Disguise mechanisms in regulation definitions: the private health system

Abstract

Purpose

Studies of institutional logics have emphasized two fundamental conceptions: first, that there is continuous competition between the various logics embedded in any context and, second, that certain mechanisms influence the promotion or modification of existing logics. The purpose of this paper is to contribute to these studies by broadening the propositions on the mechanisms used by the actors to disguise the fact that they are not prioritizing non-prevailing logics.

Design/methodology/approach

The paper examines the disguise mechanisms used in the regulation of the private health field in Brazil, which has still been rarely explored in the literature on the theme. The research strategy was qualitative, involving documentary research that provided information to create a script for interviewing different actors in this field, such as health plan companies, service providers, medical associations, trade unions, regulatory agency, consumer defense organizations and the judiciary, lending credibility to the study.

Findings

The field data suggest important findings. Field actors pursue exerting influence in defining the outcomes of the institutional logics prevailing at each event. In this pursuit, they work to keep representative parts of prescribed practices non-transparent to allow them a margin in which to maneuver when confronted with a non-prevailing logic.

Originality/value

This paper emphasizes that, in any context, actors, while following the prescriptions of a prevailing logic, might have to disguise not following the prescriptions of other logics; thus, they will have to seek for mechanisms to do so. This paper, by identifying disguise mechanisms that operate in the specific field of private health in Brazil, finally sheds light on disguise mechanisms, contributing to the general literature on institutionalism.

Citation

Ryngelblum, A.L., Giglio, E.M. and Silva Corrêa, V. (2019), "Disguise mechanisms in regulation definitions: the private health system", International Journal of Organizational Analysis, Vol. 27 No. 3, pp. 613-629. https://doi.org/10.1108/IJOA-07-2018-1495