Social Policy Developments in the UK and Germany - Term Paper Example

Introduction The ideology of welfare s has historical backgrounds. Welfare s expenditure comprise of funds to provide various services to its citizens. The intention of such governments is to improve the lives of its citizens. Some of the sectors that governments provide services include security, healthcare, social security and other services. However, there are various systems of welfare. These systems vary depending on regions and other factors. Healthcare is an important aspect for both the United Kingdom and Germany. There have been various changes in the healthcare system for the last 20 years. The United Kingdom uses a liberal approach to welfare while Germany takes a conservative approach. When one looks at the welfare of Sweden, one gets to realize that its system depends on trade unions. Sweden has strong unions; the country has funded healthcare and social security systems. Germany and the United Kingdom provide a classic example of welfare states. In comparison with previous welfare systems, modern systems have undergone several transformations. There have been challenges facing the global economic systems, government operation and problems arising from globalization affecting welfare states. The most important time for countries like Germany and the United Kingdom came during the Great Depression. This economic condition robbed countries and citizens of diverse rights. During this period, many people in these states became unemployed resulting in misery. These coupled with other influences in states drove policy makers into development of welfare states. Germany and the United Kingdom, have perhaps the oldest welfare systems. Policies on welfare in these countries have undergone various transformations up to now. The healthcare sector of these two countries is perhaps the backbone. The healthcare sector affects all individuals in such states. Therefore it is crucial for one to analyze their systems of Healthcare. These systems of governance can affect the consumption patterns of citizens, distribution of resources as well as personal incomes (Pierson, 1996). Consumptions and other benefits have an effect on the health of individuals in general. Crisis in the healthcare system would include an upsurge of diseases, financial or management crisis. In this light Europe’s economic crisis in the year 2008 had an effect on healthcare plans of European countries. This made individuals rethink about their medical insurance plans. According to information from the telegraph, some individuals were forced to abandon their medical cover. Theoretical Background Financial, Labor or Healthcare or any other crisis in both Germany and the United Kingdom bear different perspectives. Therefore, the healthcare system in those countries differs. To understand these differences, one needs to be familiar with the various challenges the healthcare systems face. It is imperative to note that both countries have different policies and approaches in handling healthcare crisis. There are various aspects related to de-co modification, accessibility and stratification that affect healthcare systems in these countries. De-co modification relates to the degree at which welfare services are free in the market. These aspects are also a measure healthcare growth. Citizens of both countries have access to healthcare systems cheaply, except for non mandatory healthcare services. Healthcare services like plastic surgery, facelifts and other procedures cost more in this market. Healthcare systems in such countries intend to provide services equally in their societies. However much these governments try to reform the healthcare sector they still undergo various challenges. For Germany, the government has to face challenges in ensuring better service delivery. The most important aspect for the German government is to offer health services at a cost effective rate. Their healthcare system undergoes various reform changes in providing high quality services. In relation to the United Kingdom’s healthcare system, the country has its own challenges. Some of these challenges involve finances and other aspects (Taylor-Gooby, 2002). Health care expenditures for both the United Kingdom and Germany have been on a steady increase. Both countries have their own systems and quotas of funding for healthcare services. The most popular methods of funding are through personal contributions or public spending. Figure 1Healthcare funding Germany and the U.K on Physicians Figure 2 Healthcare expense on hospital beds. (statistics according to Eurostat 2012) From the above data, it evident that Germany spends more than the united kingdom on healthcare. It is evident that Germany had increased its spending on healthcare by over 10%. The UK also had a considerable increase on its healthcare budget although less by 5% of Germany’s. The healthcare system of Germany as opposed to the United Kingdom offers a healthcare plan as a statutory service. The idea of such a system ensures that members in their scheme offer compulsory contribution. The system is same for the United Kingdom only that it does not insist on compulsory contributions. In Germany, those who are well-off hold the cost of healthcare. In the United Kingdom, healthcare services are under the responsibility of the National Health Service. England’s healthcare system involves a citizen-funded system. In this system, citizens of the country funds for most of healthcare cost through tax. The National Health Service provides healthcare services but through the assistance from other bodies. In the UK, there is also provision for private finance on healthcare (Estevez-Abe et al 2001). Private finance is largely financed through insurance schemes. These schemes might take the form of voluntary, mandatory, pensioners and voluntary payment by members. The system of healthcare finance in Germany observes some specific principles of social contribution and personal initiatives. The principles include; a sense of solidarity among its citizens towards payment of healthcare insurance. This important since it is a social health insurance scheme, users benefit in kind. Beneficiaries of these scheme benefit from direct treatment. Finance for these healthcare plans comes from employees and employers. There is a perception that social health insurance in Germany is better than insurance. The principle of this system ensures that there is a distribution of equivalent risk premiums (Daly, and Lewis, 2000). However, with all of these efforts the country has many challenges facing the health sector Challenges facing the Healthcare sector The healthcare sector in Germany and the United Kingdom faces diverse challenges. These challenges include partisan, Veto powers and competition. These aspects have had an impact in the development of economic policies, which affect healthcare. Partisan stands by policy makers might influence opinions and policy drafting. Veto players in such a situation try to exercise their powers in opposing other players’ views. This eventually affects the quality of any policy document. However, competitive veto players in policy development provide comprehensive benefits. The sector has undergone various policy changes, rising in cost of operations, rising cases of patients with chronic illness and threat of competition. Just like Germany, the United Kingdom faces same challenges. In the U.K there has been an increase in prices of Pharmaceutical drugs, the number of practicing doctors will have a future impact on the system, the number of acute beds needs to be increased to meet the number of patients. In the U.K and Germany, politics plays an important role in the development of healthcare policies. Rival political parties have a duty in the development of healthcare policies for both countries. Other challenges that the sector face include inadequate labor, drugs and the ever rise in people diagnosed with diseases (Farnworth and Irving. 2011). Other challenges facing the healthcare system in both Germany and the U.K include; the decrease in number of people paying insurance charges, a reduction in incomes of households, a change in demographics that affect the society and the rising cost of technology. There is also a lack of sufficient structures and prohibitive cost of providing medical equipments. Other challenges relate to environment and other behavioral influences. Environment has had an influence on the life expectancy rate of the people of U.K and Germany. There had been a decline in the life expectancy rate in from the years 1990 to 2004. This has drastically in female and male populations of all ages. However, one may note that life expectancy is lower in UK as compared to Germany. Life expectancy rate for Germany at the year 2012 was 83.30 for women and 78.60 for men. For UK the expectancy rate has dropped to 82.8 for women and 79.0 for men. Another very important aspect critical for to the financing of healthcare relates to lifestyles. There has been a considerable increase of people abusing alcohol in these countries and people abusing illegal drugs. Health has also an effect on individuals’ socioeconomic status. It is prudent to estimate that children raised in families with lower socio economic status tend to develop deficits. Prevalence of Chronic diseases is perhaps the most challenging aspects of healthcare in countries of the European region. Case Comparison: Healthcare Policy Reforms With a lot of challenges and globalization influences, Germany and U.K health sector face future failure if reforms do not work. There are various reforms on the healthcare sector for these countries but the greatest type of reform relates to financing. According to reports from the National Health sector service of the United Kingdom, the new reforms would raise contributions to 3 billion pounds. Reforms in Germany, seek to manage competition, improve efficiency and maintain the quality of services (Bermeo, and Pontusson, 2012). The last 10 years has seen major reforms in Germany in terms of Healthcare. In the year 2002, there was the introduction of Case Fees Act and the Contribution Rate of Stabilization Act. This Act provides the rate of contribution for every household. It also ensures that individual pay such fees in accordance to their earning rates. In the following year 2003, there was an introduction of the Statutory Health Insurance Modernization Act. This Act rolled out an insurance scheme and its cost to citizens. In the year 2004, the government introduced the Act to Adjust Financing of Debentures. The Act made the country increase its healthcare funding, making Germany one of the countries in Europe with the largest Healthcare budget. In Germany, the SHI Health Care Delivery Structure Act, Rural physician Act of 2012, provides several suggestions. The policy provides an elaborate scheme, which is risk, adjusted; these reforms materialize through selective contracting. The policy on the other hand ensures that physician negotiation is present to ensure better outpatients care (Lungen, and Irvine, 2003). Due to some inefficiency in healthcare in the country, the policy proposes for an improvement in efficiency of service delivery. This policy, wishes to improve efficiency through employment of qualified staffs, improvement of technology, use of telemedicine and the internet (Estevez-Abe et al 2001). This policy intends further on improving the quality of services offered. To ensure quality, German policy makers on health propose a mandatory quality assessment model for outpatients and inpatients. This Acts relate to healthcare funding as proposed in parliament by legislatures (Cooksey & Cooksey, 2006). The U.K in the year 2006 reformed the healthcare sector through; the National Health Service Act. The Health and Social Care Act came into operation in the year 2012. This law by the parliament of the United Kingdom seeks to reorganize the National Health Service of the country. The policies first mandate is to abolish Strategic Health Authorities, as well as trusts held by the NHS. This means that additional funds are transferred to other service sectors because of abolishment (Estevez-Abe et al 2001). There are proposals to developing a new Department of Health. The policy does not ignore the fact of privatization. Largely privatization is inevitable. Funding of healthcare in the UK, relates to several key indicators. The country has set funds for drugs and pharmaceutical expenditures, staff and provision of training. Such indicators are crucial to reforms in the country. The country has a huge healthcare staffing rate, but performs poorly in several areas. The healthcare Act of 2012 went through all readings in the parliament of the United Kingdom. The bill further came into law and the first of its tasks was to abolish NHS Care Trust. The cost of abolishing these units goes towards other healthcare service providing centers. The policy relies on these principles; empowering professionals in the sector, emphasis on quality measurements of clinical results and patients treated with dignity (Emmerson, and Alissa, 2000). In Germany on the other hand, the policy seeks to provide equality in the sector, check the rising costs of spending on healthcare. The cost of healthcare has been on the rise for decades. This trend is bound to continue as long as there is an economic growth. This is not just a myth since the truth is that healthcare cost rises with the rise in economic growth. Discussions The principle of all healthcare systems in states is for the government to offer quality health services. Most of the healthcare services involve collective responsibilities of the state and its citizens. The presence of the state in such engagements is to ensure that healthcare is offered to all persons in a population free. The National Health Service of the United Kingdom provides services through the powers of its citizens (Moran, 1999). The institution receives funds from insurance contributions of individuals, government, employers and employees. The British system of government still maintains its collective responsibility approach to funding but recognize emerging problems (Jessop, 2002). The government has taken various strategies in ensuring a smooth healthcare system. Some of its strategies include the change of policy and the restructuring of the healthcare system. Germany is another progressive country in terms of healthcare development. Recent reforms of 2012 brought various differences in the healthcare sector of the country. These developments also improved healthcare provision in the rural areas. The new system of healthcare in the state as compared to the traditional model is remarkable different. The traditional model of healthcare ideology bases on the scheme of collective aims. This system is extensively monetary. Looking at the new paradigm shift, one will realize that healthcare benefits are of a holistic nature. In the previous system of healthcare in welfare states, the market place consists of people and their behaviors determines price. Nevertheless, the new system ensures that cost concurs with the relationship between a physician and a patient. In the previous system, the management was of a top-down approach, where patients receive treatment collectively. Today’s healthcare system however, ensures that individual patients benefit from the system. Healthcare financing in the United Kingdom consists of 10 territories. Each of these territories has its authorities responsible for providing healthcare services. Their functions are to monitor several service provisions within regions. These Authorities on the other hand ensure that interested parties comprehensively follow policy guidelines (Bonoli, 2006). The system in the country promotes the sharing of resources between several trusts. The funding of such trust relates to provision of funds for NHS acute trust administrator hospitals. Such funds go to ambulance service sectors and to the mental health sector. With a budget of 100 Euros the government is therefore able to cater for most of its healthcare needs. The process of distribution of such resources follows the social economic status of people and on other factors. Most of the services provided by private physicians in such institutions are subsidized by the state in U.K. Such acts by the government ensure uniformity on the quality of services offered by the state. The British government faces the challenge of rising costs of services. With several initiatives and strategies, the government of Britain has been able to meet its performance targets; managed finances as well create efficiency within the system (Emmerson et al 2000). Germany in the Healthcare financing has greatly improved. With life expectancy as the indicator of growth, there has been an upsurge of the expectancy rates between the years 1990 and 2004. The life expectancy rate has improved for all genders and age groups. Since the period of 1990, the expectancy rate of men has increased by 3.8 while for women increased by 2.8 years. Germany and Britain a welfare states, represent a group of states who value welfare ideology. To say that welfare states are is in crisis is not a myth. From the healthcare perspective, we have seen that these nations undergo various problems. The problems may range from lack of adequate finances, socio-economic issues as well as politics. Therefore, welfare states do encounter various challenges (Connolly, Bevan, & Mays, 2010). Esping-Anderson classifies welfare states into three categories. According to this scholar, welfare states are either Social- democratic, Christian democratic and liberal states. These states have their unique way of managing affairs. The difference in style means a difference in policy as well as operation. The states have their own ways of overcoming economic pressures, as well as other pressures. Pressures on these states may be of an economic, social or political nature (Bonoli, 2006). The United Kingdom uses the liberal model of governance. In such a system, the state interferes with operations in order to provide for the poor. On the other hand, Germany represents a Christian Democratic also “corporatists”. The country promotes the principle of subsidiary. In such a system, schemes of social insurance become important. The other important aspect of the system is that the system permits stratification. Stratification ensures that there is uniformity in service provision (Taylor-Gooby, 2002). Through the years, welfare states have evolved. It is imperative to note that welfare states have devised ways of survival in every economic and social situation they encounter. The world is undergoing various budget crisis and other austerity measures (Robinson, 2002). Since historical times, welfare states have had means of overcoming such challenges. Take for example, a scenario where a government faces a fiscal crisis. The fiscal crisis seem a great mountain, but with considerable efforts, a welfare sates is able to adjust itself. Many Healthcare scholars regard Fiscal crisis as a challenge, but through experience governments have been able to avoid challenges that might collapse the healthcare system. Welfare states may not be the best solution; one might argue, but what is the best system of government? All systems of governments irrespective of design face its challenges (Douglas, 2002). In relation to the future welfare, certain problems are inherent; certain situations need reform or abolishing. Conclusions To solve such inadequacies in a society would mean certain shifts of policies and procedures. The paradigm shift of a welfare economy would have to consider the aging population, unemployment levels and a definite increase in expectancy levels. In this system of governance, there is a possibility of welfare states to solve the fiscal crisis. To solve such crisis it is an observation that welfare states may reduce the cost of operation. To reduce the cost of welfare states does not mean the state will lose its role of ensuring the society is humane (Bermeo, and Pontusson, 2012). The countries may adjust its expenditure. There are some specific sectors in the economy that might need more funds than others might. For example, health care services falls much on birth and on old aging citizens. Therefore, the government needs to adjust their spending in relation to needs of that time. Globalization as phenomena has a declining influence on states. With global trends and influence on individuals, governments need to developed different system of governance. People’s movement, flow of capital, goods, media and information are now under international governance. Governments will content with changing their laws to suit certain regions or groups. This would eventually end the popular notion of sovereignty of people (Kimberly, Pouvourville, & DAunno, 2008). Globalization as an aspect in this new era is perhaps a wonderful becoming. Majority of old styled policy makers would wish to hold on to “Golden age” ideologies (Busemeyer, 2009). Holding to such ideologies promotes ignorance. Globalization will influence healthcare reforms. The phenomena will reduce the number of people paying taxes. Nevertheless, on the positive side governments would now fight with private groups in the provision of services. This is a benefit to consumers. This type of effect would yield a tax pre-distribution. In this type government systems funds, originate from tax redistribution. For both states, healthcare sector is vital. Germany funds its healthcare services through insurance scheme while the U.K has a mixed economy where the government provides as well as funds from citizens. These strategies coupled with emanating ideas help states stay afloat despite economic times. Moreover, one must not ignore the fact that the future is here and now. Globalization is the next field of debate. Will globalization end states? Will states be able to undergo future changes? This can only be answered by the progressive nature of humanity. Reference List Bermeo, N. and Pontusson, J. 2012. coping with crisis.Government reactions to the Great recession, New York: Russel Sage Foundation. Bonoli, G.2006. "New social risks and the politics of post-industrial social policies." The politics of post-industrial welfare states: adapting post-war social policies to new social risks Pp: 3-26. Briggs, A.2000. "The welfare state in historical perspective." The welfare state reader 2. Busemeyer, M.2009. 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