Taking responsibility or averting risk? A socio-cultural approach to risk and trust in private health insurance decisions

Abstract

The increasing political significance of private health insurance can be located in an altered understanding of the role of individuals and the State in protecting citizens' welfare. In common with other Western societies, contemporary Australia is marked by an expectation that people will fund their own needs and identify and manage their own risks throughout their life course. However, we lack information on how people come to make their decisions. In particular, there is no analysis of why people choose to invest in private health insurance. This paper reports on an exploratory study investigating the motivations for the uptake of private health insurance. Taking a socio-cultural approach, the study indicates that while people's stated reasons for buying health insurance show some surface similarities with the reasoning expected of neo-liberal citizens, a closer reading of the data indicates they do not approach their decisions in a rational or calculative way. They rely less on weighing evidence (e.g. relevant statistics, the provisions of their contract with the insurance provider and their own experiences) than they do on trust in an impersonal system, i.e. they believe people and systems will not harm them in future situations (Gilson 2003).

Keywords:

• Risk
• trust
• decision making
• public health
• private health insurance
• health care consumers