Abstract
Encompassing health care systems in modern welfarestates embody several forms of solidarity: between thesick and the healthy, the old and the young andbetween those who take good care of their health onthe one hand and fellow citizens who choose to risktheir lives by smoking or unsafe sex on the other. Thelatter form is called lifestyle solidarity. In theNetherlands this type of solidarity has become theobject of a debate between medical ethicists. Mostmedical ethicist seem to want to uphold lifestylesolidarity. Most Dutch citizens agree with them. TheDutch government, however, embarked on a project tochange the health care system by transferring stateresponsibilities to other actors (employers, insurers,individuals). This changing policy may diminish ordestroy lifestyle solidarity despite the fact that noone intended this to happen.
Similar content being viewed by others
Notes and References
Blank, R.H. (1997) The Price of Life. The Future of American Health Care, Columbia University Press, New York, p. 106.
An example of Dupuis, H., discussed in De Beaufort, I.D. (1991) Eigen schuld, dikke bult: een pijnlijke kwestie? (It's Your Own Fault: a Painful Issue?), background study for the Committee on Choices in Health Care, SDU, Zoetermeer. 75
An example of see ref. 2.
Cf. Stronks, K. (1997) Socio-economic inequalities in Health: Individual Choice or Social Circumstances? thesis Erasmus University, Rotterdam.
Arguments for and against lifestyle solidarity are discussed in De Beaufort (see ref. 2.
Van der Veen, R.J. (1991) De Sociale Grenzen van Beleid. Een Onderzoek naar de Uitvoering en Effecten van het Stelsel van Sociale Zekerheid (The Social Boundaries of Policy. An Inquiry into the Implementation and Effects of the Social Security System), Stenfert Kroese, Leiden/Antwerpen; Trommel,W.A. (1996) Korter Arbeidsleven. De Wording van een Rationele Mythe (Early Retirement: the Birth of a Rational Myth), SDU, Den Haag.
Kohli, M., Rein, M., Guillemard, A.-M. and Van Gunsteren, H. (Eds.) (1991) Time for Retirement. Comparative Studies of Early Exit from the Labor Force, Cambridge University Press, Cambridge.
Andriessen, S., Veerman, T.J. and Vijgen, J. (1995) Risicoselectie op de Nederlandse Arbeidsmarkt. Selectieve Aanstelling en Afvloeiing van Personeel op grond van (Vermeende) Risico's binnen de Ziektewet en WAO (Risk selection on the Dutch labour market. Selective hiring and firing of workers based on (assumed) risks according to the laws on sickness and disability), CTSV, Zoetermeer.
Leichter, H.M. (1997) Lifestyle correctness and the new secular morality. In Morality and Health, ed. by A.M. Brandt and P. Rozin, Routledge, New York/London, pp. 359–378, p. 362.
Van Dartel, H. (1997) De wachtende werknemer: voor welke gezondheid kiest de gezondheidszorg? (The waiting worker: what kind of health does the health care system choose?). Beleid en Maatschappij 24, 221–236.
Van der Maas, P.J., Barendregt, J.J. and L. Bonneux (1996) The future of the health and health care of the Dutch. In Gunning-Schepers, L.J., Kronjee, G.J. and Spasoff, R.A. (Eds.), Fundamental Questions about the Future of Health Care, Preliminary and background studies, WRR Den Haag, pp. 23–40.
See ref. 11, p. 36.
Cf. e.g. NIPO (1999) U over de gezondheidszorg. Nederland over de toegankelijkheid van de gezondheidszorg (Your opinions about health care. The Netherlands on accessibility of the health care system). Onderzoek in opdracht van AGIS Groep Zorgverzekeraars, Agis Groep, Utrecht, p. 39.
Dunning, A.J. (Chairman) (1991) Kiezen en delen (an English version entitled Choices in Health Care was published in 1992), SDU, Zoetermeer.
Tijmstra, Tj. and Heinsbroek, N. (1998) Meningen over de zorgverlening in Nederland. Teruggang in tevredenheid geeft te denken (Opinions about health care in the Netherlands. Growing dissatisfaction food for thought). Medisch Contact 53, 811–813.
Dunning, A.J. (Chairman) (1992) Choices in Health Care, SDU, Zoetermeer, p. 145.
See ref. 1, p. 177.
Lomas, J. (1996) Reticent rationers: consumer input to health care priorities. In Gunning-Schepers, L.J., Kronjee, G.J. and Spasoff, R.A. (Eds.), Fundamental Questions about the Future of Health Care, Preliminary and background studies, WRR Den Haag, pp. 71–85.
Marmor, Th. and Werner, F.J.M. (1996) Discussion. In Gunning-Schepers, L.J., Kronjee, G.J. and Spasoff, R.A. (Eds.), Fundamental Questions about the Future of Health Care, Preliminary and background studies, WRR Den Haag, pp. 71–85.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Trappenburg, M. Lifestyle Solidarity in the Healthcare System. Health Care Analysis 8, 65–75 (2000). https://doi.org/10.1023/A:1009463023119
Issue Date:
DOI: https://doi.org/10.1023/A:1009463023119