Health services for children in Germany, Austria, Great Britain, and Denmark

Children depend on institutions for their protection. An important institut ion for the promotion of children's well-being is the health care system. T he article compares different forms of health care systems and finds that i n countries where children are directly insured on the basis of citizenship children's needs are addressed both more comprehensively and more specific ally than in countries where children's rights to protection are derived fr om their status as dependants of an insured family member. This is empirica lly tested by comparing Great Britain and Denmark on the one hand (national health service) and Germany and Austria on the other (compulsory health in surance). Great Britain and Denmark offer comprehensive health care and pre vention for children up to the end of compulsory schooling. Health programm es are directed and co-ordinated by a single institution. Go-operation betw een the various providers ensures that a significant part of the child popu lation - particularly at-risk groups - undergo health examinations. By cont rast, in Germany and Austria the individual's responsibility for his or her own health is emphasised and it is left up to parents to take advantage of the recommended early intervention programmes. These systems encourage com petition between providers, which makes it more difficult to co-ordinate he alth services for children. A comparison between Germany and Austria shows, however, that it is not necessary to change from one system to the other i n order to better address children's needs, but that reforms within the exi sting system may do.