Schwartz F W, Busse R
Abteilung Epidemiologie und Sozialmedizin, Medizinische Hochschule Hannover.
Gesundheitswesen. 1997 Apr;59(4):207-12.
In spite of the growing criticism of the social welfare principles, the social health insurance model is remarkably stable in Europe. Key features of this model are even implemented in more market oriented models (as in Switzerland) and in national health systems as in the United Kingdom. In Germany, however, the discussion is almost solely centred around the argument of globalisation of capital and labour and, subsequently, the high additional costs on labour. This endangers social security which is financed through wages. If the social welfare system in Germany would be abolished de facto and not intelligently adapted, this would be a dramatic signal against social principles all over Europe. Consequences for social medicine as a scientific discipline are: Social medicine as a public health discipline with the goal of equality in health care must get involved in health politics. Social medicine as an empirical science has to evaluate- and refute, if necessary-existing myths and prejudices. Social medicine needs a stable network for research, teaching and practice-this is the growing field of "public health".
尽管对社会福利原则的批评日益增多，但社会医疗保险模式在欧洲仍非常稳定。这种模式的关键特征甚至在更具市场导向的模式（如瑞士）以及英国的国家卫生系统中也得到了实施。然而，在德国，讨论几乎完全集中在资本和劳动力全球化的论点上，以及随之而来的劳动力高额附加成本。这危及了通过工资融资的社会保障。如果德国的社会福利体系事实上被废除而不是明智地进行调整，这将是一个反对整个欧洲社会原则的强烈信号。对作为一门科学学科的社会医学的影响是：作为以医疗保健平等为目标的公共卫生学科的社会医学必须参与卫生政策。作为一门实证科学的社会医学必须评估并在必要时反驳现有的神话和偏见。社会医学需要一个稳定的研究、教学和实践网络——这就是“公共卫生”这个不断发展的领域。
