Self-Help Groups and Consumer Participation: A Look at the German Health Care Self-Help Movement

Abstract

Institutionalized rights for the participatioii of consumers in the decision-making processes or provision of health and social services do not exist in West Germany. However, consumers have begun to voice their concerns about this state of affairs and have undertaken more involvement in the planning and implementation of their own forms of health care, while concurrently pressuring the health care and social services systems to become more responsive to their needs. We note two reasons for the existence of such opposition to such participation. We argue that self-help associations (several types of which are described herein) are at present the only relevant form of consumer participation in West Germany, by focusing our attention on the tasks and accomplishments of health relevant to self-help associations. These associations offer effective ways of dealing with the rigidity and heaviness of large bureaucratic organizations such as political parties and unions. We conclude by identifying newer pro-active roles and responsibilities of the patient as consumer both within and external to the official health care system.