Providing the population with existential services, such as health care, schooling, electricity and road access, is a basic condition for human development. The governments of the individual countries assume responsibility for the comprehensive provision of the population with these services of general interest. This does not automatically imply that governments must also provide these services themselves, but they do have the responsibility. In rural, peripheral areas, central planning and organization are particularly important, since the free market does not automatically ensure that services of general interest are available in sufficient quantity and quality at every location.

Health care is an example of services of general interest in rural areas that is of particularly existential importance. While it is basically possible to live in rural areas with more distant schools (up to and including boarding schools), without electricity and with poor roads, a region without health care services that are perceived as adequate by the population practically implies uninhabitability. It is literally a matter of life and death for most health services. For this reason, this subproject analyzes the health care system as an example of services of general interest in rural areas.

It can be noted that resources, structures, processes and outcomes of health care in the countries of the Baltic Sea Region are very different. However, upon closer examination, not only do the resources and outcomes differ, but so do the methods of health care service delivery. While some differences are historical (e.g., tax-funded national health services in Scandinavia, Bismarckian social insurance in Germany), other differences are due to innovations in health care delivery that have been introduced in the countries in recent decades. For example, Estonia and Denmark are considered pioneers of e-health, i.e., the use of modern digital communication, processing and storage technologies in healthcare. Germany, on the other hand, is among the laggards within the OECD. But why are such innovations not finding their way from Denmark and Estonia to Germany?

This subproject investigates this fundamental question about the emergence and spread of innovations in the healthcare sector.