Solidarity in practices of provision: distributing access to genetic technologies in health care in Germany, the Netherlands and the United Kingdom

Solidarity is widely described as one of the leading principles for the public provision of health care in Western Europe and is therefore prominently discussed in debates on the introduction of genetic technologies in national health care provision arrangements. However, solidarity is often defined in an essentialist and quantitative way, which does very little to show the complexities of and changes in health care allocation. In this paper we therefore propose to analyze solidarity as a value that is reproduced in practices of providing health care. This means that we analyzed how three particular genetic technologies are incorporated in basic health care provision in Germany, the Netherlands and the United Kingdom and how individuals or groups at risk get access to them. On the basis of a characterization of the distributive mechanisms in these three countries, we argue for a discussion on genetics and solidarity that pays attention to the complexity and specificity of practices in the analysis and politics of solidarity.