TY  - JOUR
A1  - Friedlein, Nicole
T1  - Promoting individual health tesponsibility in the welfare state
JF  - European journal of health law
N2  - The public health insurance in Germany will face huge economic challenges in the upcoming years. New diagnostic and therapeutic methods as well as the demographic change contribute to constantly rising expenditure. Although incentives for health-promoting behaviour or financial sanctions for an unhealthy lifestyle have been already discussed in the past, there has been a general reluctance to legally establish corresponding mechanisms for fear of eroding solidarity and increasing state control. In the course of the Coronavirus pandemic however, a stronger awareness rose to the fact that personal health-related life choices can have a huge impact on the stability of the healthcare system including public health insurance. Not only in Germany but throughout much of Europe, the pandemic led to a new and more fundamental debate about the relationship between individual responsibility for personal health and the wider responsibility for public health assumed by the community of solidarity.
KW  - German legislation
KW  - individual health responsibility
KW  - public health insurance
KW  - solidarity
KW  - welfare state
Y1  - 2024
U6  - https://doi.org/10.1163/15718093-bja10128
SN  - 1571-8093
SN  - 0929-0273
SP  - 1
EP  - 12
PB  - Brill Nijhoff
CY  - Leiden
ER  - 
TY  - JOUR
A1  - Kuhlmann, Sabine
A1  - Reiter, Renate
T1  - Decentralization of the French welfare state: from 'big bang' to 'muddling through'
JF  - International Review of Administrative Sciences
N2  - This article analyses the decentralization of the French welfare state focusing on the transfer of the Revenu minimum d’insertion (RMI) welfare benefit to the departments in 2003 and 2004. We map and explain the effects of the reform on the system and performance of the subnational provision of welfare tasks. To evaluate the impact of decentralization on the RMI-related action of the departments, we carry out a qualitative document analysis and use data from two case studies. The RMI decentralization offers an exemplary insight into the incremental implementation of French decentralization. We find many unintended effects in terms of the performance and outcome of the subnational welfare provision. This is traced back to the combining of institutional and policy reforms and the inadequate translation of high political expectations into an inadequate action programme both resulting in excessive demands on the local actors.

Points for practitioners

The decentralization of public tasks is associated with high expectations in terms of the effects on the performance of public services and public governance on the subnational levels. For an in-depth measure the range of administrative performance and political systems effects should be taken into account. We propose a five-dimensional scheme allowing for the determination of decentralization effects on the resource input to and the operative output of subnational public services, on the horizontal coordination between subnational task holders and the affected non-public stakeholders, on the vertical intergovernmental coordination, and on the democratic accountability of subnational authorities.
KW  - decentralization
KW  - France
KW  - incremental reform
KW  - welfare state
Y1  - 2016
U6  - https://doi.org/0.1177/0020852315583194
SN  - 0020-8523
SN  - 1461-7226
VL  - 82
IS  - 2
SP  - 255
EP  - 272
PB  - Sage
CY  - London
ER  -