Welfare with or without Growth? Potential Lessons from the German Healthcare System

Sustainability - Tập 8 Số 11 - Trang 1088
Matthias Fischer1
1Institute of Sustainability Governance, Leuphana University of Lüneburg, Scharnhorststraße 1, Lüneburg 21335, Germany

Tóm tắt

This article is meant to be a contribution to the debate on growth and welfare. Its argument is based on results of a Grounded Theory study about the German healthcare system, which suggests that the core of the healthcare system can be expressed by two abstract basic ideas that are contradictory and yet dependent on each other. The implications of the results, both for future research on the healthcare system and for the debate on growth and welfare, are discussed. As a final suggestion, “sustainability” is proposed as a concept that could potentially resolve the debate.

Từ khóa


Tài liệu tham khảo

Report of the World Commission on Environment and Development: Our Common Future. Available online: http://www.un-documents.net/our-common-future.pdf.

Farley, 2013, Monetary and fiscal policies for a finite planet, Sustainability, 5, 2802, 10.3390/su5062802

Jackson, T. (2011). Prosperity without Growth: Economics for a Finite Planet, Routledge.

Pascual, 2010, Sustainable de-growth: Mapping the context, criticisms and future prospects of an emergent paradigm, Ecol. Econ., 69, 1741, 10.1016/j.ecolecon.2010.04.017

2013, The Impacts of Spatial Planning on Degrowth, Sustainability, 5, 1067, 10.3390/su5031067

Schneider, 2010, Crisis or opportunity? Economic degrowth for social equity and ecological sustainability. Introduction to this special issue, J. Clean. Prod., 18, 511, 10.1016/j.jclepro.2010.01.014

Jackson, 2005, Live better by consuming less?: Is there a “double dividend” in sustainable consumption?, J. Ind. Ecol., 9, 19, 10.1162/1088198054084734

Paech, N. (2012). Liberation from Excess: The Road to a Post-Growth Economy, Oekom.

Barbier, 2010, How is the global green new deal going?, Nature, 464, 832, 10.1038/464832a

European Commission Manifesto for a Resource Efficient Europe. Available online: http://europa.eu/rapid/press-release_MEMO-12-989_en.htm.

Sachs, J. (2015). The Age of Sustainable Development, Columbia University Press.

2011, Environment versus growth—A criticism of “degrowth” and a plea for “a-growth”, Ecol. Econ., 70, 881, 10.1016/j.ecolecon.2010.09.035

Heath, 2004, Developing a grounded theory approach: A comparison of Glaser and Strauss, Int. J. Nurs. Stud., 41, 141, 10.1016/S0020-7489(03)00113-5

Ehrenfeld, J. (2008). A Subversive Strategy for Transforming Our Consumer Culture, Yale University.

Ehrenfeld, 2008, Sustainability needs to be attained, not managed, Sustain. Sci. Pract. Policy, 4, 1

Glaser, B.G., and Strauss, A.L. (1980). The Discovery of Grounded Theory: Strategies for Qualitative Research, Aldine. [11th ed.].

Klein, B., and Weller, M. (2012). Masterplan Gesundheitswesen 2020, Nomos. (In German).

Rosenbrock, R., and Gerlinger, T. (2012). Gesundheitspolitik: Eine Systematische Einführung, Huber. [3rd ed.]. (In German).

All interviews were conducted in German. As Sustainability is an English journal, all quotes are translated literally into English in this article. If readers are interested in the original German versions of the quotes, they are invited to contact the author. For information on how to contact the author, please check the correspondence at the beginning of this article.

Creswell, J.W. (2007). Qualitative Inquiry and Research Design: Choosing among Five Approaches, Sage.

Glaser, B.G. (1978). Theoretical Sensitivity, Sociology Press.

Hesse-Bieber, S.N., and Leavy, P. (2008). Handbook of Emergent Methods, Guilford Press.

Breuer, F. (2009). Reflexive Grounded Theory. Eine Einführung für die Forschungspraxis, VS Verlag für Sozialwissenschaften. (In German).

Effectively, the German state has outsourced some of its decision-making power to the so-called Joint Self-Government (Selbstverwaltung), where umbrella organizations of the interest groups of physicians, dentists and hospitals negotiate in the Federal Joint Committee (Gemeinsamer Bundesausschuss) with the public health insurance funds about payments and practices in the healthcare system or medicaments with quasi-sovereign rights.

Hegel, G.W.F. (2000). Grundlinien der Philosophie des Rechts oder Naturrecht und Staatswissenschaft im Grundrisse. Mit Hegels Eigenen Motiven und den Mündlichen Zusätzen, Suhrkamp. (In German).

Hegel, G.W.F. (2013). Gesammelte Werke. Vorlesungen über die Philosophie des Rechts. Hand 26,1. Herausgegeben von Dirk Felgenhauer, Felix Meiner. (In German).

Glaser, B.G., and Holton, J. (2004). Remodeling grounded theory. Forum Qual. Soc. Res., 5, Available online:http://www.qualitative-research.net/index.php/fqs/article/view/607.

Dick, B. Grounded Theory: A Thumbnail Sketch. Available online: http://www.aral.com.au/resources/grounded.html.

Breyer, F., Zweifel, P., and Kifmann, M. (2013). Gesundheitsökonomik, Springer. [6th ed.]. (In German).

Marmor, 2012, Conceptual frameworks for comparing healthcare politics and policy, Health Policy, 107, 11, 10.1016/j.healthpol.2012.06.003

2010, Policies, politics and polity: Comment on the paper by Bianchi, Syst. Res., 27, 385, 10.1002/sres.1051

Ragin, 1999, Using qualitative comparative analysis to study causal complexity, Health Serv. Res., 34, 1225

Khan, 2015, Putting ‘Good Society’ Ahead of the Economy: Overcoming Neoliberalism’s Growth Trap and its Costly Consequences, Sustain. Dev., 23, 55, 10.1002/sd.1571

Abson, 2016, Leverage points for sustainability transformation, Ambio, 45, 1

Sommer, B., and Welzer, H. (2014). Transformationsdesign. Wege in eine Zukunftsfähige Moderne, Oekom. (In German).

Jakob, 2014, Green growth, degrowth, and the commons, Oxf. Rev. Econ. Policy, 30, 447, 10.1093/oxrep/gru026

Cristina, 2014, Saferational approach to a valid sustainable development, Procedia Econ. Financ., 8, 497, 10.1016/S2212-5671(14)00119-1

Fischer, 2015, Fit for the future? A new approach in the debate about what makes healthcare systems really sustainable, Sustainablity, 7, 294, 10.3390/su7010294

Fischer, 2016, Importance of Actors and Agency in Sustainability Transitions: A Systematic Exploration of the Literature, Sustainability, 8, 476, 10.3390/su8050476

Heinrichs, 2014, “Sustainability State” in the Making? Institutionalization of Sustainability in German Federal Policy Making, Sustainability, 6, 2623, 10.3390/su6052623

Fischer, 2015, Design it! Solving sustainability problems by applying design thinking, Gaia, 24, 174, 10.14512/gaia.24.3.9

Renn, 2006, Participatory processes for designing environmental policies, Land Use Policy, 23, 34, 10.1016/j.landusepol.2004.08.005

John, 2015, How much sustainability substance is in urban visions?—An analysis of visioning projects in urban planning, Cities, 48, 86, 10.1016/j.cities.2015.06.001

Mey, G., and Mruck, K. (2011). Grounded Theory Reader, VS Verlag für Sozialwissenschaften. (In German).