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Sammanfattning

The Swedish Social Insurance Agency (SSIA) is the public authority that administers health insurance, and it is very important that there is great confidence in the authority, both among those in need of the insurance and the public in general. The aim of this focus group study was to investigate how people with experience of the health insurance apprehend and describe their confidence in the SSIA. Eight focus groups (n=41) were carried out, and each group met at one occasion. The participants described how structural and so- cietal factors, such as stricter rules and tightening of the insurance, affected confidence negatively. It also emerged that the health insurance process was seen as insecure, and the work and the guiding principles of the SSIA lacked transparency. The participants were of the opinion that their personal contact with the administrators affected the image of the SSIA as an authority. The participants could feel vulnerable and there was a feeling of impotence in relation to the SSIA which impaired their health. The conclusion is that there is no easy way for the SSIA to break the negative confidence trend. Politicians and officials need to clarify the rules and regulations, make sure that the health insurance decision-making process is fair and easy to understand, and that the grounds for the decisions are not haphazard or arbitrary. All this together can stop clients from experiencing deteriorated health, and steer public confidence in the SSIA in a positive direction.

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