Equal access to healthcare in national legislations: how do Croatia, Germany, Poland, and Slovenia counteract discrimination in healthcare?

Katarzyna Bielińska; Anna Chowaniec; Robert Doričić; Marianne Nowak; Marcin Orzechowski; Mojca Ramšak; Paweł Łuków; Amir Muzur; Zvonka Zupanič-Slavec; Florian Steger

doi:10.1186/s12913-021-07453-6

Equal access to healthcare in national legislations: how do Croatia, Germany, Poland, and Slovenia counteract discrimination in healthcare?

BMC Health Serv Res. 2022 Jan 24;22(1):100. doi: 10.1186/s12913-021-07453-6.

Authors

Affiliations

¹ Center for Bioethics and Biolaw, Faculty of Philosophy, University of Warsaw, Warsaw, Poland. katarzyna.bielinska@uw.edu.pl.
² Center for Bioethics and Biolaw, Faculty of Philosophy, University of Warsaw, Warsaw, Poland.
³ Department of Social Sciences and Medical Humanities, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
⁴ Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany.
⁵ Institute of History of Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
⁶ Department of Public Health, Faculty of Health Studies, University of Rijeka, Rijeka, Croatia.

Abstract

Background: The aim of the study was a comparative analysis of legislative measures against discrimination in healthcare on the grounds of a) race and ethnicity, b) religion and belief, and c) gender identity and sexual orientation in Croatia, Germany, Poland and Slovenia.

Methods: We conducted a search for documents in national legal databases and reviewed legal commentaries, scientific literature and official reports of equality bodies. We integrated a comparative method with text analysis and the critical interpretive approach. The documents were examined in their original languages: Croatian, German, Polish, and Slovenian.

Results: All examined states prohibit discrimination and guarantee the right to healthcare on the constitutional level. However, there are significant differences among them on the statutory level, regarding both anti-discriminatory legal measures and other legislation affecting access to healthcare for groups of diverse race or ethnicity, religion or belief, sexual orientation or gender identity. Croatia and Slovenia show the most comprehensive legislation concerning non-discrimination in healthcare in comparison to Germany and even more Poland. Except for Slovenia, explicit provisions protecting equal access for members of the abovementioned groups are insufficiently represented in healthcare legislation.

Conclusions: The study identified legislative barriers to access to healthcare for persons of diverse race or ethnicity, religion or belief, sexual orientation or gender identity in Croatia, Germany, Poland and Slovenia. The discrepancies in the level of implementation of anti-discriminatory measures among these states show that there is a need for comprehensive EU-wide regulations, which would implement the principle of equal treatment in the specific context of healthcare. General anti-discrimination regulations should be strengthened by inclusion of anti-discrimination provisions directly into national legislation relating specifically to the area of healthcare.

Keywords: Croatia; Discrimination; Ethics; Germany; Healthcare access; National legislation; Poland; Slovenia.

MeSH terms

Croatia
Delivery of Health Care*
Female
Gender Identity*
Germany
Humans
Male
Poland
Slovenia