These nineteen original essays explore the ways in which political and social values help to shape health care systems by analyzing what happened to the German health care system when it split after World War II into communist and noncommunist sectors. Since both systems evolved from the same foundation they form a natural experiment in history where the same phenomenon becomes divided into an experimental and control group. The book is the first to take advantage of this unique opportunity for comparative analysis; it is also the first social history of the German health care system from Bizmarck to the present. Donald Light's introduction, "State, Profession, and Political Values," is followed by eighteen essays grouped in four parts which cover the state and society, the social history of German health care, structural aspects of health care in the two Germanies, and healers and their patients.
Essays in Part I compare structures and values of state and society, the medical-industrial complex, and sociological patterns in the two Germanies. Those in Part II take up the origin and development of compulsory health insurance, the consequences of the National Socialist takeover for the administration of sick funds and for panel doctors, public health policy following the war, and political values and reconstruction. Part III focuses on comparisons of social security and health care systems, political values and the regulation of hospital care, ideological influences on the organization of ambulatory and hospital medical care, state control and drug supply, and the organization of tuberculosis prevention. Essays in Part IV discuss qualification and professionalization in the health care professions, legal aspects of the physician-patient relationship, the problem of induced abortion, mother and child care, occupational health and the older worker, and ideology and psychotherapy.
Donald W. Light is Professor of Social Medicine and Psychiatry at the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine and Senior Fellow at the Leonard Davis Institute of Health Economics.
Alexander Schuller is Professor of Sociology at the Free University of Berlin.
Light and Schuller's book shows sociological imagination at its best, used here in comparative health services research to separate generic characteristics in systems that are constant from those that reflect socio-political differences.
Odin W. Anderson, PhD, Professor of Sociology, University of Chicago and University of Wisconsin-Madison
This excellent work avoids one of the central problems of cross-national health care studies: the many antecedent differences between nations that confound rather than elucidate analysis of the differences in their systems of care. By exploring health care in two nations with a common history and culture this tudy is able, in a way that is exceptional for such studies, to isolate and analyze some of the current political and economic factors that determine the structure and function of a country's health care. The data and analysis have much to teach those concerned with health, with political economy, and with cross-national studies.
Victor W. Sidel, MD, Distinguished Univeristy Professor of Social Medicine, Montefiore Medical Center/Albert Einstein College of Medicine