Three weeks ago I had meetings and was guest teacher at the Temple University in Philadelphia, USA. It was a very exciting time. I got plenty of presents of thoughts over there. I also became aware of Philadelphia as not only a very special and unique place of Music Therapy, but also as the place of the birth of the USA.
The Independence Hall, the Declaration of Independence, the Bill of Rights and the Constitution of USA are found here, or they were born here. I want to imagine the big British Empire with its very big buildings of power in London and then to imagine this little Independence hall (on that time the city hall of Philadelphia) where worldwide politic was changed completely. From my point of view it had lots of European "feedbacks" such as the French Revolution only two years later (or vice versa). However, the old systems of power i.e. with the European Kingdoms seem also to have parallels with the political development in the USA. In the constitution centre in Philadelphia I saw such an interesting exhibition about the US constitution. From a very critical point of view it shows the history of USA as a history of fulfilling, step by step, all the paragraphs of the constitution of the USA and the bill of rights. One of the plenty of examples given and discussed there is that the law is more important then the man. In the words of the US President Ford this could be realized completely nearly two hundred years after writing and confirming US constitution in the Watergate affair. In our days another little part of the first sentence of the US constitution seems to start to be completely realized: "We the People of the United States … promote general welfare ...".
The welfare systems in the US and Europe seem to be very different. Not only are the health and educational system very different between US and Europe, we have also differences between the European countries. I want to start here a discussion about the health and educational systems in Germany and in the world with some brief ideas of it and thoughts about it. From my point of view Music Therapy is very much touched by the health system and by the educational system. In the health system clients can get their benefits from our Music Therapy. In the educational system music therapists are trained to become qualified for the Music Therapy input into the health and social services. It would be great, if views from other countries and also other German views would discuss and comment on the following.
In the German health and educational systems we currently have very large ongoing changes. For both systems we don’t know exactly what the future will bring to us. But here I can briefly explain the current state of the art of the German health and educational systems.
"Health system for everybody" has a long history in Germany. It insures everybody with no acknowledging of how ill she or he is. The only one question is: What is your income? A fixed percentage of the income goes to the general health insurance. If someone is working, then the same money is also given from the office or the factory where she or he is working to the general health insurance. All visits to the medical doctor, sick leaves, hospital stays, medicine, etc. is paid from this. Kids are included for free and for people with no income the social administration is paying the health insurance. At the end of the year, if the general health insurances can not cover their expenses, the state is given additional money. But some general insurance do not need this. However, now we have ongoing changes.
The one change is a very old one: especially people with a higher income have to pay a private health insurance. This insurance is becoming more and more the better health care. These people have the right of getting medical doctor in chief treatment, double or single rooms in hospital, etc. AND: they get more money back of paying medicine, glasses, and etc. then clients with general health insurance. This we call in Germany the "two class medical system."
Secondly, on the other side the general health insurance cuts more and more services. People of the general health insurance now partly have to pay their medicine themselves and they have to pay 10 Euro each three months for visiting the medical doctor. The payments for different necessary materials like wheel chairs, glasses, etc. are more and more reduced. (On the other hand the number of rich people in Germany is permanently increasing. Is there a relation or not at all?) The only one exception of the rule is -thanks God- children. For them all is free and also a lot of preventing services is available for them.
In the end, in Germany like in other European countries, we have a long and broad history of general welfare i.e. in health care, which seems to be changed in very small but more and more important steps into …?
The same change is currently going on in our German educational system, especially in the upper part of the education system at the universities. Up to the nineties it was mainly free to study in Germany. No fees were necessary and in West-Germany people with low income got half of their everyday needs as a free grant by the state. In East-Germany all students got free grants for all everyday needs. The exception of the rule was a very little number of private universities in Germany, but even they got some state support in the past. A very interesting point discussed with this free study system in Germany was that mainly children of parents with higher income used it (even though it was free).
Now all is changing but in very different ways:
From my point of view some competition between the universities, which is supported by these changes, is also good. Some conditions i.e. the learning materials and the teaching stuff could even be better off with the new additional money. But in a worldwide view a special European educational system seems to go under here, step by step. I think, that a very clever system of grants, talent support, lower class support, permanent state financial support and fees could bring the best benefits for all: for students, for the science and its benefits for the society and for all the teaching system for getting the best and most results from it. I.e. in the Scandinavian countries I see excellent European research and teaching possibilities with very good and important outcomes. These countries follow more or less the "old" European educational system. But also in the US we have a very good situation of research in the field of Music Therapy, which is really worldwide leading too, but following quite another system.In the end of the day there are plus and minus for different systems and a really very interesting discussion can start. You are very welcome to join the discussion.
Wosch, Thomas (2009). Health and Educational Systems. Voices: A World Forum for Music Therapy. Retrieved June 10, 2013, from http://testvoices.uib.no/?q=fortnightly-columns/2009-health-and-educational-systems