The Transformation of the Social Right to Healthcare

Evidence from England and Germany

This pathbreaking book investigates welfare state change in the area of health care- a field widely neglected by comparative welfare state research. While some work on health care expenditure exists, health care rights have not been systematically studied since social rights have exclusively focused on entitlement to cash benefits. Addressing this research gap, Böhm analyses in what way the social right to health care has been modified in the course of general welfare state transformation since the late 1970s. Taking England and Germany as examples, she assesses how health care reforms conducted under the conditions of constrained budgets, demographic ageing, and rapid medical progress, have altered access to and generosity of public health care systems over the past 35 years. The book’s findings significantly increase our understanding of social rights and reveals fundamental differences of approach: while Germany provides absolute and enforceable rights to health care for each (entitled) individual, English social health care rights are directed towards the population as a whole and contingent upon the availability of resources, i.e. they are not absolute and not enforceable. This distinction between individual and collective social rights will be an important contribution to the theory of social rights given its applicability to other types of social rights and its usefulness in tracing changes in social rights over time.