Healthcare Futures: Visions of Solidarity and the Sustainability of European Healthcare Systems

Abstract

Four distinct visions of health care solidarity emerged from our Deliberative Forums on health care in the UK, Norway, Germany and Slovenia, which we term exclusive solidarity, universal solidarity, contributory solidarity, and equalitarian solidarity. These visions reveal national differences in citizens' ideas about the appropriate risk-community for healthcare, as well as the rights and duties of the members of this community. To some extent, these visions are related to the institutional organization of healthcare, and the history of healthcare institutions in these countries. They are often compatible with the attitudes expressed in large public opinion surveys. But the unusual opportunity provided by the Deliberative Forums for allowing participants to fully articulate their ideas and their justifications for their values also allows us to identify more coherent and measured rationales for these differences in public opinion, and their implications for the future politics of the welfare state.