Abstract
This article sheds light on a policy area where the notion of the active citizen has gained prominence as part of the transformation of the welfare state: purchasing private health services and private health insurance for children in Finland. Although the country’s universal health care system offers free primary health care for children, 40 per cent of children now have private insurance. Drawing on interviews with parents who seek private solutions, we examine what they perceive to be good health care. Our analysis reveals that parents are looking for certain practices – in Finland available only in the private sector – that they see as signs of good care. The unavailability of these practices in public health care calls into question the access, quality and efficiency of the public system. Based on these findings, we discuss the possible consequences of the disparity between parents’ expectations and the universal health care system.
Highlights
Health and social care policy is a core area in which welfare state change has occurred in many European countries
For the purposes of this study, we focused on the parents’ perceptions of their children’s health care services and how they are connected to private insurance
Our analysis demonstrated that parents are looking for certain practices that indicate good care, including quick access to a doctor based on parents’ own assessments
Summary
Health and social care policy is a core area in which welfare state change has occurred in many European countries. One area of study that has drawn attention to the perspective of everyday life is approaching welfare state changes as emotional reform (Tonkens et al, 2013). By emotional reform, Tonkens et al (2013: 407) mean that welfare state retrenchment occurs in relation to rules, rights and entitlements and to people’s experiences of cutbacks in public services and what they feel they are entitled to. The emotional and practical implications of retrenchment have been explored in the area of long-term social care (Tonkens, 2012; Grootegoed, 2013; Grootegoed et al, 2013)
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