History of social insurance

Milestones in Germany and the EU

Bismarck's social legislation

When Otto von Bismarck laid the foundations for social legislation in Germany 140 years ago, he probably did not think that his "brainchild", German social insurance, would one day fly the flag in the capital of Europe.  

15 June 1883

Founding of health insurance

The "Law concerning workers health insurance” introduced statutory health insurance, even though it was only for industrial workers and employees in craft and trade businesses initially. The focus was on avoiding existential hardship in the event of an incapacity to work.

6. July 1884

Birth of accident insurance

With the Accident Insurance Law, workers and low-earning company officials in certain industrial sectors such as mines, ironworks or the construction industry were insured against accidents at work for the first time. The second step was insurance against occupational diseases.

22 July 1889

Old-age insurance

The laws covering invalidity and old-age insurance for workers created pension insurance’s predecessor. Even very low-earning employees could get coverage. The possibility of voluntary insurance was created for low-income self-employed people.

Social policy in the EEC

Social and health policy issues were raised for the first time in the Treaty of Rome that established the European Economic Community (EEC). Nevertheless, it has long been said that they had a "socio-political slant". European social policy has developed from the very beginning in close connection with the free movement of employees. With priority for economic policy. This culminated in the 1990s with the Economic and Monetary Union and the Single Market.


Coordination law, occupational health and occupational safety

Council Regulation (EEC) No. 3 and its implementing Council Regulation (EEC) No. 4, based on the 1957 Convention on the Protection of Migrant Workers in the Community, followed one year later. They formed the first two substantive regulations of "European social law". They would be followed by others, because coordination law is continuously being developed. The EC was given the right to support research and cooperation between the member states in occupational health and occupational safety.


Revising coordination law

Council Regulation (EEC) No. 1408/71 about applying social security schemes to employees and their families moving within the Community coordinated various member states’ social security schemes in the European Economic Area as well as Switzerland. It had considerable significance for the everyday life of EU citizens and it formed the basis for the introduction of the European Health Insurance Card (EHIC), which replaced the international health insurancecertificate (the E111 form). It expired on 30 April 2010 and was replaced by Regulation No 883/2004.


First occupational safety und health and directives

With Directive 80/1107/EEC of 27 November 1980 about protecting employees from the risks related to being exposed to chemical, physical and biological agents at work, the action programme for safety and health at work adopted by the Council in 1978 was given its first specific implementation. The separate Directive 83/477/EEC of 19 September 1983 about protecting employees from risks related to being exposed to asbestos at work came into force. It was the second specific directive about protecting employees from the risks related to being exposed to chemical, physical and biological agents at work and it was codified in 2009 after being amended several times.


Single European Act

The Single European Act came into force on 1 July 1987. It was intended to accelerate the development of the single market. The Council of Ministers was given the power to adopt decisions covering health protection in the working world made by qualified majority.


Occupational health and safety framework

Directive 89/391/EEC defined employers' obligations to improve employees' safety and health at work and it became the basis for numerous specific directives covering occupational health and safety. Its objective was to reduce the number of occupational accidents and work-related illnesses. Workers were now obliged to take care of their own safety and health as well as the safety and health of colleagues within their means. The Directive was amended several times, most recently in December 2008 by Regulation (EC) No 1137/2008.


European Economic and Monetary Union

The member states of theEuropean Economic Community agreed to create the European Economic and Monetary Union (EMU). It was intended to complement the European single market by establishing the free movement of capital and a common currency with high price stability.


Maastricht Treaty

Signed by the European Council in Maastricht, the Netherlands, on 7 February 1992, the Maastricht Treaty established the convergence criteria for joining the EMU and it set upper limits for total and new debt. The social security budgets were included in this calculation as parafisci. Recommendations about the convergence of social security systems followed in the same year. Initially they had no practical implications at all.

Single market and social policy

The single market is considered to be the heart of the EU. It is the driver of developments such as the free movement of workers, medicines or medical products, but at the same time it also poses the danger of giving greater weight to economic opportunities than to socio-political achievements or standards. It became clearer over time: that a strong single market needs flanking social policies. The European Pillar of Social Rights provided a common set of values, the implementation of which has been successfully demanded time and again.


European single market and health

The creation of the European single market resulted in the free movement of goods, services, capital and labour. A high-level of health protection was also to be realised by preventing widespread serious diseases through research, information and health education. The European Commission would promote cooperation between member states and support them in their actions. Directive 93/42/EEC covering medical devices was adopted on 14 June.


Centralised pharmaceutical authorisation and Community procedure

As part of the overall strategy for a single market for pharmaceutical products, the "centralised" procedure for medicinal product authorisations was codified on 1 January 1995 and this resulted in the founding of European Medicines Agency. Existing Community law was also further developed when the "mutual recognition" of national marketing authorisations for medicinal products for both human and veterinary use between member states was introduced.


Stability and growth pact

The stability and growth pact was adopted on 7 July to guarantee sound public finances for the EMU. A debt ceiling was set at 60 per cent of Gross domestic product (GDP) as well as a maximum deficit of 3 per cent of GDP.


Open Method of Coordination

The European Council meeting that was held in Gothenburg on 15 June agreed to apply the Open Method of Coordination (OMC) – a form of intergovernmental policy-making that did not entail binding EU legislative action being imposed on the pensions sector. Eleven common objectives were set.


Introduction of the euro

The euro was introduced on 1 January as the common official cash currency in twelve member states and three other countries. It replaced the national currencies at fixed conversion rates. The world's largest currency changeover was accompanied by unusual price increases in specific consumption sectors, especially during the first year. However, the average consumer price increase associated with the introduction of the new euro only accounted for 0.1 to 0.3 per cent of annual inflation.


Sustainable pensions

Applying the OMC in the pensions sector lead to the first joint report from the Council and the European Commission about adequate and sustainable pensions being released on 9 July 2003. The higher-level objectives of it were that the systems must continue to fulfil their socio-political tasks, be financially sustainable and take the changing social requirements into consideration.


Protection against carcinogens or mutagens at work

Directive 90/394/EEC of 28 June 1990 about protecting employees from the risks related to being exposed to carcinogens at work was codified after several amendments. This Directive has been amended four times since then. Most recently, in 2022, exposure limits were introduced or corrected downwards for three more carcinogenic substances.


European Centre for Disease Prevention and Control

The European Centre for Disease Prevention and Control (ECDC), which is based in Stockholm, started its work on 20 May. It was primarily intended to support the actors in the public health sectors. This European agency was upgraded in the wake of the Corona pandemic through European Health Union legislation introduced in early 2022.


REACH regulation

The EU Chemicals Regulation (EC) No. 1907/2006 came into force on 1 June 2007. The previous Chemicals legislation was fundamentally harmonised and simplified by it. REACH stands for Registration, Evaluation, Authorisation and Restriction of Chemicals. This regulation has been continuously updated since it came into force. A revision with the aim of promoting sustainable chemicals, streamlining regulatory processes and reducing pressure on the environment as well as reducing risks to human health was announced for the end of 2023.


Patient mobility

The European Commission presented its proposal for a directive about exercising patients' rights in cross-border healthcare. This was preceded by various rulings from the European Court of Justice (ECJ) between 1996 and 2006 about assuming the costs in the event of cross-border use of health services. The directive about exercising patients' rights in cross-border healthcare became legally binding in 2011.


Asbestos Directive

For reasons of clarity and transparency, Directive 2009/148/EC of 30 November 2009 about protecting employees from the risks related to being exposed to asbestos at work codified existing legislation about protecting against asbestos. It was preceded by Directive 83/477/EEC of 19 September 1983, which has been substantially amended several times.


Coordination of social security schemes

Regulation (EU) 883/2004 about coordinating social security schemes and its implementing Regulation (EU) 987/2009 applied as of 1 May. They replaced Regulation 1408/71 of 14 June 1971 about applying social security schemes to employees and their families moving within the Community.Unemployment, paternity or early retirement benefits would now be provided across borders for the first time. A new system (EESSI) will be introduced for the electronic exchanging of social security information.


European Semester

The European Semester was implemented for the first time. It unified economic, financial, social and employment policy coordination. This process was initiated annually through the Annual Growth Survey held in November (general policy guidelines). The process ended in June with the adoption of country-specific recommendations for each member state.


Adequate pensions

The European Commission and the Social Protection Committee published their first report about the adequacy of pensions. It provided an overview of current pension reforms and analysed the main challenges to the adequacy of current and future pensions. In contrast to the OMC, the adequacy report and the sustainability report were now up for political discussion independently of each other. Adequacy issues were given more weight again.


Revision of coordination law

In December, the European Commission proposed amendments to the regulations about coordinating the social security schemes. Despite good compromises, especially with regard to coordinating care benefits, the Council and Parliament became caught up over questions of applicable law and unemployment benefits. After two failed trialogues, an end to the dispute is still nowhere in sight in mid-2023.


Medical devices

The medical devices directives were given the character of a regulation and this meant that they became directly applicable law. Regulation (EU) 2017/745 about medical devices (MDR) and Regulation (EU) 2017/726 about in vitro diagnostic medical devices (IVDR) emerged. They came into force on 25 May 2017. The transitional periods were extended at the beginning of 2023 through an emergency law and a reference to impending shortages. This meant that significant parts of the new law could still not be applied.


European Pillar of Social Rights

The then 28 member states proclaimed the European Pillar of Social Rights in Gothenburg on 17 November. Through its 20 principles, it forms the guideline for a social Europe and a congruent approach for a European social policy that does not need the standardisation of national social protection systems.

Current European health and social policy

The current 9th legislative period is strongly affected by the Corona pandemic and how it has been managed. The "European Health Union" is gradually becoming a brand for initiatives that are broadly designed to increase the EU's crisis resilience to health threats. Social protection systems are once again proving to be an anchor of stability in difficult times. Europe continues to address major issues for the future. The "Green Deal" is beginning to be felt in health and social policies.


European Health Union

With the publication of a package of three draft regulations, the European Commission responded to the new health threat situation posed by COVID-19 and is upgrading structurally. The European Medicines Agency and the European Centre for Disease Prevention and Control will be strengthened and the European Commission will give itself extended rights in the event of crises. Irrespective of this, a parallel discussion about extended EU competences in health policy was held.


Porto Social Summit

At the Social Summit held in Porto on 7 May 2021, member states committed to implementing the European Pillar of Social Rights’ action plan. For their part, the social partners also committed to implementing social policy objectives. One of the objectives is to get at least 78 per cent of adults in the EU into work by 2030. At least 60 per cent of all adults will be offered training once a year.


Platform work

The European Commission presented their Europe-wide plan to enable platform workers to access social protection and labour rights. It was intended to create legal certainty for platform operators and their employees. The aim is to reap the benefits of the digital transformation and protect the European social market economy.


Health Technology Assessment, Artificial Intelligence

After years of tug-of-war, Regulation (EU) 2021/2282 about the Health Technology Assessment (HTA) will be adopted on 15 December. It marks the entry into the Community evaluation of medicinal products and pharmaceuticals. They complement, but do not replace, the benefit assessment procedures carried out in many member states. On 21 April, the European Commission also proposed the world's first regulations for artificial intelligence (AI) through a draft law.


European Health Data Space

On 3 May, the European Commission presented its ideas for a European Health Data Space (EHDS). EU-wide digital use of health data should improve medical care, serve science, promote innovation and support political action. A major challenge here is ensuring the compatibility of European and national telematics infrastructures. The specifications must also comply with the strict provisions of the General Data Protection Regulation.


Amendment Asbestos Directive

With its proposal to amend Directive 2009/148/EC about protecting employees from the risks related to being exposed to asbestos at work from 2009, the European Commission is taking a further step to improving occupational safety and health. However, the European Parliament is calling for even stricter requirements.


Future of Social Protection

A high-level 12-member group of experts on the future of social protection, which was established at the end of 2021, presented its report on 7 February. The effects of demography, digitisation and climate change on social protection systems were studied. The report lists 21 recommendations for the future designing and financing of social protection systems. In view of the huge challenges, it recommended that the revenue base should be broadened and that a rethink about Maastricht criteria for national debt was needed.


New limit values for lead and diisocyanates

On 13 February, the European Commission proposed stricter workplace exposure limits for lead. For the first time, limit values are to be introduced for the diisocyanates chemical group, which are found in composite materials, amongst others.


Revision of European pharmaceutical legislation

Health Commissioner Stella Kyriakides let the cat out of the bag on 26 April. The Commission's proposals for revising European pharmaceutical legislation have met with widespread criticism. However, the European Commission is talking about a concerted balancing act. It has had an easier time with its proposal to combat antimicrobial resistance. The countries are going with it. A Council recommendation regarding this will be decided in the Employment, Social Policy, Health and Consumer Affairs Council (EPSCO) on 13 June.