Cognitive dissonance in health insurance consumers: Analysis through financial literacy

Authors

  • Diana Anggraini Faculty of Communication, LSPR Institute of Communication and Business https://orcid.org/0000-0001-6319-5341
  • Rudi Sukandar Faculty of Communication, LSPR Institute of Communication and Business https://orcid.org/0000-0002-1999-5795
  • Chawla Fatmaduri Faculty of Communication, LSPR Institute of Communication and Business

DOI:

https://doi.org/10.24914/jeb.v29i1.18278

Keywords:

Cognitive Dissonance, consumer behavior, financial literacy, health insurance, post-purchase dissonance

Abstract

The low public participation in health insurance in Indonesia is influenced not only by economic barriers but also by psychological factors. This study aims to examine the role of cognitive dissonance in health insurance purchasing decisions and to analyze how financial literacy reduces psychological tension among consumers. Using a mixed-methods approach with an exploratory sequential design, the qualitative phase was conducted through in-depth interviews, while the quantitative phase involved survey data from 290 respondents analyzed using SmartPLS. The findings indicate that cognitive dissonance positively influences financial literacy, while financial literacy negatively affects behavioral intention and post-purchase dissonance. These results highlight the importance of financial literacy in helping consumers develop more rational perceptions of insurance premiums, benefits, and claims processes, thereby reducing regret and dissatisfaction after purchase. This study concludes that effective communication strategies and financial literacy education can play a crucial role in increasing public participation in Indonesia's health insurance.

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References

Borthwick, M., Tomitsch, M., & Gaughwin, M. (2022). From human-centred to life-centred design: Considering environmental and ethical concerns in the design of interactive products. Journal of Responsible Technology, 10, 1–10. https://doi.org/10.1016/j.jrt.2022.100032

Boyce, T., & Brown, C. (2019). Economic and social impacts and benefits of health systems (1st Ed.). World Health Organization.

Çalişkan, F., Işiksaçan, N., Yilmaz, S., & Uysal Kasap, E. (2025). The health science students emotional-behavioral problems, childhood trauma and screen exposure. Journal of General Health Sciences (JGEHES) Necmettin Erbakan University, 5(3), 310–323. https://doi.org/10.51123/jgehes.2023.95

Castor, D., & Borrell, L. N. (2022). The cognitive dissonance discourse of evolving terminology from colonial medicine to global health and inaction towards equity – A Preventive Medicine Golden Jubilee Article. Preventive Medicine, 163(August), 1–4. https://doi.org/10.1016/j.ypmed.2022.107227

Creswell, J. W., & Clark, V. L. P. (2011). Choosing a mixed methods design. In Designing and Conducting Mixed Methods Research (pp. 53–106). Sage Publications, Inc.

Dash, G., & Paul, J. (2021). CB-SEM vs PLS-SEM methods for research in social sciences and technology forecasting. Technological Forecasting and Social Change, 173. https://doi.org/10.1016/j.techfore.2021.121092

England, A. (2021). Quantitative and qualitative research methods. Research for Medical Imaging and Radiation Sciences, 71–96. https://doi.org/10.1007/978-3-030-79956-4_5

Festinger, L. (1957). A theory of cognitive dissonance. Row, Peterson.

Gao, L., Ying, N., Wang, G., & Li, F. (2022). The impact of public health education on people’s demand for commercial health insurance: Empirical evidence from China. Frontiers in Public Health, 10(03), 1–15. https://doi.org/10.3389/fpubh.2022.1053932

Goertzen, M. J. (2017). Introduction to quantitative Research. Quantitative Research in Communication, 53(4), 1–16. https://doi.org/10.4135/9781452274881.n1

Hair, J. F., Hult, G. T. M., Ringle, C. M., Sarstedt, M., Danks, N. P., & Ray, S. (2021). Partial Least Squares Structural Equation Modeling (PLS-SEM) using R: A workbook (Vol. 30, Issue 1). Springer. https://doi.org/10.1080/10705511.2022.2108813

Harmon-Jones, E., Harmon-Jones, C., & Levy, N. (2015). An action-based model of cognitive-dissonance processes. Journal of Psychological Science, 24(3), 184–189. https://doi.org/https://doi.org/10.1177/0963721414566449

Harmon-Jones, E., & Mills, J. (2019). An introduction to cognitive dissonance theory and an overview of current perspectives on the theory. In Cognitive dissonance: Reexamining a pivotal theory in psychology (2nd ed.) (second edi, pp. 3–24). https://doi.org/10.1037/0000135-001

Indwar, R. G., & Mishra, A. S. (2023). Emojis: can it reduce post-purchase dissonance? Journal of Strategic Marketing, 31(4), 918–939. https://doi.org/10.1080/0965254X.2021.2013935

International Trade Administration. (2022). Healthcare Technologies Resource Guide. Official Website of the United States Government. https://www.trade.gov/healthcare-technologies-resource-guide

Kock, N., & Hadaya, P. (2018). Minimum sample size estimation in PLS-SEM: The inverse square root and gamma-exponential methods. Information Systems Journal, 28(1), 227–261. https://doi.org/10.1111/isj.12131

Kotler, P., & Keller, K. L. (2016). Marketing Management (15th-Glo ed.). Pearson Education, Inc.

Kotler, P., Keller, K. L., & Chernev, A. (2021). Marketing Management (16 ed.). Pearson Education, Inc.

Lawler, M. (2022). Real-Life Examples of Cognitive Dissonance. Https://Www.Everydayhealth.Com/.

Lee, L. M., Heilig, C. M., & White, A. (2012). Ethical justification for conducting public health surveillance without patient consent. American Journal of Public Health, 102(1), 38–44. https://doi.org/https://doi.org/10.2105/ajph.2011.300297

Li, Z., Zhou, Q., & Zhang, R. (2025). The persuasion effects of vaccination message: The interactive effects of language style, source type, and the provision of choice. Science Communication, 48(2). https://doi.org/https://doi.org/10.1177/10755470251314725

Liao, T.-H. (2017). Online shopping post-payment dissonance: Dissonance reduction strategy using online consumer social experiences. International Journal of Information Management, 37(6), 520–538. https://doi.org/https://doi.org/10.1016/j.ijinfomgt.2017.03.006

Littlejohn, S. W., & Foss, K. A. (2016). Encyclopedia of communication theory (1st ed.). SAGE Publications, Inc.

Lusardi, A. (2019). Financial literacy and the need for financial education: evidence and implications. Swiss Journal of Economics and Statistics, 155(1), 1–8. https://doi.org/10.1186/s41937-019-0027-5

Lusardi, A., & Mitchell, O. S. (2014). The economic importance of financial literacy: Theory and evidence. Journal of Economic Literature, 52(1), 5–44. https://doi.org/10.1257/jel.52.1.5

Moreira Costa, V., De Sá Teixeira, N. A., Cordeiro Santos, A., & Santos, E. (2021). When more is less in financial decision-making: Financial literacy magnifies framing effects. Psychological Research, 85(5), 2036–2046. https://doi.org/10.1007/s00426-020-01372-7

Ndasi, W., & Akcay, E. E. (2020). Understanding authenticity in digital cause-related advertising: Does cause involvement moderate intention to purchase? Westminster Papers in Communication and Culture, 15(2), 103–122. https://doi.org/10.16997/WPCC.344

Ngoma, M., & Chowa, T. (2021). Factors leading to low penetration of property and liability insurance products in the Zambian insurance industry. International Journal of Research in Engineering and Management, 5(1), 1–17.

OECD. (2025). Understanding and responding to financial consumer vulnerability (83; OECD Business and Finance Policy Papers, Issue 83). https://doi.org/https://doi.org/10.1787/bf84ff64-en

Otoritas Jasa Keuangan Indonesia. (2023). Press release the launch of Indonesia insurance industry development and strengthening roadmap 2023-2027. Otoritas Jasa Keuangan (OJK). https://ojk.go.id/en/berita-dan-kegiatan/siaran-pers/Pages/The-Launch-Of-Indonesia-Insurance-Industry-Development-And-Strengthening-Roadmap-2023-2027.aspx

Rahman, M., Isa, C. R., Masud, M. M., Sarker, M., & Chowdhury, N. T. (2021). The role of financial behaviour, financial literacy, and financial stress in explaining the financial well-being of B40 group in Malaysia. Future Business Journal, 7(1), 52. https://doi.org/10.1186/s43093-021-00099-0

Saranya, P., & Joji, A. N. (2024). Consumer confusion on cognitive dissonance: A conceptual framework. NMIMS Management Review, 32(1), 14–20. https://doi.org/10.1177/09711023241260519

Sekaran, U., & Bougie, R. (2016). Research methods for business: A skill building approach (7th Editio). John Wiley & Sons.

Siano, A., & Palazzo, M. (2015). Tetra Pak Italy’s ingredient branding: An exploratory case of strategic communication. Journal of Communication Management, 19(1), 102–116. https://doi.org/https://doi.org/10.1108/jcom-02-2012-0017

Subagyo, F. A. K. D., & Irwansyah, I. (2021). Cognitive dissonance in health-seeking behavior of people in Indonesia to prevent Covid-19. Jurnal Sosial Dan Budaya Syar-I, 8(1), 251–266. https://doi.org/10.15408/sjsbs.v8i1.18692

Suprihatin AH, Bakti, D. K., Septiandi, W., & Ardani, K. P. (2024). The effect of e-commerce factors on consumer purchasing behavior. Jurnal Terekam Jejak, 2(2), 1–22. https://doi.org/10.1109/IT61232.2024.10475736

Sweeney, J. C., Hausknecht, D., & Souta, G. N. (2000). Cognitive dissonance after purchase: A multidimensional scale. Psychology & Marketing, 17(5), 369–385. https://doi.org/https://doi.org/10.1002/(SICI)1520-6793

Taddicken, M., & Wolff, L. (2020). ‘Fake News’ in science communication: Emotions and strategies of coping with dissonance online. Media and Communication, 8(1), 206–217. https://doi.org/https://doi.org/10.17645/mac.v8i1.2495

Weder, F., Tungarat, A., & Lemke, S. (2020). Sustainability as cognitive “friction”: A narrative approach to understand the moral dissonance of sustainability and harmonization strategies. Frontiers in Communication, 5(February), 1–12. https://doi.org/10.3389/fcomm.2020.00008

Weingarten, N., Lagerkvist, C. J., Meraner, M., & Hartmann, M. (2023). Triggering cognitive dissonance with textual information and images: Data from three experiments with meat-eaters. Data in Brief, 48, 1–7. https://doi.org/10.1016/j.dib.2023.109116

West, R., & Turner, L. H. (2021). Introduction communication theory: Analysis and application (7th Ed.). McGraw-Hill Education (Asia).

Wolford, L. L., Arratia, V., Behn, N., & Power, E. (2025). The impact of acquired communication impairments on sexuality and intimacy: A scoping review. International Journal of Language & Communication Disorders, 60(2), 1–27. https://doi.org/10.1111/1460-6984.70023

World Bank. (2023). International bank for reconstruction and development program document for a proposed loan. https://documents1.worldbank.org/curated/en/099204003072310404/pdf/BOSIB0416933cf02d0a830073b1d44662b4.pdf

Xiao, Z., & Su, C. C. (2021). Transnational media consumption dissonance and ambivalent sexism: How american and korean television drama consumption shapes chinese audiences’ gender-role values. International Communication Gazette, 83(5), 428–450. https://doi.org/https://doi.org/10.1177/17480485211029020

Yakın, V., Güven, H., David, S., Güven, E., Bărbuță-Mișu, N., Güven, E. T. A., & Virlanuta, F. O. (2023). The effect of cognitive dissonance theory and brand loyalty on consumer complaint behaviors: A cross-cultural study. Sustainability, 15(6), 1–17. https://doi.org/10.3390/su15064718

Zhang, S., & Pan, Y. (2023). Mind over matter: Examining the role of cognitive dissonance and self-efficacy in discontinuous usage intentions on pan-entertainment mobile live broadcast platforms. Behavioral Sciences, 13(3), 1–22. https://doi.org/10.3390/bs13030254

Zhang, Y. F., Askar, M. W., & Quattara, B. (2020). Financial literacy and poverity reduction: The case of Indonesia (1097; ADBI Working Papers).

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Published

2026-07-20

How to Cite

Anggraini, D., Sukandar, R., & Fatmaduri, C. (2026). Cognitive dissonance in health insurance consumers: Analysis through financial literacy. Jurnal Ekonomi Dan Bisnis, 29(1), 135–158. https://doi.org/10.24914/jeb.v29i1.18278

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