Trust not required for cooperation if common interests can be found
An article published last week in the New York Times describes the apparent realization by both the administration and the health insurance industry — long time adversaries on health care reform — that they both have significant interests in the success of health care reform now that the legislation has passed, and HHS Secretary Kathleen Sebelius is now reportedly considering some sort of public-private partnership to implement the provisions in the law. The need to collaborate does not invalidate the real and present distrust between the parties, even if it helps both the government and the insurance industry in the pursuit of their separate interests. In this context the situation illustrates the possibility for successful inter-organizational cooperation to occur, even in the absence of trust. Such as idea runs counter to some established schools of thought on trust, in which scholars such as Robert Putnam and Francis Fukayama have suggested that trust is a prerequisite for cooperation on a significant scale. In contrast, somewhat more recent literature, such as that presented in Cook, Hardin, and Levi’s Cooperation Without Trust, embody a different perspective on trust and on trustworthiness, in which “a trust relation emerges out of mutual interdependence and the knowledge developed over time of reciprocal trustworthiness” (2005, p. 2). The interdependence of the relationship is crucial to any evaluation of trust that has as its basis what Hardin has termed “encapsulated interest” — the fact that two or more organizations, working independently, may pursue the same outcome is not sufficient to engender trust. If, however, their collective action is needed, even when the benefits sought are different (profitability for the insurance companies, cost reduction and universal access for the government) then the commonality of interests can still provide the motivation needed for the parties to cooperate. What’s missing from the health care example that would make this less a case of cooperation-despite-distrust is the consideration of trustworthiness. Those in the administration are well aware that the insurance industry needs to stay solvent (the alternative of course could have serious economic implications far beyond the health sector), but understanding their interests does not make them trustworthy. Instead, trustworthiness (or more specifically, the consideration by one party that another is trustworthy) depends on the actions and demonstrated intentions of the parties over multiple interactions, with the key assumption for mutual trustworthiness that all parties have an interest in maintaining the relationship going forward. It’s not at all clear to what extent this envisioned public-private sector collaboration will occur, and if it does, how long the collaboration may go on, particularly once the key features of the health care reform law are implemented. The theoretical good news is that neither the government nor the insurance industry needs to wait for trust to develop, as mutual distrust should not be a barrier to cooperation if both sides realize that their different interests can be furthered by making health care reform a reality.