Solidarity and Care in the Netherlands
In his chapter on solidarity, based on the theories of classical and modern sociologists, Van Oorschot (1998) defines solidarity as ‘an actual state of interrelations between individuals, groups and the larger society, which enables the collective interest to take priority over the interests of individuals or sub-collectivities’. In doing so, he seems to rephrase Durkheim’s organic solidarity. The Dutch health care system may cause one to wonder if such a definition enables us to grasp what solidarity really means. In our view, it makes the existing solidarity arrangements only partly visible. It takes solidarity on the macro-level into account, but not solidarity on the micro level, with regard to the delivery of informal care.
Cost containment and the right to health care
This article addresses the question of how cost containment programmes affect the right to health care in The Netherlands. A distinction is made between three different dimensions of the right to health care: health care entitlements, need assessment and enforceability. The analysis starts with a discussion of entitlements in social and private health insurance and a brief overview of how decisions on entitlements are made. Next, it is shown how the search for cost containment has influenced health care entitlements in Dutch health care (e.g. critical screening of entitlements) and has resulted in a need for more stringent guidelines for need assessment to use health care resources more efficiently. The growing gap between the growth rates in health care demand and the resources for health care points to the creation of enforceability problems in hearth care (waiting lists). The final section discusses the question of whether Dutch health care is moving towards a two-tier system. Throughout the analysis attention is given to the political dimension of the debate on hearth care entitlements, need assessment and the enforceability of entitlements.
An anionic shell shields a cationic core allowing for uptake and release of polyelectrolytes within core-shell responsive microgels.
To realize carriers for drug delivery, cationic containers are required for anionic guests. Nevertheless, the toxicity of cationic carriers limits their practical use. In this study, we investigate a model system of polyampholyte N-isopropylacrylamide (NIPAM)-based microgels with a cationic core and an anionic shell to study whether the presence of a negative shell allows the cationic core to be shielded while still enabling the uptake and release of the anionic guest polyelectrolytes. These microgels are loaded with polystyrene sulfonate of different molecular weights to investigate the influence of their chain length on the uptake and release process. By means of small-angle neutron scattering, we evaluate the spatial distribution of polystyrene sulfonate within the microgels. The guest molecules are located in different parts of the core-shell microgels depending on their size. By combining these scattering results with UV-vis spectroscopy, electrophoretic mobility and potentiometric titrations we gain complementary results to investigate the uptake and release process of polyelectrolytes in polyampholyte core-shell microgels. Moreover, Brownian molecular dynamic simulations are performed to compare the experimental and theoretical results of this model. Our findings demonstrate that the presence of a shell still enables efficient uptake of guest molecules into the cationic core. These anionic guest molecules can be released through an anionic shell. Furthermore, the presence of a shell enhances the stability of the microgel-polyelectrolyte complexes with respect to the cationic precursor microgel alone.