Health Care Analysis 8 (4):355-376 (2000)

We analyse solidarity as a mixture of social justice on the onehand and a set of cultural values and ascriptions on the otherhand. The latter defines the relevant sense of belonging togetherin a society. From a short analysis of the early stages of theDutch welfare state, we conclude that social responsibility wasoriginally based in religious and political associations. In theheyday of the welfare state, institutions such as sick funds,hospitals or nursing homes became financed collectively entirelyand became accessible to people of all denominations. Solidaritywas transformed in a more general category, related to the statusof Dutch citizenship. Responsibility was transformed tocollective responsibility.Financial pressures on the Welfare State have resulted in adebate on choices in health care and in a number of systemreforms, so far relatively small. In the surrounding discourse,justice was linked to private responsibility. Both fromgovernment officials and from participants in the societaldebate, moralistic overtones could be heard concerning the threatof overburdening of the health care system by citizens.In this paper, we develop a concept of reflexive solidarity thatlinks elements of social justice to conceptualisations ofresponsibility that address policy makers and health careinstitutions as well as citizens, in their role of carereceivers. A short analysis of the phenomenon of personal budgetsin care services should prove that our concept of reflexivesolidarity is not empty. Linked to, but beyond the concept ofjustice, issues of social responsibility can be addressed withoutmoralistic overtones
Keywords citizenship  health care  justice  Netherlands  personal budgets  solidarity
Categories (categorize this paper)
DOI 10.1023/A:1026587031528
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 70,265
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

Political Liberalism.J. Rawls - 1995 - Tijdschrift Voor Filosofie 57 (3):596-598.
Liberalism and the Limits of Justice.Michael J. Sandel - 1998 - Cambridge University Press.

View all 21 references / Add more references

Citations of this work BETA

Global Health Justice and Governance.Jennifer Prah Ruger - 2012 - American Journal of Bioethics 12 (12):35-54.
Bonuses as Incentives and Rewards for Health Responsibility: A Good Thing?H. Schmidt - 2008 - Journal of Medicine and Philosophy 33 (3):198-220.

View all 20 citations / Add more citations

Similar books and articles


Added to PP index

Total views
52 ( #218,232 of 2,507,667 )

Recent downloads (6 months)
1 ( #416,871 of 2,507,667 )

How can I increase my downloads?


My notes