Emil Lederer: Intervention on Pharmacies (1921)

This recorded commission intervention concerns the place of pharmacies within a proposed framework of municipal provision. Lederer argues for retaining a legal mechanism through which municipalities could enable sickness insurance funds to supply medicines at cost. His position is provisional: he acknowledges that he cannot immediately assess the full weight of the preceding arguments, but resists excluding the provision on principle. The excerpt does not reproduce those arguments or the complete legislative proposal, so its scope is the institutional choice defended in this speaking turn.

The decisive circumstance is the expansion of compulsory health insurance:

Solange dieses Gesetz aber nicht besteht, ist durch die Ausdehnung der Krankenversicherungspflicht auf die überwiegende Mehrheit der Bevölkerung eine Situation geschaffen, in der man den Krankenkassen in weit höherem Maße zubilligen wird, Apotheken selbst zu betreiben, um ihre Mitglieder zweckmäßig zu versorgen.

English translation: As long as this law does not exist, however, the extension of compulsory health insurance to the overwhelming majority of the population has created a situation in which sickness insurance funds will be conceded, to a much greater extent, the right to operate pharmacies themselves in order to provide appropriately for their members.

Lederer thus connects wider insurance coverage to a stronger claim for direct pharmaceutical provision. The funds’ role need not stop at financing treatment: operating pharmacies could serve their responsibility toward members. He also treats the provision as legally revisable, explaining that a subsequent law abolishing municipalization would abolish the associated rule.

His concluding sentence distinguishes preserving a municipal power from requiring its exercise:

Wenn die Gemeinde es nicht für zweckmäßig findet, braucht sie das Monopol nicht zu errichten, hat aber nach § 4 in der Fassung, die wir vielleicht noch etwas verändern wollen, die Möglichkeit, den Krankenkassen gleichsam als Konsumentenorganisationen der Arzneimittelbezieher eine Versorgung zu Selbstkosten zu ermöglichen, was wir ihnen versagen, wenn wir die Apotheken ganz frei lassen.

English translation: If the municipality does not consider it expedient, it need not establish the monopoly, but under § 4, in the wording that we may still wish to modify somewhat, it has the possibility of enabling sickness insurance funds, as, so to speak, consumer organizations of those obtaining medicines, to provide supplies at cost—a possibility we deny them if we leave pharmacies entirely unrestricted.

The conceptual move is to recast sickness insurance funds as consumer organizations. Municipal authority would preserve an option for collective, at-cost supply without obliging every municipality to establish a monopoly. The intervention’s significance lies in this practical distinction: unrestricted pharmacy operation is not simply the absence of compulsion; in Lederer’s account, it also forecloses a particular means of organizing provision for insured consumers.