Exploring Interactions in the Sickness Insurance System in Terms of Power and Trust

Purpose Activation policies and efforts to reduce sick leave rates has influenced sickness insurance systems in Western countries, which has led to social security being more connected with work and attempts to expose malingering among the sickness absent. The aim of this study was to explore how po...

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Bibliographic Details
Published in:Journal of occupational rehabilitation 2022-09, Vol.32 (3), p.483-493
Main Authors: Karlsson, Elin A., Sandqvist, Jan L., Seing, Ida, Ståhl, Christian
Format: Article
Language:English
Subjects:
Analysis
Clients
Clinical Psychology
Employee benefits
Employers
Environmental Health
Health Psychology
Illnesses
Insurance
Medicine
Medicine & Public Health
Moral hazard
Occupational Medicine/Industrial Medicine
Orthopedics
Qualitative research
Rehabilitation
Sick leave
Social security
Vocational rehabilitation
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Summary:Purpose Activation policies and efforts to reduce sick leave rates has influenced sickness insurance systems in Western countries, which has led to social security being more connected with work and attempts to expose malingering among the sickness absent. The aim of this study was to explore how power and trust are expressed by clients and stakeholders within the Swedish sickness insurance system. Methods This was a longitudinal qualitative study based on semi structured interviews and case files from 31 clients on sick leave in Sweden. Data was analyzed using a thematic analysis. Results The main theme ‘Acts of power and distrust’ illustrates how stakeholders’ express suspicions towards each other, and how clients need to demonstrate desire and efforts to return to work which other stakeholders verified. Conclusions The clients desire to prove themselves able to contribute to society was prominent in this study and power relations need to be acknowledged, in particular between client and the SIA. Further, to preserve citizens trust in the system, the system needs to demonstrate trust also in the clients.
ISSN:1053-0487
1573-3688
1573-3688
DOI:10.1007/s10926-021-10017-4