|Postmodernism in health: the rising of alternative medicine in Western-Europe|
Health service use is susceptible to societal trends. The biomedical supremacy has evolved into a dynamic health market, wherein alternative therapies complement the conventional supply of health care. This change is realized thanks to the consumerist behavior of patients nowadays who aspire not only absence of disease, but strive for optimal well-being. Those individual attitudes are inspired by the postmodern value pattern. Due to the demystifying of science and the awareness of risks in our society, health services are not taken for granted anymore, but are assessed with a skeptical viewpoint. Thanks to the knowledge society, the responsibility within the medical decision process can be redefined by empowered patients who donít follow implicitly their doctorís orders. The self-directed, natural and holistic approach of healing of alternative medicine fits those values. On the country level, the field of health is set as a priority in welfare states. Public funding on health is excessive, in line with private expenditure. Besides, the government facilitates choice in health care by reimbursing alternative therapies in some countries. Based on the Behavioral Model of Andersen (1995), our study considers three components of the use of alternative therapies in case of daily health complaints: medical need, cultural predisposing attitudes and structural enabling national indicators.
The sample (N= 31 739) is representative of all people older than 15 years old, living in private households in Belgium, Austria, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom and Iceland, based on data of the European Social Survey (Round 2, 2004). The hierarchical logistic model is estimated by means of the multilevel program HLM 6.0.
The odds ratios show that on the one hand, the subjective health status has no impact on the tendency to contact an alternative therapist, neither as the (lower) frequency of visits to a general doctor. On the other hand, the quest for empowerment stimulates the use of alternative medicine, next to dissatisfaction with conventional medicine. The results on the macro-level make clear that financial aspects influence the preference for alternative medicine. Both a higher amount of money spent on health and public reimbursement of alternative therapies facilitate the use. All the analyses were controlled for gender, age, education level and income to avoid composition effects.
A blend of pragmatic and ideological motives of the eclectic consumers influence the broadening appeal of alternative medicine in the health market, combined with some structural facilitators on the national level. Because medical need is not a determining predictor of health service use, alternative medicine takes part into the commercialization of health as a complement to conventional care, which is legitimized by the institutionalization of alternative medicine into public insurance.