The Development of Self-help Support by the Public Medical Insurance in Germany

: An Analysis besed on the Concept of Welfare Pluralism

Abstract

The concept of welfare pluralism proposed in the U.K. was introduced in Japan with the framework of the small government theory. According to the concept of welfare pluralism, non-profit organizations have an important role. However, the self-help activities（self-help groups, self-help organizations and self-help“Kontaktstellen(clearinghouses)”）that belong to the non-profit sector have the extreme risks. That is, on the one hand the self-help activities are not supported by professionals, but on the other hand they are controlled by professionals in case of cooperation. This paper analyzes the development of self-help support by the public medical insurance in Germany and thereby is to clarify the rules that activate the self-help activities. Consequently, that rules have four elements: the support of the entire structures (including advocacy) of self-help, the competition under the solidarity principle, the guarantee of the participation and the response to the exclusion from the institution. The network of self-help from 1970s has contributed greatly to the development of this rule.