PREVENTION IN HEALTH-POLICY IN THE FEDERAL-REPUBLIC-OF-GERMANY

The comparative study of what tend to be regarded as marginal questions of health policy, such as prevention, is developing slowly. This case study covers important developments in preventive policy making in the Federal Republic of Germany in the period 1968-1990. The paper is intended both as a descriptive summary of institutional arrangements for prevention in health and as a preliminary analytical essay. It considers the evolving positional interests of federal and state governments, the public health service, the sickness insurance funds and the medical profession. It looks in detail at constitutional conflict over prevention at the end of the 1960s, at the progressivism of health policy conceptions of the early 1970s, at the liberal conservatism which characterised the 1980s and at the place of prevention in health care reform legislation. It refers to responses to HIV and AIDS and comments on the extent to which the circumstances of preventive policy making in health have changed with unification. The paper concludes by discussing the importance of the German case in developing ideas about the role played by prevention in health politics.