This essay is about how the government formulates its policy regarding the health insurance and how these ambitions are then translated in the steering of the Swedish Swedish Social Insurance Fund. We have formulated the following questions: ● How is government policy and governance formulated in terms of health insurance? ● How does government policy and governance differ in terms of health insurance policy during the period studied? ● How does government's policy orientation affect the overall governance they provide to the Social Insurance Fund? We also analyze whether there are differences in policy and governance and between governments that took place in 2006, 2010 and 2014. We have read political material such as election manifesto and the Prime ministers´statement of government policy and compared this with the governments appropriation directions to the Swedish Social Insurance Fund and directions in the state budget. For the analysis, we use text analysis and we have, under the results and conclusions, identified two themes that all three governments commute between: the labor theme and the security theme. Our theoretical approach is the theory formulated by Frank Baumgartner och Bryan Jones Punctuated Equilibrium. We find that although there are differences in policy depending on the government's political color, governance is relatively stable. The overall objectives of the Swedish Social Insurance Fund have only been changed once during the period we have studied. In our analysis we have a reasoning for our outcome based on our theoretical perspective.

The Swedish Social Insurance agency has a need to develop a dynamic system to manage employee holidays. Today, all information about employee holidays ar stored in in diffrent holiday lists and takes form of documents such as Excel spreadsheets. This creates unnecessary administrative work and frustration, so the need for a common vacation list exist. A list that contains all employees of the Swedish Social Insurance Agency, which can be shaped as needed. The list should be able to be filtered so that only those people who are of interest to the user are displayed. The user should also be able to easily save the his/hers vaca- tion days. After the agile meetings with the clients of the agency, could a solu- tion be developed. This solution is based on an external code library named Te- lerik, and store employees holidays in a single database. This solution can be added to the Social Insurance Agency's intranet FIA, so that it is easily acces- sible for employees. The new holidays list's design was chosen from the clients wishes and the guidelines of how a good design should be. At present there is no license on the insurance agency to use Telerik, but this solution was chosen anyway because it was considered the best approach for this project. If the solu- tion is selected as the new system for storing holidays, there is an opportunity to continue the project by buying a license for Telerik, add up the vacation list of FIA and use personal data from the Social Insurance Agency's database so all employees are included. / På Försäkringskassan finns behovet av att ta fram ett dynamiskt system för att hantera de anställdas semester. Idag sparas all information om ledighet i semes- terlistor på olika vis i form av dokument som till exempel Microsoft Excel-ark. Detta skapar onödigt administrativt arbete och frustration, så behovet av en ge- mensam semesterlista finns. En lista som innehåller samtliga anställda på För- säkringskassan, och som kan formas efter behov. Listan ska kunna filtreras så att endast de personer som är intressanta för användaren ska visas. De ska också enkelt kunna spara användarens ledigheter. Efter agila möten med beställare kunde en lösning tas fram. Denna lösning har sin grund i ett externt kod-biblio- tek vid namn Telerik, och lagrar anställdas ledigheter i en enda databas. Denna lösning går att lägga upp på Försäkringskassans intranät FIA, så att den blir lätt- åtkomlig för de anställda. Semesterlistans design valdes från beställarnas önske- mål. I nuläget finns ingen licens på Försäkringskassan för att använda Telerik, men denna lösning valdes ändå eftersom det ansågs vara det bästa tillväga- gångssättet för detta projekt. Ifall lösningen väljs till det nya systemet för att lagra ledigheter finns det möjlighet att fortsätta projektet, genom att köpa en li- cens för Telerik, lägga upp semesterlistan på FIA och använda persondata från Försäkringskassans databas för att samtliga anställda ska finnas med.

The purpose of this essay has been to investigate whether the Swedish Social Insurance Agency´s administrators and investigators feel that they perform gender-neutral assessments in sickness benefit and work injury cases. The method was based on interviews who gave the informants the opportunity to explain and describe their experiences around gender neutrality in their work. The results, which were analyzed using the qualitative method content analysis, clearly showed that the work ability assessments required in sickness benefit and work injury cases differ both depending on which company carries them out, where in the country they are carried out and that the scientific investigations that investigators at the Social Insurance Agency are required to do to follow are mainly designed on men. It is easier to investigate men´s work ability than women´s work ability, because they can follow the documents designed for men in male-dominated occupations. The informants know there is no or too little evidence that fits women´s disease pictures. Employees feel that their assessments are gender-neutral, but that their assessments are based on ready-made assessments templates that mainly work for men in male-dominated occupations. / Om Försäkringskassan inte utför könsneutrala arbetsförmågebedömningar av anställda inom kvinnodominerande yrken samt i förlängningen vid sjukpenning-och arbetsskadeärenden, så sker inte den likvärdiga behandling av kvinnor och män som Försäkringskassan är ålagda. Syftet med den här uppsatsen har varit att undersöka om Försäkringskassans handläggare och utredare upplever att de utför könsneutrala bedömningar vid sjukpenning- och arbetsskadeärenden. Den metod som följts har utgått från en kvalitativ ansats där semistrukturerade intervjuer givit informanterna möjlighet att både förklara och beskriva sina upplevelser runt könsneutralitet i sitt arbete. Resultatet, som analyserades med den kvalitativa metoden innehållsanalys, visade tydligt att de arbetsförmågebedömningar som krävs vid sjukpenning-och arbetsskadeärenden skiljer sig åt både beroende på vilket företag som utför dem, var i landet de utförs och att de vetenskapliga undersökningar som utredare vid Försäkringskassan är ålagda att följa främst är utformade på män. Informanterna upplever att det är lättare att utreda mäns arbetsförmåga än kvinnors arbetsförmåga, eftersom de då kan följa de underlag som är utformade för män inom mansdominerade yrken. Informanterna anser att det finns inga eller alldeles för få underlag som passar in vid kvinnors sjukdomsbilder. Anställda vid Försäkringskassan upplever därför att deras bedömningar sker könsneutralt, men att deras bedömningar sker utifrån de färdiga utredningsmallar som främst fungerar för män inom mansdominerande yrken. Det har i denna studie även framkommit att läkare gör skillnad i läkarintygen för män och kvinnor, till nackdel för kvinnor, samt att de utredare vid Försäkringskassan som försöker göra skillnad bestraffas av sin arbetsgivare Försäkringskassan.

Ett allt vanligare fenomen i dagens arbetsliv är att tjänsteproduktion organiseras efter modeller som i grunden är anpassade för varuproduktion. En av dessa organisationsmodeller är Lean, som har implementerats inom Försäkringskassan. Försäkringskassans byråkratiska organisation har därmed struktureras upp i ännu fler regler, rutiner och processer. Finns det något utrymme för lärande i en sådan organisation? Denna studie har som ambition att bidra till en ökad förståelse för hur lärande i det dagliga arbetet uppstår i en byråkratisk organisation där regler och rutiner är en del av jobbet. Syftet är att belysa personliga handläggares upplevelse av lärande i det dagliga arbetet. Utifrån syftet har följande frågeställningar formulerats; Hur upplever handläggare att styrande rutiner för arbetets utförande inverkar på deras lärande? Hur upplever handläggare att de lär sig av sina kollegor? I vilken utsträckning upplever handläggare att lärande sker över det egna teamets gränser? Studien bygger på en kvalitativ metodansats och åtta semistrukturerade intervjuer har genomförts med handläggare på försäkringskassan. Det empiriska materialet har analyserats utifrån Wengers teori om Communities of Practice. Resultatet visar att regler och rutiner används för att fylla kunskapsluckor och därmed bidrar till lärande. Handläggare lär också i det dagliga arbetet genom social interaktion som bland annat uppstår vid informella diskussioner och formella möten. Interaktionen leder till ett erfarenhetsutbyte mellan kollegor. Genom att ta del av andra myndigheters eller individers erfarenheter och kompetens har handläggarna möjlighet att utveckla ett lärande över gränser. Dock skiljer sig handläggarnas uppfattningar när det kommer till kunskaps- och erfarenhetsutbyte med aktörer utanför Försäkringskassan. / An increasingly common phenomenon in today's working life is that the production of services is organized through production models that originally was created to organize the production of things. One of these organizational models is Lean, which has been implemented within the Swedish Social Insurance Agency. This bureaucratic organization has thus been structured into even more rules, procedures and processes. Is there any room for learning in such an organization? This study is an attempt to contribute to an understanding of how learning in daily work occurs in a regulated organization where rules and procedures are part of the job. The aim of the study is to investigate the social insurance officers personal experience of learning in the daily work. To answer the purpose of the study the following questions has been formulated; How do social insurance officers experience that common routine descriptions of work design influence their learning? How do social insurance officers experience that they learn from their colleagues? To what extent do social insurance officers experience learning over the boundaries of their own team? The study is based on a qualitative method using eight semi-structured interviews with social insurance officers at the Swedish Social Insurance Agency. The empirical data has been analyzed from Wengers theory Communities of practice. The result shows that rules and procedures are used to fill knowledge gaps and thus contribute to learning. The social insurance officers also learn in daily work through social interaction by informal discussions and formal meetings. By studying other authorities or individuals' experiences, the social insurance officers can develop cross-border learning. However, the perceptions of the social insurance officers differ when it comes to knowledge and experience exchange with actors outside the Swedish Social Insurance Agency.

This thesis contributes to the field of causal inference, where the main interest is to estimate the effect of a treatment on some outcome. At its core, causal inference is an exercise in controlling for imbalance (differences) in covariate distributions between the treated and the controls, as such imbalances otherwise can bias estimates of causal effects. Imbalance on observed covariates can be handled through matching, where treated and controls with similar covariate distributions are extracted from a data set and then used to estimate the effect of a treatment. The first paper of this thesis describes and investigates a matching design, where a data-driven algorithm is used to discretise a covariate before matching. The paper also gives sufficient conditions for if, and how, a covariate can be discretised without introducing bias. Balance is needed for unobserved covariates too, but is more difficult to achieve and verify. Unobserved covariates are sometimes replaced with correlated counterparts, usually referred to as proxy variables. However, just replacing an unobserved covariate with a correlated one does not guarantee an elimination of, or even reduction of, bias. In the second paper we formalise proxy variables in a causal inference framework and give sufficient conditions for when they lead to nonparametric identification of causal effects. The third and fourth papers both concern estimating the effect an enhanced cooperation between the Swedish Social Insurance Agency and the Public Employment Service has on reducing sick leave. The third paper is a study protocol, where the matching design used to estimate this effect is described. The matching was then also carried out in the study protocol, before the outcome for the treated was available, ensuring that the matching design was not influenced by any estimated causal effects. The third paper also presents a potential proxy variable for unobserved covariates, that is used as part of the matching. The fourth paper then carries out the analysis described in the third paper, and uses an instrumental variable approach to test for unobserved confounding not captured by the supposed proxy variable.

Syftet med uppsatsen har varit att se hur Försäkringskassan skapar eller återskapar en bild av individer som blir sjukskrivna för psykisk ohälsa samt dennes arbetsförmåga. För att bli sjukskriven, via sjukförsäkringen, bedöms individen utefter sin arbetsförmåga. Uppsatsen har i analysen hittat flertalet diskurser. Diskursen om spänningen som finns mellan att individen ska ta ansvar för sin återhämtning samtidigt som hen inte har något mandat i beslutet om sjukpenning. En diskurs om att psykisk ohälsa inte är en sjukdom men att individen med psykisk ohälsa ändå ses som avvikande. Förutom detta återfinns i texterna från Försäkringskassan diskursen om misstro och fusk från den som ansöker om sjukpenning. Den sista diskursen belyser att arbetsförmåga bedöms olika av olika aktörer men att Försäkringskassan inte lyfter fram detta i sina texter. Diskursen om bedömningen av arbetsförmåga är tvetydlig, det finns inget bestämt sätt att se och bedöma arbetsförmåga. Dock att det är Försäkringskassan som har makten att bestämma ifall bedömningen av arbetsförmågan från andra aktörer är riktig eller ej och genom detta ge individen rätt att vara sjukskriven eller inte. / The purpose of this paper has been to observe how the Swedish Social Insurance Office create and/or reproduce the conceived image of individuals on sick leave for mental illness and their work ability. To be eligible for sick leave via the Swedish health insurance, the individual will be judged based on their work ability. The paper has found multiple discourses in the analysis. One discourse is about the tension that exists in that the individual is simultaneously responsible for their own rehabilitation and how they lack authority in the decision-making process of getting sick pay. Another discourse that mental ill health is not a disease, but that the individual with mental health is nevertheless considered to be abnormal. In addition to this, the text of the Swedish Social Insurance Office contains the discourse of suspicion and cheating from the applicant for sickness benefit. The last discourse illustrates that work ability is judged different by different actors, but that the Swedish Social Insurance Office does not highlight this in their texts. The discourse around work ability is ambiguous in that there is no determined praxis on how it will be judged or measured. Furthermore, the analysis states that the Swedish Social Insurance Office has the ultimate power to decide whether judgements made from other actors about a person's inability to work is valid and justified, and by this determining if they should be granted sick pay or not.

In 2020, many Swedes were infected by the COVID-19 virus. The individuals who now suffer from post-COVID conditions have symptoms that resemble the neurological disorder myalgic encephalomyelitis (ME). ME is predicted to increase in the aftermath of the pandemic. Both post-Covid and ME patients commonly encounter misunderstandings, a lack of treatment options and experience difficulties with the Swedish Social Insurance Agency. The purpose of this study is to examine how patients with ME experience their condition to affect the relationships to people in their everyday life and the reception from the health care system as well as the Swedish Social Insurance Agency. The study also examines important factors in coping with the condition. Previous research on the disorder shows difficulties with getting diagnostic legitimacy, a drastically diminished social life, stigma and traumatic experiences with the Swedish Social Insurance Agency. This study is based on six semi-structured video interviews with people who have ME. The analysis of the results has its foundation in Goffman’s dramaturgical theory and his concept of stigma. It further draws on Elias’ and Scotson’s explanation of moral differentiation and Antonovsky’s determining factors of coping with traumatic events. The empiric material shows that having ME leads to a diminished group of friends, which seems to affect the young participants the most. They are also more prone to stigmatization by superficial acquaintances and new contacts. A shared experience among the participants is stigmatization in primary care, which also complicates their encounters with the Swedish Social Insurance Agency. Emotional, practical and financial support make it easier to handle the situation. When needed, it is essential to be able to rest. The situation also becomes easier to handle if the individual is able to create meaning from the new life circumstances. / 2020 smittades många svenskar av covid-19. De individer som drabbats av långtidscovid har en symptombild som liknar den neurologiska sjukdomen myalgisk encefalomyelit (ME). En sjukdom som förutspås öka i spåren av pandemin. Båda dessa patientgrupper möts av oförståelse, brist på behandlingsalternativ och problem med Försäkringskassan. Denna studie ämnar undersöka hur ME-sjuka upplever att sjukdomen påverkar relationen till de människor individen möter i vardagen samt bemötandet från vård och Försäkringskassan. Den fokuserar även på vad som är viktigt för individens hantering av situationen som sjuk. Tidigare forskning om sjukdomen visar på problem med diagnostisk legitimitet, krympta sociala nätverk, stigmatisering och traumatiserande behandling av Försäkringskassan. Studien är baserad på 6 semistrukturerade videointervjuer med ME-patienter. Resultaten har analyserats utifrån Goffmans dramaturgiska perspektiv samt teori om stigma. Vidare används Elias och Scotsons beskrivning av moralisk differentiering samt de faktorer Antonovsky uppger som avgörande för att hantera traumatiska händelser. Empirin visar att ME leder till en reducerad vänskapskrets, vilket de unga lider mest av. Unga är i större mån även utsatta för stigmatisering av ytliga bekanta och nya kontakter. Samtliga deltagare upplever stigmatisering inom primärvården, vilket bidrar till en komplicerad ärendeprocess hos Försäkringskassan. Hanteringen av situationen som sjuk främjas av emotionellt, praktiskt och ekonomiskt stöd, möjlighet att vila samt att utifrån nya förutsättningar finna mening i livet.

Studiens syfte är att undersöka hur förändringsmodellen ADKAR har använts bland enhetschefer på Försäkringskassan och vilken betydelse den har haft för de under en organisationsförändring. För att uppfylla studiens syfte har en organisationsförändring studerats utifrån ett första linjens chefsperspektiv. Studiens teoretiska utgångspunkter baseras på teori och begrepp relaterat till översättning och meningskapande. Utgångspunkterna har använts för att studera hur ADKAR- modellen översatts och skapat mening kring förändringen. Studiens metod är kvalitativ med fokus på fyra semistruktuerade intervjuer och fyra textdokument. Resultatet av studien påvisar att förändringsmodellen ADKAR internaliserats hos cheferna i samband med deras chefsintroduktion. Modellen har blivit ett etablerat sätt att kommunicera och tänka utifrån vid förändring. ADKAR- modellen idientifieras genomgående under förändringen som en vattenfallsmodell. / The purpose of this thesis is to investigate how the change model ADKAR has been used among section directors at the Swedish Social Insurance Agency and what significance it has had for them during an organizational change. To fulfill the purpose of the study, an organizational change has been studied through the perspective of a first line director. The thesis theoretical starting points are based on theory and concepts related to translation and sensemaking. The starting points have been used to study how the ADKAR model has been translated and created sensemaking around the change. The study method is qualitative with a focus on four semi-structured interviews and four text documents.The results of this thesis shows that the change model ADKAR has been internalized in the managers in connection with their manager introduction. The model has become an established way of communicating and thinking from the outside in the event of change. The ADKAR model is consistently identified during the change as a waterfall model.

The main purpose of this dissertation is to analyse and identify problems arising from the Swedish Social Insurance Agency’s (SSIA) perceptions of parents, as they appear in the brochures targeted at expectant or new parents between 1974 and 2007. The aim is to distinguish who are being pointed out, constructed, and normalised as parents; and to analyse the functions of the recipients and the senders respectively. The aim is to be considered in the light of the SSIA’s commitment to gender equality, a policy that promotes equal access to the insurance of parents to share the parent’s insurance more equally. The dissertation is based on a theoretical framework that may principally be described as a feminist discourse analysis, which, among other things, means that a constructivist approach is of central importance. In addition, an intersectional perspective is an important starting point, putting the focus on the interaction and interdependence between different social categorisations. In four analysing chapters, the material is being tackled from different approaches or angles. In the first chapter, a picture is drawn of the institutional and political context that sets the prerequisites of the insurance regulations as well as the way the texts have been written and may be understood. The second chapter presents an analysis, in the terms of space deixis, of whom is/are being pointed out and positioned as recipient/s by SSIA. In the third chapter, an analysis of the normalised notions of parents that are identified in the texts; and of what parents are being favoured and described as ‘normal’. In the fourth chapter, the functions of the different actors are being analysed, showing how the relationship between the SSIA and the parents is constructed from in the texts. The results show that, in all brochures, parenthood is strongly gender-marked and that gender equality, above all, is to be understood as a quantitatively even distribution between mothers and fathers. In today’s brochures, the agency identifies and normalises recipients who primarily are biological mothers with orderly conditions, living in nuclear families with biological children. The older brochures have a higher level of gender neutrality in their texts, where mothers and fathers are placed equally and at the same distance from the position of the sender. The newer brochures, however, represent a wider range of social categorisations, and thus present a more complex picture of parenthood. The results also show that the function of SSIA in the texts is primarily economic, and that there is no obligation for parents to share the parent’s insurance equally, despite the political resolutions that impose this task on the agency.

This thesis aims to analyze how tendencies to corruption affect trust in Central Managing Authorities: Sweden Public Employment Service, National Service Center, and Swedish Insurance Agency.  The research questions are:  · Can the trust and legitimacy for the three Central Managing Authorities has been affected by corruption?  · What similarities and differences exist about the corruption into Swedish Public Employment Service, National Service Center, and Swedish Social Insurance Agency?  · Can the lack of trust and legitimacy have other causes than the occurrence of corruption?  The study used comparative method, where cases have been compared and analyzed out from theoretical framework. Through comparation, similarities and differences between the cases and find explaining factors about how corruption can affect trust through applying of the theoretical framework was identified. There are some important implications. First, corrupt tendencies can lead to common interests be override because of personal interests. Second, the democratic values in the public administration can be affect negatively because of corrupt tendencies. Lastly, knowledge and awareness are fundamental for how corrupt tendencies affect citizen’s trust for Central Managing Authorities.