Determinants of Willingness to Pay for Health Insurance in Germany—Results of the Population-Based Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study)

Abstract

Objective: To investigate which factors are associated with the willingness to pay (WTP) for health insurance. Methods: The analysis ( n = 1,248 individuals) is based on data of a large population-based study—the Health Study of the Leipzig Research Centre for Civilization Diseases (LIFE-Adult-Study). With regard to WTP for health insurance, a contingent valuation method with a payment card was used. Several explanatory variables were included. For example, personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience) were assessed using the NEO-16 Adjective Measure. Results: Average WTP for health insurance per month equaled about €240 which corresponds to ~14% of household net equivalent income. Multiple regressions showed that an increased WTP was associated with lower age (β = −1.7, p < 0.001), higher (log) household net equivalent income (β = 153.6, p < 0.001), higher social support (β = 2.0, p < 0.05), and private health insurance (β = 131.1, p < 0.001). Furthermore, an increased WTP for health insurance was associated with higher openness to experience (β = 10.1, p < 0.05), whereas it was not associated with agreeableness, conscientiousness, extraversion, and neuroticism. Conclusion: The quite large amount of average WTP for health insurance may suggest that individuals accept current contributions to health insurances and would probably accept higher contributions. While previous studies mainly focused on individuals in late life, we identified a link between socioeconomic, health-related factors, and personality factors (in terms of openness to experience) and WTP in the general adult population.

Willingness to pay for National Health Insurance Services and Associated Factors in Africa and Asia: a systematic review and meta-analysis

“…This dictates that the slightly higher WTP for NHI in Africa may be due to the continent's youngest population, with 70% of SSA under 30 years old (154). Similarly, original studies in Germany (155), St. Vincent and the Grenadines (108), Malaysia (156), Ghana (157), and Vietnam (158), as well as systematic reviews in LMICs (125,159), showed that the WTP for health insurance and membership was positively associated with younger age groups. However, some other original studies, such as the one conducted in Indonesia among non-salaried participants (160), Ghana (161), and in LMICs (Europe and the Eastern Mediterranean, Latin America and the Caribbean, Southeast Asia and the Western Pacific, and SSA) (162), found that older people were more likely to have health insurance and a lower probability of dropping out compared to younger adults (163).…”

Analysis of The Influence of Personal Factors and The Quality of Health Facilities Services and The Quality of Insurance Services on The Intention to Pay Health Insurance Contributions With Participant Satisfaction as an Intervening Variable

“…In this study, personal factor variables were measured with 5 statements adapted from (Hajek et al, 2020) . For the health facility service quality variable, 7 statements were adapted from (Ratnawati and Kholis, 2020) and (Agyapong et al, 2017) .…”

“…In a study in Ethiopia, people who had Inrernational Journal of Social Service and Research, Sasongko Nugroho IJSSR Page 2194 heard about a health insurance scheme were 2.5 times more willing to pay for it than those who had not heard about it (Nguyen and Hoang, 2017) . In addition, increased intention to pay health insurance contributions is also associated with increased desire based on experience, education level, income, agreeableness, conscientiousness, extraversion, and neuroticism (Nosratnejad et al, 2016;Hajek et al, 2020;Wu et al, 2020;Batbold and Pu, 2021) . An important factor influencing the intention to pay contributions is the level of participant satisfaction, however only 40% of participants are satisfied with social health insurance.…”

“…Many studies have been conducted regarding factors that influence the intention to pay insurance contributions, such as health services, with the object of research being health services in hospitals (Bala et al, 2011;Ahmad et al, 2012;Agyapong et al, 2017;Pathak, 2018;Pinna et al, 2018) . Furthermore, there is also research related to health insurance services (Nosratnejad et al, 2016;Hajek et al, 2020;Wu et al, 2020;Batbold and Pu, 2021) . However, research is still rare that analyzes personal status factors on the intention to pay contributions, more specifically on BPJS health insurance objects in Indonesia.…”

Kegagalan Pembayaran Premi pada Pengguna Asuransi Kesehatan Swasta

“…Selain itu, peningkatan WTP untuk asuransi kesehatan dikaitkan dengan keterbukaan yang lebih tinggi terhadap pengalaman pengguna lainnya (Hajek et al, 2020). Berbeda dengan negara berkembang dimana WTP untuk private health insurance lebih rendah.…”