The signs of the times are also being recognized in politics. For some years now, there has been discussion about how and in what form the requirement for prevention could be enshrined in law. This seems all the more important because in recent years increasing cuts in social benefits in the federal budget have led to restrictions on previous health promotion activities by health insurance funds, and health promotion measures may only be financed by insurance contributions within a firmly defined, narrow framework.
The Prevention Act
Unfortunately, the discussion about the draft of the “Law for Strengthening Health Prevention” published at the beginning of 2007 is dragging on. The plan was to establish prevention as a fourth, independent pillar in this law – alongside acute treatment of illnesses, rehabilitation and care – and thus improve its status. The aim is to promote health and prevent chronic diseases, thereby improving quality of life and cutting costs.
The Prevention Act, one of the few projects agreed in the coalition agreement that has not yet been implemented, is proving to be a tough nut to crack – in 2008, there was already talk of its failure behind closed doors. The parties are currently in talks again to find a solution – and there is currently no end in sight. It is important for preventive measures to reach as many people as possible, or those who are affected. For this reason, education, preventive measures and their implementation should not be practiced in a “quiet chamber”, but should be located in the immediate living environment. This includes, for example, kindergartens and schools, companies and municipal areas, sports clubs and facilities for senior citizens.
It is also important for the measures to be sustainable – local, short-term action usually has no demonstrable effect. Individual responsibility is an important basis of prevention. It is supported by “social prevention carriers” such as statutory health insurance funds and carriers of statutory pension, accident and long-term care insurance. Doctors, too, must increasingly act in an educational, advisory and accompanying capacity.
Where can prevention start?
In order to achieve medium- and long-term success by means of prevention, various levels and starting points must be interlinked. In addition to an overall policy that promotes health, the living environments for society and individuals must be designed accordingly, health-related community activities must be promoted, and individual knowledge must be increased.
In order to align health services accordingly, the framework conditions must also be adapted. Qualified people must be available at all levels to acquire, deepen and pass on the relevant competence.
In addition, legal regulations also provide a framework – examples are the Youth Protection Act or regulations in road traffic that are intended to influence the use of alcohol and drugs. Interestingly, prohibitions and regulations are often more effective than measures to educate and provide information.
