Soziokulturelle Wandlungsprozesse als Herausforderung an das Gesundheitswesen

The present dissertation, connecting bases- and problem topics, analysesand discusses fundaments, motives and perspectives of development ingerman health system. Federation (´Bund´), counties and municipalauthorities pursue selective interests as well as corporatively unitedsuppliers do. Objectives of social securities and industry are opposingdiametrally. Hence, not known, specific singular symptoms, but techniquesand mechanisms for selfish handling-off federation and corporatism areevident, systematic challenges even to the health system. Social-economical bases of health policy are indeed directed from out of its´ realscope, and global changes of 1989 were ruling for increased significance ofpublic debate. Since then, a mainly subjective pression of competition isaccelerating, reinforcing economical divergence between incomes,expenses and tasks of social- and health policy. Employment andproductivity, demography, poverty, development of values and migration - inthose essentials for health policy, there is no release in sight. Even more,those structural problem dimensions are reinforcing mutually. Especiallyregarding epidemiological practice, health system is not competent to holdup, reduce or even to overcome harms with chronical potentials. Increasingscope of mortality, biographical extension of harmed life phases andadvance of such restrictions into more younger cohorts, are evident´epidemiological illusions´. Nevertheless, supply with empirical dataremains permanently unaltered. Given that, german federation has nointerest in a real, sustainable reform of known, structural and practicalproblem subjects. Epidemiological and economical tasks in its´comprehension, these issues are indeed market in a ´trade of future´ for anunleashed private economy.