Solidarity in Insuring Financial Risks of Illness: A Comparison of the Impact of Dutch Policy Reforms in Health Insurance and Disability Insurance since the 1980s

Abstract

Solidarity is the “moral infrastructure” of social insurance arrangements that protect citizens against financial risks of illness: costs of medical care (health insurance) and loss of income (disability insurance). Although these arrangements have both met reforms, the effects of these reforms on the two forms of insurance have not yet been compared. This article presents a comparative analysis of these reforms’ impact on solidarity since the 1980s in the Netherlands. It develops an analytical framework, distinguishing coverage and financing dimensions, and concludes that the reforms affected several solidarity dimensions and that the effects were partly different in health insurance and disability insurance.