HEALTH RISK ANALYSIS AND SOCIOMEDICAL TECHNOLOGIES OF THE SELF - PRIVATE HEALTH-INSURANCE GETS INTO HEALTH PROMOTION

In October 1994 the then Australian Federal Minister for Health, Dr Ca rmen Lawrence, announced that Medicare, the Australian universal natio nal healthcare fund was considering introducing Healthtrac a computeri sed health promotion program. The change of government in 1995 put pai d to this plan, however lifestyle based health promotion programs, inc luding computerised programs, are an increasing trend in contemporary health care. Research from the United States indicates a growing inter est by private insurers and Health Maintenance Organisations (HMOs) in funding and encouraging members, particularly older members and retir ees, to engage in healthy lifestyle programs, some of which provide wr itten reports, periodic up-dates and checks to members as well as summ ary advice to employers and insurers. In this article we argue that wh ile many of these programs are well researched programs that rake cogn isance of the contradictions surrounding scientific research related t o lifestyle behaviours, disease and disability they take a narrow appr oach to health promotion. Further in the hands of private insurers and HMOs these programs have the potential to become sociomedical techniq ues (Stone 1989) of dominance, arising out of risk analysis that infor ms and refines techniques of governance of the self (Burchell 1993; Ro se 1993). Consistent with Stevensen and Burke (1991) we see health pro motion not as a new social movement, but as a political strategy of th e state and capitalism to deal with among other things, escalating hea lth care budgets. Given this, health promotion strategies that overly focus on risk analysis for the individual citizen reinforce techniques of self-governance by linking lifestyle behaviour to immorality as we ll as potentially creating a culture of anxiety - surely a public heal th problem in itself.