The article deals with concepts of disease in a historical perspective. The aim is to show that every medical concept of disease is based in a historically specific form on extra-medical ideas of human wealth and happiness. The focus is on the analysis of social consequences of concepts of disease and illness. The social interactions triggered by their attribution and the following social dynamics will be developed from the perspective of a disease concept in historical change using the example of ‚lepraʻ as well as from the perspective of institutionalized inpatient health care in hospitals.
An injection for two million euros, an antihypertensive for less than one cent per tablet: drug prices differ extremely and therefore cause controversy. The article explains how these price differences come about. It describes a historically grown, internationally accepted system of pricing that leads to temporarily high prices by securing market exclusivity, but in the long run ensures a cost-effective supply of medicines globally. However, this presupposes solvent social systems. This in turn puts economically weaker countries at a disadvantage when it comes to access to innovative and high-priced medicines. But in the future, the disease patterns in developing countries will converge with those in industrialised countries. As a result, the relevance of widely used, now low-cost innovations such as cardiovascular drugs will also increase.
Expectations of modern medicine are high. Its offers appear correspondingly diverse and tempting. With increasing age, however, the questions become more pressing: Should everything really be done to preserve life for as long as possible? Health care planning for the last phase of life, which is refinanced by the statutory health insurance funds, offers beneficiaries a tailored range of advice. A systemic approach to counseling is essential if individual needs are to be met, thereby discouraging a narrowing of the focus to medico-legal aspects.
The Pharmaceutical Market Restructuring Act (AMNOG) is enacted since the beginning of 2011. It regulates the price of patent-protected drugs seeking access to the German market. On the one hand, the law aims to gain control over the enormous price increases in the area of drug innovations for health insurance funds, and on the other hand, to provide incentives for innovativeness and avoiding cuts in provision of medical care. On the 10th anniversary of the law, its actual normative-ethical premises and objectives were examined; whether these desired results were achieved, and whether there have been starting points for criticism or potential for improvement. The „common good“ and innovativeness are the central normative valuation criteria.