Legal provisions for medical treatment and rehabilitation of children and adolescents can be found, according to the contribution of competencies as laid down in Austrian constitutional law, under the social health insurance schemes (at federal level) and under (regional) regulations for persons with disabilities. As legal distinctions between these areas are not quite clear, access to essential provision and even the enforcement of legal entitlement is often difficult. Many people have to face a “negative conflict of competencies”, meaning that providers that may be responsible try to shift responsibility to other providers.
The responsibility of social health insurance schemes in legal terms is subject to the necessity and expected possibility of medically treating a “deviant state of health” (i. e. sickness). These opportunities have increased enormously owing to medical and technical progress. Furthermore, the links between treatment and rehabilitation have—finally—become more comprehensive. Thus, the meaning of the legal term sickness has widened, especially with respect to children and adolescents, causing an increase in the legal responsibilities of health insurance schemes.
This should not lead to a withdrawal of the regions, but better coordination of these systems, giving more consideration to people’s needs, should be facilitated. This could be achieved, even in the short term, by co-financing programs (in which other providers are also included), by establishing joint clearing centers that set binding regulations for all providers, and organizing the best possible individual service models.