How have historical conditions shaped the character of health policy in different states? Use two or more countries to illustrate your answer.

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How have historical conditions shaped the character of health policy in different states? Use two or more countries to illustrate your answer.

        The history of a country plays an important part in shaping public policy. This essay will discuss the historical conditions that have affected the development of health policy in different states. The essay will begin by defining the term ‘state’. It will then discuss the origins of health policy in certain states. The essay will focus on the emergence of health policy in Germany and Britain. The essay will, finally, try to determine if there is a similarity in the development of health policy in these three countries.

        Hague and Harrop (2001) define the term ‘state’ as “a political community formed by a territorially defined population which is subject to one government” (p 6). This is a good definition for the purpose of this essay because it is very clear and quite broad.

        There are a number of historical factors that can help influence the development of health policy in different states. In order to determine these factors it is important to discuss the origins of the policy within that state. This essay will focus on the development of health policy in Germany and Britain. Germany is important to the understanding of health policy because they were the first country to introduce health care legislation.

        The most important piece of legislation to be introduced in Germany, with regards to health policy, was the Sickness Insurance Law of 1883. This legislation became the cornerstone of German healthcare policy and had an immense impact on the development of health policy in other European countries. The Sickness Insurance Law was the first of a number of healthcare policies to be introduced by chancellor Otto von Bismarck in the latter part of the nineteenth century. (Leichter, 1979)

        The Sickness Insurance Law (1883) came into effect in December 1884. The underlying premise of the law was that the most vulnerable members of the population should, when ill, have access to medical assistance. The law also made provisions for dependants to receive income maintenance during periods of illness. Under the law the worker was entitled to four main types of benefits. These were medical, cash, maternity and funeral. The medical benefit provided free medical and dental treatment and allowed for free hospital treatment for up to twenty six weeks. The maternity benefit entitled to free medical attention and a lump sum cash benefit. Finally, the law provided money for the family of a deceased worker for funeral costs. The Sickness Insurance Law provided for compulsory participation for all industrial wage earners and by 1886 had been changed to incorporate most of the wage earning population. The program was financed through joint contributions by both employees and employers. The state, contrary to Chancellor Bismarck’s original intention, made no contribution. (Leichter 1979)

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        The Sickness Law was the first major piece of healthcare legislation to be introduced in Germany and was closely followed by the introduction of accident insurance in 1884 and invalidity and old age insurance in 1889. However, the 1883 health insurance law did not take into consideration the relation between sickness funds and doctors. The funds had full authority to determine which doctors were allowed to participate in the program and to set the rules and regulations under which that were able to do so. These rules and conditions were set down in individual contracts between the funds and the ...

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