
J. Clasen and W. van Oorschot (2001) Changing Principles and Designs in European Social Security (European Institute of Social Security; Centre for Social Science).
J. Clasen and W. van Oorschot (2002) ‘Changing Principles in European Social Security’, European Journal of Social Security, 4.2, 89–115.
Comité d’Histoire de la Sécurité Sociale. Association pour l’Étude de l’Histoire de la Sécurité Sociale (2006) L’esprit de Réforme dans la Sécurité Sociale à travers Son Histoire (Paris).
B. De Mars, D. Pieters and P. Schoukens (2010) ‘“Security” as General Principle of Social Security Law in Europe: Conclusions on Legislative Aspects’ in U. Becker, D. Pieters, F. Ross and P. Schoukens (eds.) Security: A General Principle of Social Security Law in Europe (Groningen: Europa Law Publishing).
R. Dillemans, J. Van Langendonck, B. Van Buggenhout et al. (1978) Ontwerp van Wetboek Sociale Zekerheid (Leuven: Universitaire Pers).
I. Dingeldey (ed.) (2009) Governance of Welfare State Reform: A Cross National and Cross Sectoral Comparison of Policy and Politics (Cheltenham: Edward Elgar).
A. Downes (ed.) (2018) It’s Basic Income: The Global Debate (Bristol: Policy Press).
J.-J. Dupeyroux (2001) Droit de la Sécurité Sociale (Paris: Dalloz).
E. Eichenhofer (2000) Bismarck, die Socialversicherung und deren Zukunft (Berlin: Berlin Verlag).
W. Eichhorst and A. Hemerijck (2010) ‘Welfare and Employment: A European Dilemma?’ in J. Alber and N. Gilbert (eds.) United in Diversity: Comparing Social Models in Europe and America (New York: Oxford University Press).
J.-F. Funck (2014) Droit de la Sécurité Sociale (Brussels: Larcier).
W. Gekiere, R. Baeten, and W. Palm (2010) ‘Free Movement of Services in the EU and Health Care’ in E. Mossialos, G. Permanand, R. Baeten, and T. K. Hervey (eds.) Health Systems Governance in Europe: The Role of European Union Law and Policy (Cambridge: Cambridge University Press).
B. Greve (ed.) (2013) The Routledge Handbook of the Welfare State (Abingdon: Routledge).
B. Greve and D. Pieters (eds.) (1999) Social Security in an Interdisciplinary Perspective (Antwerpen and Apeldoorn: Maklu).
H. Hansen (2002) Elements of Social Security: A Comparison Covering Denmark, Sweden, Finland, Austria, Germany, The Netherlands, Great Britain, Canada (Copenhagen: Danish National Institute of Social Research).
S. Häusermann (2010) The Politics of Welfare State Reform in Continental Europe: Modernization in Hard Times (Cambridge: Cambridge University).
M. Hill (1996) Social Policy: A Comparative Analysis (New York: Prentice Hall).
D. D. Hoskins (2000) Social Security Research: Change and Continuity (Helsinki: Kansaneläkelaitos).
D. D. Hoskins, D. Dobbernack, and C. Kuptsch; ISSA (2001) Social Security at the Dawn of the 21st Century: Topical Issues and New Approaches, VIII (Piscataway, NJ: Transaction Publishers).
B. Kahil-Wolff and P-Y. Greber (2006) Sécurité Sociale: Aspects de Droit National, International et Européen (Genève: Helbing & Lichtenhahn).
K. Kapuy, D. Pieters, and B. Zaglmayer (2007) Social Security Cases in Europe: The European Court of Human Rights (Antwerp and Cambridge: Intersentia).
P. A. Kemp, K. Van den Bosch, and L. Smith (2008) Social Protection in an Ageing World (Antwerp and Cambridge: Intersentia).
K. Kremalis (1996) Simplification and Systematisation of Social Protection Rules (Athens: Sakkoulas).
B. Lund (2002) Understanding State Welfare: Social Justice or Social Exclusion? (Thousand Oaks, CA: Sage).
J. Millar (ed.) (2009) Understanding Social Security: Issues for Policy and Practice, 2nd edn (Bristol: Policy Press).
J. Motmans, D. Cuypers, P. Meier, D. Mortelmans, and P. Zanoni (2011) Equal Is Not Enough: Challenging Differences and Inequalities in Contemporary Societies (Antwerp: Steunpunt Gelijkekansenbeleid).
G. Nezosi (2005) Problèmes Politiques et Sociaux: La Gouvernance de la Sécurité Sociale (Paris: Documentation Française).
A. Norton, T. Conway, and M. Foster (2001) Social Protection Concepts and Approaches: Implications for Policy and Practice in International Development (London: Overseas Development Institute).
M. P. Olivier (1999) Social Security Law: General Principles, XXXVII (New York: Butterworths).
J. Olk (1998) ‘Soziale Sicherheit im Globalen Dorf’, Zentralblatt für Sozialversicherung, Sozialhilfe und Versorung: Zeitschrift für das Recht der Sozialen Sicherheit, 52.4, 106–114.
Organización Iberoamericano de Seguridad Social (2006) Código Iberoamericano de Seguridad Social (Madrid: OISS).
F. J. L. Pennings (2006) ‘Social Security’ in J. M. Smits (eds.) Elgar Encyclopedia of Comparative Law (Cheltenham: Edward Elgar).
F. J. L. Pennings and G. Vonk (eds.) (2015) Research Handbook on European Social Security Law (Cheltenham: Edward Elgar).
D. Pieters (1998) ‘Reflections on the Methodology of Social Security Law Comparison’ in F. Ruland, B. von Maydell, and H.-J. Papier (eds.) Verfassung, Theorie und Praxis des Sozialstaats. Festschrift für Hans F. Zacher zum 70. Geburtstag (Heidelberg: C. F. Müller Verlag).
D. Pieters (2002) ‘Social Security Systems in Europe: Reacting to a Difficult Economic Context’ in Reform and Perspectives on Social Insurance: Lessons from the East and West (London, The Hague and New York: Kluwer Law International).
D. Pieters (2002) ‘What Is A Social Security Contribution and What Is A Tax?’ in Sozialrecht and Sozialpolitik in Deutschland und Europa: Festschrift für Professor Bernd Baron von Maydell (Neuwied and Kriftel: Herman Luchterhand Verlag).
D. Pieters (2002) The Social Security Systems of the Member States of the European Union (Antwerp and Cambridge: Intersentia).
D. Pieters (2003) The Social Security Systems of the States Applying for Membership of the European Union (Antwerp and Cambridge: Intersentia).
D. Pieters (2006) Social Security: An Introduction to the Basic Principles (Alphen aan den Rijn: Kluwer Law International).
D. Pieters (2009) Onze Sociale Zekerheid: Anders en Beter (Kapellen: Pelckmans).
D. Pieters (2010) ‘La Seguridad Social en Europa: Entre la Conservación del Pasado y la Construcción del Futuro’ in Asociación Española de Salud y Seguridad Social (eds.) El Futuro Europeo de la Protección Social (Murcia: Ediciones Laborum).
D. Pieters (2014) ‘Fuentes de Financiación y Futuro del Derecho Europeo’ in Los Retos Financieros del Sistema de Seguridad Social. Libro Homenaje al Profesor Antonio Ojeda Avilés (Murcia: Ediciones Laborum).
D. Pieters (2015) ‘Social Security and Freedom of Religion’ in S. Devetzi and C. Janda (eds.) Freiheit-Gerechtigkeit-Sozial(es) Recht. Festschrift für Eberhard Eichenhofer (Baden-Baden: Nomos Verlag).
D. Pieters (2016) ‘Assistencia Sanitaria, diez áreas de Actuación’ in Los Retos Actuals de la Asistencia Sanitaria Española en el Contexto de la Unión Europea (Murcia: Ediciones Laborum).
D. Pieters and B. Zaglmayer (2006) Social Security Cases in Europe: National Courts (Antwerpen and Cambridge: Intersentia).
D. Pieters and P. Schoukens (2015) ‘Social Security Law Instruments of the Next Generation: European Social Security Law as a Source of Inspiration?’ in F. Pennings and G. Vonk (eds.) Research Handbook on European Social Security Law (Cheltenham: Edward Elgar).
P. Rosanvallon (2000) The New Social Question: Rethinking the Welfare State (Princeton, NJ: Princeton University Press).
W. Schmähl (2009) Soziale Sicherung: Ökonomische Analysen (Wiesbaden: VS Verlag für Sozialwissenschaften).
E. Schokkaert (2001) Ethics and Social Security Reform, XIII (Farnham: Ashgate).
P. Schoukens (ed.) (2010) Security: A General Principle of Social Security Law in Europe (Groningen: Europa Law Publishing).
P. Schoukens (2016) EU Social Security: The Hidden Social Model (Tilburg: Tilburg University).
P. Schoukens and D. Pieters (2007) Social Security Quo Vadis? Interviews with Social Security Administration CEOs in 15 Western European Countries (New York: IBM Global Social Segment—IBM Corporation).
P. Schoukens, D. Pieters, U. Becker, and F. Ross (eds.) (2010) Security: A General Principle of Social Security Law in Europe (Groningen: Europa Law Publishing).
R. Sigg and C. Behrendt; Internationale Vereinigung für Soziale Sicherheit (2003) Soziale Sicherheit im Globalen Dorf (Bern: Peter Lang).
D. Simoens, D. Pieters, J. Put, P. Schoukens, and Y. Stevens (2005) Sociale Zekerheden in Vraagvorm; Liber Amicorum Jef Van Langendonck (Antwerp and Cambridge: Intersentia).
H. W. Sinn (1995) ‘A Theory of the Welfare State’, The Scandinavian Journal of Economics, 97.4, 495–526.
F. Stamati and R. Baeten (2015) Healthcare Reforms and the Crisis (Brussels: ETUI report).
A. Tollenaar (ed.) (2010) Social Security as a Public Interest: A Multidisciplinary Inquiry into the Foundations of the Regulatory Welfare State (Antwerp and Cambridge: Intersentia).
UNRISD (2009) Social Policies in Small States (Genève: UNRISD).
W. van Eeckhoutte and R. Blanpain (vol. ed., gen. ed.) (2018) International Encyclopaedia of Laws/Social Security (London, The Hague, and New York: Kluwer Law International).
J. Van Langendonck (2009) Een Andere Kijk op Sociale Zekerheid (Antwerp and Cambridge: Intersentia).
W. van Oorschot (ed.) (2014) Invisible Social Security Revisited: Essays in Honour Jos Berghman (Leuven: Lannoo Campus).
F. Vandenbroucke and B. Vanhercke (2014) A European Social Union: 10 Tough Nuts to Crack, Background report for the Friends of Europe High-Level Group on ‘Social Union’ (Brussels: Friends of Europe).
B. Vanhercke, S. Sabato, and D. Bouget (ed.) (2017) Social Policy in the European Union: State of Play 2017—Eighteenth Annual Report (Brussels: ETUI, OSE).
B. von Maydel and A. Nussberger (2000) Transformation von Systemen Sozialer Sicherheit in Mittel- und Osteuropa: Bestandsaufnahme und Kritische Analyse aus dem Blickwinkel der Rechtswissenschaft (Berlin: Duncker und Humblot).
G. Vonk and A. Tollenaar (ed.) (2009) Social Security as a Public Interest: A Multidisciplinary Inquiry into the Foundations of the Regulatory Welfare State (Antwerp and Cambridge: Intersentia).
Numerous papers and policy papers on social security topics coming from the European Union, the Council of Europe, the International Labor Organization, the World Bank, the International Monetary Fund, the European Institute of Social Security, the International Social Security Association and the European Social Observatory should be added, as well as the many interesting articles to be found in the European Journal of Social Security and in the International Social Security Review.
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Pieters, D. (2019). Policy Choices Relating to Social Health Care Schemes. In: Navigating Social Security Options. Palgrave Pivot, Cham. https://doi.org/10.1007/978-3-030-05992-7_4
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