Solidarity, Health and Social Care in Europe Introduction to the Volume

Abstract

When people in Europe are interviewed about the values, which they consider fundamental for the design of their health and social care systems, they often refer to the values of equity and solidarity. While equity may be a term for which most people have a quite similar and clear-cut understanding, solidarity is a less familiar notion that is subject to divergent interpretations and reflections. In general, the idea of solidarity is associated with mutual respect, personal support and commitment to a common cause. These interpretations come to the fore when Europeans in large-scale surveys are questioned about their understandings of this idea of solidarity. Their verbal answers to these kind of questions reflect notions as ‘belonging together’, ‘mutual understanding’, ‘support of the weak and needy (benevolence)’, ‘shared responsibility’ and commitment to the common good. To explain these notions, solidarity is often juxtaposed against individualistic and even egoistic behaviour or contrasted with the alleged self-centred individualism that is often superficially associated with the cultural habits, societal norms and liberal values of the United States. For example, the plain evidence that forty-five millions of inhabitants of the United States lack any sort of health care insurance is for many Europeans, especially on the leftist stance, writing on the wall. In contrast to the alleged irresponsibility and lack of concern that is generally associated with this kind of individualism, Europeans proudly refer to the notion of solidarity and how it shaped their national health and social care systems. How ill-defined solidarity often is, the basic understanding is that everyone is assumed to make a fair financial contribution to a collectively organised insurance system that guarantees equal access to health and social care for all members of society. This equally applies to other systems of social protection, which are operating in Europeans welfare states, such as social insurance systems covering the financial risks of unemployment and work related illness and disability, as well as old age insurance systems and pension schemes.