Falling ill is one of the most fundamental risks in life. To alleviate this peril, most industrialized countries have established more or less universal public health care systems, thus rendering health care a social right for every welfare state citizen today. Within the last three decades however, public health systems have witnessed an almost infinite number of reforms. Even though those reforms have been intensively studied by health policy researchers, little is known about how these reforms have altered the social right to health care. Focusing on health care entitlement, my paper will analyse if and how the social right to health care has been affected by those reforms. For this purpose a framework for the qualitative analysis of the social right to health care is established. This framework adapts the traditional categories of social rights research – coverage, generosity and access – to account for the service character of social health care and includes a category that comprises the conditionality of welfare benefits. In a second step, this framework is applied to study the transformation of health care entitlement in Germany and England between 1979 and 1989. I find that despite the categorical differences in the conception of the social right to health care in the two countries, reforms stunningly resemble each other in this first phase of welfare state transformation. They almost entirely focus on entitlement generosity by cutting service as well as cost coverage in the same service areas while eligibility criteria, the conditionality of benefits and population coverage remain nearly unchanged. In the third part I will discuss the reasons for the observed similarity of reforms before I finish with an outlook to the successive reform phases.
