Exploring Trust in Health Insurers: Insights from Enrollees' Perceptions and Experiences

Area of Science:

• Health Services Research
• Health Economics
• Consumer Behavior in Healthcare

Background:

• Managed competition is a key healthcare system feature in countries like Germany, Switzerland, and the Netherlands.
• Low trust in health insurers in the Netherlands may stem from perceived profit motives, negative experiences, media portrayal, and misunderstanding of their functions.

Purpose of the Study:

• To explore Dutch enrollees' perceptions of health insurers.
• To identify factors contributing to these perceptions, particularly regarding trust.

Main Methods:

• Conducted semi-structured interviews with 17 participants from the Nivel Dutch Health Care Consumer Panel.
• Employed Braun and Clarke's six-step method for inductive thematic analysis of qualitative data.

Main Results:

• Enrollees generally view insurers positively for financial management and care access.
• Concerns exist regarding insurers prioritizing profit and cost reduction over individual needs, leading to dissatisfaction.
• Negative experiences and media coverage significantly shape perceptions of health insurers.

Conclusions:

• Health insurers should enhance transparency regarding their non-profit status, benefit utilization, and purchasing decisions.
• Clearer communication about financial obligations and the insurers' broader contributions to healthcare is recommended.
• Building trust requires insurers to actively demonstrate their commitment to care accessibility, quality, fair cost distribution, guidance, and prevention.