Social security and medical care: Proceedings of the post graduate course organised by the foundation for higher medical education Netherlands Antilles

176 Pages·1977·5.354 MB·English

by  Dr. G. M. J. Veldkamp (auth.)

Social security and
medical care
Social security and
medical care
Proceedings of the post graduate
course organised by the foundation
for higher medical education
Netherlands Antilles
Under chairmanship of
Dr. G.M.J. Veldkamp
1977
Springer Science+Business Media, BV.
Cover design: Eija Stevenhagen
ISBN 978-90-312-0058-0 ISBN 978-1-4899-3774-2 (eBook)
DOI 10.1007/978-1-4899-3774-2
© 1977 Springer Science+Business Media Dordrecht
Originally published by Kluwer Academic Publishers in 1977
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system,
or transmitted in any form by any means, electronic, mechanical, photocopying, recording or
otherwise, without the written permission of the publisher.
Social Security and Medical Care
Proceedings of the post graduate course organised by the foundation for
higher medical education Netherlands Antilles in conjunction with the State
University of Groningen (The Netherlands) on Curalfao, 13-15 October
1975.
With collaboration of:
Dr. G.MJ. Ve1dkamp;Prof. Dr. C.M. Barrosjr.; Dr. G.A.A.M. Boot; Prof. Dr.
R. Dillemans; Dr. G. van 't Hull; Prof. Dr. J.H.P. Jonxis; Prof. Dr. J. van
Langendonck; L.L. Marselis, Prof. Dr. P. Muntendam; Prof. Dr. R. Nugent;
Prof. Dr. M. Alonso Olea; Prof. Dr. G. Perrin; Dr. R. Roter; Dr. V. Ryss;
Dr. A.E.C. Saleh and Prof. Dr. E.R. Stafforini.
Table of Contents
In troductory Address
Dr. G.M.J. Veldkamp, The Hague. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
I. PRINCIPLES
Health care and social security
Dr. G.M.J. Veldkamp, The Hague. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Medical care provisions contained in recent international labour
standards
Prof. Dr. G. Perrin, Geneva. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
The contribution of social security to national health
Prof. Dr. P. Muntendam, The Hague. . . . . . . . . . . . . . . . . . . . . . . . . . . 37
II. TRENDS IN SOCIAL SECURITY THROUGHOUT THE WORLD
General outline of the social security in Spain and South America
Prof. Dr. Manuel Alonso Olea, Madrid. . . . . . . . . . . . . . . . . . . . . . . . . . 49
Social security in South and Central America
Prof. Dr. C.M. Barrosjr., Sao Paolo. . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Health insurance in South America
Prof. Dr. E.R. Stafforini, Buenos Aires. . . . . . . . . . . . . . . . . . . . . . . . . 81
Scheme of the health insurance in Central America
Prof. Dr. R. Nugent, Lima. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Medical care in the Netherlands Antilles. A new approach
Dr. A.E.C. Saleh, Willemstad. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Comparative analysis of the European and Anglo-Saxon social
security in relation with medical care
Prof. Dr. R. Dillemans, Leuven . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
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TABLE OF CONTENTS
Social security for migrant workers in the European Community
Dr. G.A.A.M. Boot, The Hague. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 117
Human rights and modern social medicine
Prof. Dr. J.H.P. Jonxis, Groningen . . . . . . . . . . . . . . . . . . . . . . . . . . .. 130
Social security and rehabilitation
Dr. G. van 't Hull, Amsterdam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 135
III. EFFICACY OF SOCIAL SECURITY
Financial aspects - influence on medical infrastructure
L.L. Marselis, Amsterdam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 143
Medical infrastructure in Europe
Prof. Dr. J. van Langendonck, Leuven. . . . . . . . . . . . . . . . . . . . . . . . .. 149
The redistributive potential of voluntary and obligatory insurance
schemes
Dr. R. Roter, Jerusalem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 160
Planning of medical care services within social security schemes
Dr. V. Ryss, Geneva. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 173
Closing Address
Dr. G.M.J. Veldkamp, The Hague. . . . . . . . . . . . . . . . . . . . . . . . . . . .. 185
8
Introductory Address
Dr. G. M. 1. Veldkamp, The Hague
Your Excellencies, Ladies and Gentlemen,
At the opening of this study conference on health care and social security, I
have great pleasure, first of all, in extending a warm word of thanks to His
Excellency Mr. Godett, for having done us the honour of opening this con
ference. I know, Sir, the great concern you have for the social development
of not only the Netherlands AntiIles but also the whole socio-geographical
region of which the Netherlands AntiIles form a part. Since you are of the
opinion that even the best is not good enough, I am particularly happy that
we have succeeded in bringing such a select group of experts from all over
the world to Cura<;ao to carry out a programme that is unique in the history
of in ternational social security policy. I want to thank the governmen t of the
Netherlands Antilles for everything the government did for the conference
and Minister Godett for his excellent introductory speech dealing with the
principles of social security and medical care and practice in the Netherlands
Antilles as well. I also want to welcome the ministers attending the confer
ence: His Exc. Minister Soeperman and His Exc. Minister Brahim of Suri
name and His Exc. Minister Carrington of Guyana and all other personalities
who honour the conference with their presence. I would like to express my
special gratitude to all my colleagues - most of you are already my personal
friends and all of you will be by the time we leave this beautiful island - for
coming here to make this conference a real world conference. I would also
like to thank all the students who have come here to listen to us. I do assure
them that we shall endeavour to present the - sometimes rather arid - sub
ject-matter as clearly and comprehensibly as possible. For all of us, students
and teachers, I feel that the time we shall spend together outside the study
conference - when we will all be more relaxed - will be every bit as profit
able as the time we shall spend giving or listening to lectures.
If I may be permitted with the list of people deserving of our gratitude, by
no means the least of them are Guido Romer, who is applying his great tal
ents to assisting the conference as a whole and each one of us in particular,
and our dean, President Terborg and Professor Jonxis of Groningen, who
have assisted me with their wise counsel and active support from Holland.
Finally, my thanks go to all those I may not have mentioned by name, in
cluding Guido Romer's secretariat and our interpreters, without whom we
would be unable to make ourselves understood.
Let us all do our best to make this conference a great success. With this aim
in view, we shall now get down to work.
9
I. Principles
Health care and social security
Dr. G. M. J. Veldkamp, The Hague
1. Today, one cannot speak of health care and the connection between
health care and social security without mentioning the premise of the so
called right to health.1 Since World War II and under the impact of the
World Health Organization and the generally prevailing desire to lay down
social constitutional rights in respect of the public health system, the right to
health has increasingly become a major concern. In the abstract, this right to
health is not an absolute and individually enforceable right. It could be com
pared to the so-called right to work. The right to health, as proposed by the
WHO, obliges authorities to create conditions such as to enable citizens to
live in optimal circumstances with regard to their health. In the same way,
authorities are obliged, for instance, to create optimal conditions for optimal
work opportunities or full employment. The creation, maintenance and,
wherever possible, improvement of such conditions is the task of the public
health system. This implies that every individual must, in so far as is possible,
be given a share of public health provision in order to be able to assume his
personal responsibility with regard to the health care obligation. This means
that, when authorities take health measures - i.e. lay down rules and regu
lations for health care - such measures must be as comprehensive as possible
and, consequently, comprise the fewest possible exceptions. In other words,
such health measures and provisions must be available to every citizen who
requires them. Furthermore, this abstract right to health implies that, when
authorities make financial means available to private institutions responsible
for providing health care, the principle of equality must be observed. Finally,
this right implies that special different measures can be permitted only in
special circumstances, for instance as regards special groups.
For the purpose of the symposium, we can now ignore the last two points.
The most important point is that the right to health implies the development
of a health system giving individuals the most equal possible right to health
care.
2. With regard to the connection between social security and health care, it
should be noted that social security and health care are two different things.
If one takes social security in the widest sense, to mean a collective guaran
tee of income for employees and, today, increasingly, for citizens in general
as well; and if one regards this guarantee of income not only as a guarantee
of substitute income but also as cover for particularly heavy expenses, such
as those incurred in children's education and medical care, then health care is
part of social security.2 On the other hand, if one takes social security in the
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