The Price of Unification: The Emergence of Health & Welfare Policy in Pre-Bismarckian Prussia

Abstract

till the German model of a “welfare state” based on compulsory health insurance is seen as a main achievement in a wider European framework of health and welfare policies in the late 19th century. In fact, health insurance made medical help affordable for a steadily growing part of population as well as compulsory social insurance became the general model of welfare policy in 20th century Germany. Without doubt, the implementation of the three parts of social insurance as 1) health insurance in 1883; 2) accident insurance in 1884; and 3) invalidity and retirement insurance in 1889 could stand for a turning point not only in German but also in European history of health and welfare policies after the thesis of a German “Sonderweg” has been more and more abandoned. On the other hand, recent discussion seems to indicate that this model of welfare policy has overexerted its capacity. Economically it is based on insurance companies with compulsory membership. With the beginning of 2004 the unemployment insurance in Germany has drastically shortened its benefits and was substituted by social S