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Exploring Interactions in the Sickness Insurance System in Terms of Power and Trust
Elin A Karlsson1, Jan L Sandqvist2, Ida Seing3
1Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. elin.a.karlsson@liu.se.
Journal of Occupational Rehabilitation
|December 22, 2021
Summary
Clients on sick leave must prove their willingness to return to work, highlighting power imbalances and distrust within the Swedish sickness insurance system. The system must reciprocate trust to maintain public confidence.
Area of Science:
- Social Sciences
- Health Policy
- Sociology of Work
Background:
- Western sickness insurance systems are increasingly linked to employment activation policies.
- There is a growing emphasis on detecting malingering among individuals on sick leave.
Purpose of the Study:
- To investigate the dynamics of power and trust between clients and stakeholders in the Swedish sickness insurance system.
- To understand how clients and stakeholders express and perceive power and trust within this system.
Main Methods:
- Longitudinal qualitative study design.
- Semi-structured interviews with 31 clients on sick leave in Sweden.
- Analysis of case files and thematic analysis of collected data.
Main Results:
- A dominant theme of 'Acts of power and distrust' emerged.
- Stakeholders frequently expressed suspicion towards clients.
- Clients were required to actively demonstrate their desire and efforts to return to work, with verification from stakeholders.
Conclusions:
- Clients' strong desire to contribute to society was a key finding.
- Acknowledging and addressing power relations, particularly between clients and the Swedish Social Insurance Agency (SIA), is crucial.
- The system must demonstrate trust in clients to foster and preserve public confidence.
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