Welfare States and Public Opinion
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Welfare States and Public Opinion

Perceptions of Healthcare Systems, Family Policy and Benefits for the Unemployed and Poor in Europe

Claus Wendt, Monika Mischke and Michaela Pfeifer

Welfare States and Public Opinion comprises an informed inquiry into three fields of social policy – health policy, family policy, and unemployment benefits and social assistance. Though the analyses stem from research spanning fifteen countries across Europe, the conclusions can be applied to social policy problems in nations worldwide. Combining a detailed analysis of the institutional structure of social policy with the study of public attitudes toward healthcare, family policy, and benefits for the unemployed and poor, this book represents a new stream in public opinion research. The authors demonstrate that the institutional designs of social policies have a great impact on inequalities among social groups, and provide best practices for gaining public support for social policy reform.
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Chapter 3: Healthcare – Our Greatest Good?

Claus Wendt, Monika Mischke and Michaela Pfeifer


Health is generally considered the most valuable commodity by individuals in all societies. As a consequence, healthcare providers are traditionally equipped with a high social status, and healthcare systems were institutionalized earlier than most other social security programs. Despite the great importance of health and healthcare, there has always been a dispute over the institutional structure that would best serve the goal of providing good-quality healthcare. Values that are partly in conflict with one another, such as equality, security and individual choice, have contributed to a complex process of institutionalization. Furthermore, powerful interest groups, such as doctors’ associations and public and private insurance funds, have been influential players in the health policy arena (Immergut 1992; Tuohy 2003; Wendt 2006), resulting in a great variety of healthcare systems in modern societies. Since the early 1990s, a great number of countries have begun implementing market mechanisms in their public healthcare schemes. Some health policy makers consider healthcare to be a good much like other goods and services and prefer a provision of healthcare to be negotiated among providers and purchasers in the healthcare market. Scholars of comparative health policy, on the other hand, have argued that market principles and profit-making incentives clash with the ideas of equality and security in healthcare (see Gauld 2009; Marmor et al. 2009; Okma and Crivelli 2009; Marmor and Wendt 2011). White (2009) even concludes that ‘it is silly to expect “market forces” to create integrated, high quality multispecialty medical organizations’ (White 2009, p. 51). These discussions...

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