Paper long abstract:

Insurance is an economic technology which creates security through elaborate actuarial calculations, the pooling of resources and the spreading of risk. Because insurance always involves the sharing of responsibility, solidarity is inherent to this technology. However, the Finnish case of health care insurance for children shows that insurance solidarities can go in many directions, and they can even be mutually exclusive. In Finland, all children are covered by social insurance and are entitled to free public health service. Yet, many families want to supplement this service: some 40% of children under 7 years are insured privately, despite the extra cost of some 350€ per year per child. In addition to an increased sense of security, families are willing to pay for the convenience of use; private health centres are more flexible service providers for parents with demanding work schedules. Many fear, however, that the strengthening of the private health care sector threatens to weaken both the legitimacy of, and the service given by, the public sector. The analysis of this issue shows that the way in which the insurance tool is assembled affects whether insurance creates solidarity with the population at large, or rather, with the workplace, for example. The question examined in this paper is: how can forms of solidarity not only be produced but also dismantled by the use of the insurance tool? The data studied are interviews with families and with the representatives of insurance companies and public administration.