Between State, Local Government and Market
Edited by Hellmut Wollmann and Gérard Marcou
Chapter 6: Health Services: Issues and Trends in Italy, France and Germany
Dieter Grunow, Francesco Longo and Martine Long INTRODUCTION Health as a Public Policy Reference Point and Goal The health status of the population is one of the central issues for all societies: it is a question of general survival, life expectancy and quality of life. It is also a prerequisite for the functioning of society as a whole. Many health care problems cannot be solved by primary social networks. Specialized collective action is needed, incentives for preventive action, intervention against illness, or compensation of side effects (i.e. income for food, clothing and housing). The three basic elements – causes, types of illness and forms of intervention – have been developing over time, and they now constitute a complex setting of health-related public issues. The definition, that is, the cognitive framework of health and illness plays the most important role in this setting. Health can be defined (negatively) as the absence of (known) diseases or (positively) – according to the World Health Organization (WHO) – as a status of complete physical, psychic and social well-being. It is evident that any type of definition has multiple effects on the search for causal factors – which more and more often are produced by society itself and not by nature. The development of infrastructure and treatment – curing, caring and compensating – is likewise influenced by the concept of health. There might also be some intervening factors stemming from societal belief systems and different systems of professionals or practitioners – that is, shamans, traditional Chinese medicine, and professional Western medicine. Most of...
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