Social Policy in Healthcare of Germany and France - Essay Example

 A comparative cross-national account of social policy in Healthcare of Germany and France with applicability of convergence/functionalist and path dependency/institutionalist Economic opportunity usually enables a nation to manage its assets for the generation of income and alternative options of development. With this concern, the essay has been structured with formulating diverse healthcare policies of various nations with an intention of providing the society with better healthcare related prospects and facilities. The approaches with respect to healthcare services generally include proper financing framework and effective governmental regulations (Mahmud & Parkhurst, 2007; OECD, 2010).This particular essay will provide an insight about the healthcare policies prevailing within France and Germany. Apart from this, the essay will also discuss about the key characteristics of the social policies with respect to the aforementioned two countries. On further note, the essay will relate about the implications of the healthcare polices with respect to France and Germany. Furthermore, the social policy field i.e. healthcare would be analysed from the perspective of two comparative perspectives i.e. convergence/functionality and path dependency/institutionalist. The healthcare policies are formulated with the sole intention of providing the society with better healthcare prospects. The approaches with respect to healthcare services generally include proper financing framework and effective governmental regulations (Mahmud & Parkhurst, 2007). In relation to determine the key characteristics of German healthcare system in recent years, it can be apparently observed that the system has undergone massive changes with the aim of developing the healthcare reforms and regulations. These changes being executed in an effective manner would certainly assist the government in reducing the ‘Spiralling costs’ that are associated with the healthcare reforms. In Germany, it has been often observed that the individuals who earn below €49,500 are usually provided with the benefit of ‘statutory health insurance scheme’ (SHI). Apart from the insurer, the SHI scheme provides coverage to the insurer’s dependence also. Germany’s social insurance system was established in the year 1883. In this respect, there exist few principles related to healthcare policies in Germany. These principles being identified as solidarity, subsidiarity and corporatism (Reibling, 2010) The principle of solidarity signifies taking responsibilities by the governments of helping the society at large in terms of indulging into the conduct of various initiatives. It is worth mentioning that the people who are not being able to participate in the health insurance sector are mainly covered under the aspect of solidarity. On the other hand, subsidiarity is regarded as the decentralised system, which depicts the policies being implemented by the political along with the administrative power (Reibling, 2010). Under the basic law of 1949, the policy of subsidiarity is executed and regulated by the political parties related to the German constitution. Subsidiarity with respect to the healthcare system prevailing in Germany reflects that the government of the nation involves in the planning of regulations and the legislative framework with respect to the development of effective healthcare policies. Finally, corporatism is regarded as the ‘democratically elected representation’ pertaining to the employees along with the employers based on governing boards related to sickness funds. Corporatism is looked upon as an important factor with regards to the decisions-making process of the healthcare reforms pertaining to national and regional level. In such heath regulatory reforms or policies, it becomes quite difficult for any of the health professionals to change the rules or increase the fees according to their personal interest (Reibling, 2010). The coverage under the scheme of SHI reflects upon various significant aspects that include rehabilitation, dental care and compensation for sick leaves as well as prescription drugs among others (Clarke & Bidgood, 2013). In accordance with the aspect of sickness funds, it has been often observed that there are around 300 in numbers within Germany. In this regard, the sickness funds have become the central point with respect to the development of health insurance reforms. The policy makers of Germany have adopted various measures in order to design the sickness funds as customer-oriented approach. It is worth mentioning that these funds are basically financed through the payroll taxes. The amount allocated for the payroll taxes is inscribed as 15.5% of the gross-wages of the employees. These particular sickness funds provide coverage to 90% of the population in Germany. Apart from this, another health policy exist within Germany is the Private health insurers (PHIs). PHIs policy basically charges the premium on the basis of individual risks. This particular regulation insured the contracts for the entire life of the insurer. Furthermore, this particular regulation increases the premiums only for the general expenditure. On further note, the other health reforms being implemented in Germany are ‘partial portability of ageing provisions in the PHIs’, Central health fund for the SHI and Morbidity-based risk adjustment in SHI (Morbi-RSA) among others (Stolpe, 2011; Busse & Riesberg, 2004). In contrast, the healthcare system prevailing in France mainly combines the coverage of the people with respect to private along with public sectors. It would be vital mention that the French healthcare sector is efficient enough to provide effective health related services to the societal members. The patients receive fuller satisfaction and the costs being incurred in the healthcare services are quite lower as compared to others. In France, it has been ascertained that the French parliament endure the responsibility for setting up the annual budget pertaining to the social security scheme. The Ministry of Health of France is mainly responsible for the development of the health policies. It is also involved in setting of the prices that are required for carrying out certain specific procedures associated with the healthcare treatment. It is worth mentioning that in the year 2007, the High Council of Public Health (HCSP) has been established under the Public Health Act. This particular body mainly provide solutions to the major health problems persisting within the French society (The Health Systems and Policy Monitor, 2010). In order to determine the key facets of the healthcare policies prevailing in France, it can be observed that High Council for the Future of Health Insurance (HCAAM) has formulated a few of effective health reforms that provided greater aid in developing healthcare systems pertaining to the area of finance along with equity. On further note, National Health Conference was created with a motive to gather all healthcare representatives, professionals and experts for discussing about the healthcare priorities required to be focused at the national level. Furthermore, it has been determined that the National Social Security Scheme (NSSS) has distributed its policy on the basis of four parts i.e. sickness and the maternity benefit, invalidity insurance, accidents pertaining to the work along with occupational disease and insurance during death. In the year 1983, medical assistance specifically for the poor individuals has been established in order to maintain parity in the society and also to provide the people with effective healthcare services. Furthermore (?), the National health insurance (NHI) provides guaranty of providing healthcare services to the entire society. It has been further ascertained in this regard that in France, the insurers often avail the coverage under the name ‘Carte Vitale’ (Clarke & Bidgood, 2013). This particular facility is quite similar to the credit card indicating the rights with regards to the national insurance. In this aspect, Carte Vitale is not exactly regarded as the means for paying the bills but enabling the government to provide credit to the needy patients and reimburse the amount on immediate basis. Additionally, it can be noted that the French government is enjoying (?)the role of supplementary health insurance. In this regard, supplementary insurance provides the coverage to the people, who are not covered under the NHI. there exist three principles based on which the French healthcare system depends a lot. These three principles entail personal payment, freedom of practice and choice of medical professionals. Specially mentioning, Universal health insurance (CMU) provides coverage to the French society based on two tier-processes. It has been further ascertained that at the first level, the CMU provides coverage to all the legal French residents. Furthermore, in relation to the second level related to CMU, it basically provides supplementary insurance to the person those who are earning 3600FF per month (Pen, 2009). In relation to analyse convergence and path dependency as comparative perspective, Max Weber, a sociologist of Germany has broadly influenced the social theory and the entire sociology discipline (Weber, 2004). Anthony Giddens, the modern sociologist has formulated the ‘theory of structuration’. In this regard, the theory basically reflects about the social forces that lay a greater influence on the societal change (Held & Thompson, 2004). Specially mentioning, convergence theory is regarded as the thesis, which depicts that within the healthcare ecosystem, the stakeholders require working with a motive to attain the desired outcomes. In this respect, one of the outcomes can be ascertained as better patients’ success at a lower investment. It would be vital to mention that numerous loopholes or pressures have been detected within the health care system. The common pressures that the heath care sector experience include administrative issues, unnecessary care is being imposed on the patients and perverse incentives related to health care facilities among others. The persistent differences relating to the healthcare policies include the application of health technologies and their comparative effectiveness on the insurers that often act as a remedy to health care convergence. On further note, the convergence model accelerates the focus on the real world and also introduces the loop holes within the healthcare system with regards to value-based pricing. In case of France, it has been often observed that social insurance is the common pressure, which underlies within the country’s health care system. This particular country have experienced extensive slower rate of contribution within the health care policies. In this respect, the reasons being depicted are slower economic growth along with the acceleration of the unemployment rate. This further reflects about the common problems of accelerated health care policies. This reflects one convergence aspect related to economic pressure, which is associated with the spending power of the individuals within the health care system. France has taken certain effective measures to improve the healthcare reforms and the underlying problems in the form of adopting significant policies. These policies include maximising consumer satisfaction along with quality of care and minimising health care costs among others (Figueras et. al., 2008). Germany also face the similar problems that are related to financial deficit and social insurance funds. These aspects eventually created massive pressure on the country’s wider economy. Society’s income along with expenditure is looked upon as convergence within the healthcare sector. As apparently observed, Health Technology Assessments (HTAs) are currently executed by Institute for Quality and Efficiency in Healthcare (IQWiG) within the German government for patient’s welfare. It can be noted that the government of Germany is taking effective measurers in order to mitigate the underlying common problems persisting within the healthcare system by taking support from HTAs (Kpmg, 2014; Blank & Burau, 2007). Furthermore, it has been determined that the cost-containment mechanism has been applied by the German government with a view to mitigate the health care problems. Furthermore, the concept of convergence is based upon the structures that can be applied under critical situation with respect to healthcare policies. In accordance with the convergence/functionalist perspective, the healthcare policies being implemented by the country tend to get developed in the societal, political and economic context. The common pressures that underlay the health care system are greatly impacted by the country’s environment. It would be vital to mention that industrial revolution has brought about numerous changes in the healthcare reforms. In terms of industrial development, the convergence/functionalist approach has been executed in the fields of industrial production as well as the living arrangements, income, wealth and the lifestyle of the people dwelling within the society. Specially mentioning, the convergence or functionalist perspective also lays implications on the distribution of wealth, equality concepts and right for accessing the welfare along with the health policies among others. In consideration, the healthcare policies being undertaken by the French government also reveal changes with regards to the convergence/functionalist perspective (Green & Turner, 2013). Furthermore, after the industrialisation era, the living standard of the people within the French and German society has increased. The industrialisation era has impacted greatly on both the countries. It can be further ascertained that due to industrialisation, various persistent problems within the health care system can be apparently viewed. Medical innovation and the utilisation of latest technologies are the common differences that persisted within the healthcare systems of both the nations. This projects the path dependency aspect. It can be well ascertained that medical innovation and advanced technology within the health care system have shown accelerated success rate. In comparison with the historical development of the medical innovation along with the advanced technology, recent scenario has depicted immense success rate. In this respect, it can be ascertained that the health care sector has witnessed numerous developments and growth rate only due to the application of medical innovation along with execution of advanced technologies (Figueras et al., 2008). The people are earning more and are ready to invest in healthcare reforms for accelerating numerous benefits. In-fact, it can be apparently observed that in France, people spend more in healthcare services (Green & Turner, 2013). This ensures that after industrialisation, the people are spending much due to obtaining accelerated incomes. On further note, in terms of convergence/functionalist approach, it can be well ascertained that the political pressures are also related with the convergence mode. In case of the forced policy transfer, it is a part of political pressure and a mechanism for promoting convergence such as imposition. In this regard, the convergence perspective in terms of political pressures laid influence upon the healthcare policies of both France and Germany. The implementation of the latest healthcare polices with respect to the convergence perspective reflects societal, political and economic development in both the countries (Green & Turner, 2013). In accordance with the approach of path dependency or instituitionalist, the economic policies undergo an evaluation phase. With respect to the increasing returns, relative benefits being achieved under the path dependency/institutionalist approach are higher than the available possible options. In this regard, it can be further ascertained that the concept of path dependence is quite similar to that of institutionalism (Kennett, 2004). With respect to France and German, both the countries endure certain historical implications on health reform path, which is being followed in recent times. In the context of the healthcare policies been provided by the German society, it can be apparently observed that private along with non-profit organisations largely depends on the history for changing the reforms and policies accordingly. In France and Germany, the health insurance systems take into account the medical history of the patients for setting up the medical reforms (Kennett, 2004). The percentage GDP rate of France is depicted around 11.7%, which is being contributed to the fund health care. Whereas, in case of Germany, the GDP rate is depicted around 11.3% contributed to the healthcare fund. In recent scenario, the measures of health reforms being undertaken by both the countries have shown positive outcomes (The World Bank, 2014). In conclusion, the aforementioned study provided an overview about the various reforms and healthcare policies that are being framed in France and Germany. The findings reveal that SHI emerged as one of the prior healthcare reforms being practiced in Germany. In France, the healthcare reforms such as HCSP provide ample opportunities to the society to avail the health benefits. Same. On further note, the healthcare reforms persisting within France further includes HCAAM and NHI that implies the implementation of all the latest reforms for providing the society with utmost health benefits. REFERENCES Busse, R. & Riesberg, A.,( 2004) Health Care Systems in Transition. Euro, pp. 1-227. Blank, R. & Burau, V.,(2007) Comparative Health Policy. Palgrave. Clarke, E. & Bidgood, E., ( 2013) Healthcare Systems: France. Civitas Report by David Green and Benedict Irvine, pp. 1-16. Figueras, J., McKee, M., Lessof, S., Duran, A., & Menabde, N. (2008). Health systems, health and wealth: Assessing the case for investing in health systems. World Health Organization, 1-5. Green, S. & Turner, E.,( 2013) Policy Convergence in the UK and Germany: Beyond the Third Way? Routledge. Held, D. & Thompson, J. B.,( 2004) Social Theory Of Modern Societies: Anthony Giddens And His Critics. Cambridge University Press. Kennett, P.,( 2004) A Handbook of Comparative Social Policy. Edward Elgar Publishing Kpmg, (2014) what is Driving Healthcare Convergence? Research. OECD, ( 2010) Health Care Systems: Getting More Value for Money. Economics Department Policy, pp. 1-11. Pen, C. L., ( 2009 ) The French Health Care System. ISPOR. Reibling, N.,( 2010) Healthcare Systems In Europe: Towards An Incorporation Of Patient Access. Journal of European Social Policy, Vol. 20, Iss. 1, pp. 5-18. Stolpe, M., (2011) Reforming Health Care –The German Experience. IMF, pp. 1-30. The Health Systems and Policy Monitor, (2010) Health Systems in Transition (HiT) Profile of France Public Health. The World Bank, 2014. Health expenditure, total (% of GDP). Retrieved From http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS Weber, M. ( 2004) Chapter 4 Chapter Summary. Max Weber's Methodology, pp. 1-2. Read More