Welfare and health: Systems in tension

[摘要] This thesis argues the case for active citizenship in the context of two systems of welfare and health. The argument evolves via an analysis of three philosophical models of citizenship. Detailed analysis and discussion of the three models leads to the conclusion that one of the models is the most appropriate for the practice of modern citizenship. The preferred model is Neighbour-Centred and based on a communitarian philosophy. It embodies a pluralistic view of the state which attributes equal functional significance to the state, the market, and the many groups which fall within the remit of voluntarism. Within the three models, various tensions are identified which manifest themselves in the operation of two systems of welfare and health. Analyses of the two contrasting systems of welfare and health (American and British ) lead to the conclusion that neither system is satisfactory, based as they are on opposing political ideologies. The shortcomings within the systems lead to tensions which derive from the systems themselves and from the models previously described. Critiques of the two systems by Illich and Marx further highlight the observed tensions. It is argued that the presence of these tensions is inevitable. To the extent that they are potential facilitators of change then they may have a positive effect. When they result in disequilibrium in the systems they may be destructive.

[发布机构] University:University of Glasgow

[关键词] Health care management, Public policy, Public health, Social structure