1st Edition

The Transformation of the Social Right to Healthcare Evidence from England and Germany

By Katharina Böhm Copyright 2016
    254 Pages 2 B/W Illustrations
    by Routledge

    254 Pages 2 B/W Illustrations
    by Routledge

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    This pathbreaking book investigates welfare state change in the area of health care- a field widely neglected by comparative welfare state research. While some work on health care expenditure exists, health care rights have not been systematically studied since social rights have exclusively focused on entitlement to cash benefits. Addressing this research gap, Böhm analyses in what way the social right to health care has been modified in the course of general welfare state transformation since the late 1970s. Taking England and Germany as examples, she assesses how health care reforms conducted under the conditions of constrained budgets, demographic ageing, and rapid medical progress, have altered access to and generosity of public health care systems over the past 35 years. The book’s findings significantly increase our understanding of social rights and reveals fundamental differences of approach: while Germany provides absolute and enforceable rights to health care for each (entitled) individual, English social health care rights are directed towards the population as a whole and contingent upon the availability of resources, i.e. they are not absolute and not enforceable. This distinction between individual and collective social rights will be an important contribution to the theory of social rights given its applicability to other types of social rights and its usefulness in tracing changes in social rights over time.

    Introduction; The social right to health care and the transformation of the welfare state; Health care entitlement in England; Health care entitlement in Germany; The transformation of the social right to health care; Explaining health care entitlement reforms; Conclusion; Appendix


    Katharina Böhm is Junior Professor for health policy and politics at the Ruhr University Bochum, Germany. She has published on various health policy issues, including priority setting and rationing, Europeanization of health policy and German health policy reforms.

    Many books are described as path-breaking, but this one is genuinely so. The notion of rights to health care has been rarely explored in a European context and Katharina Böhm’s scholarly study of the evolution of these rights over the last thirty years in England and Germany is unique. It is a major contribution to our understanding both of such rights in general and of their place in the two countries’ health systems.

    Julian Le Grand, Professor of Social Policy, London School of Economics, UK