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Solidarity in the health system How health apps impact users’ views on the health insurance system
From running and weight training to yoga – a broad range of sports can be tracked on wearables and fitness apps. And this pays off. According to a study by Statista, almost one in three Germans was already using a digital tool to document their own fitness back in 2019. Corona crisis and working from home have accelerated this trend. But in the long term, how does this behaviour change a society whose health insurance system is based on the principle of solidarity – the contributions of the healthy also finance the cost-intensive care of the ill? This question is being investigated by the team led by Professor Remi Maier-Rigaud from the Department of Social Policy and Social Security Studies. On behalf of the Friedrich-Ebert Foundation, the social scientist, together with Sarah-Lena Böning from the University of Cologne, conducted an analysis of the survey results of about 1,300 people. The researchers’ hypothesis is – the use of health apps, fitness trackers and other wearables decreases an individual’s willingness to show solidarity.
Gamification of health The study shows that around three quarters of the population are in fact in favour of a solidarity-based health insurance system. However, a tendency to reject this system can clearly be discerned amongst health app users.
“It seems that increasing knowledge and control over one’s own fitness leads to declining acceptance of a solidarity-based health system”, explains Maier-Rigaud. As with the already existing bonus programmes of the health insurance providers, users who take advantage of digital health opportunities expect to be rewarded for their own performance. This gamification is reinforced by social media platforms where people compare themselves to others. “Fitness apps can certainly be helpful in achieving individual goals”, says Maier-Rigaud. But the social scientist has reservations about their adoption by society as a whole. “Apps create social pressure that not everyone can live up to. What exactly constitutes a healthy lifestyle? Not everyone is able to walk 10,000 steps five times a week in every situation, but that doesn’t necessarily mean that a person is living an unhealthy life. Just think of socio-politically vulnerable groups such as single parents or wheelchair users. Ultimately, everyone should be free to make their own lifestyle choices.”
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