Who should care? Exploring the views and experiences of individuals in negotiating solutions for health security

Abstract

PurposeThe Indonesian healthcare system has been reformed in tune with economic and political changes. The reform was pursued by encouraging growing reliance on individual contributions. Consolidating citizens' support has become increasingly important for the long-term sustainability of the programme. This study explores individual views and experiences in negotiating solutions for health security under the situation where pre-industrial modes of informal network remain intact, while private healthcare continues to be in demand by population segments targeted by the system.Design/methodology/approachIndividual attitudes toward the current healthcare system were explored using online interviews (N = 75) in the cities of Jakarta and Yogyakarta, Indonesia. The qualitative exploratory approach resorted to personal views on the importance of the state, family and market in health risk management. Perceptions on who should be responsible for healthcare, and the political legitimacy of the welfare-state approach to healthcare were also observed. A thematic coding strategy was used for the data analysis.FindingsThose interviewed value and support the formal system (either state and market), yet place reliance on informal support (family and relatives). Intertwining views of religious teaching, filial piety, moral obligation were the most common reasons for individuals to support such dual welfare systems. The findings reflect the common attitudes toward welfare in the context of changing realities of individualised society at the early stage.Originality/valueThis article represents a valuable contribution at the empirical level because it provides an assessment of individuals' attitudes toward Indonesia's recent health arrangements. Such individuals are those belonging to the targeted population of the contributory system. This study also offers an alternative framework for understanding the nature of the healthcare regime generated from the perspectives of individuals.