Willingness to pay for health insurance among the elderly population in Germany

TY - JOUR

T1 - Willingness to pay for health insurance among the elderly population in Germany

AU - Bock, Jens-Oliver

AU - Heider, Dirk

AU - Matschinger, Herbert

AU - Brenner, Hermann

AU - Saum, Kai-Uwe

AU - Haefeli, Walter E

AU - König, Hans-Helmut

N1 - guw: epub ahead, Jahr umgestellt.

PY - 2016

Y1 - 2016

N2 - INTRODUCTION: All elderly Germans are legally obliged to have health insurance. About 90 % of this population are members of social health insurances (SHI) whose premiums are generally income-related and independent of health status. For most of these members, holding social health insurance is mandatory. As a consequence, genuine information about preferences for health insurance is not available. The aim of this study was therefore to determine and analyze the willingness to pay (WTP) for health insurance among elderly Germans.METHODS: Data from a population-based 8-year follow-up of a large cohort study conducted in the Saarland, Germany was used. Participants aged 57-84 years passed a geriatric assessment and responded to a health economic questionnaire. Individuals' WTP was elicited based on a contingent valuation method with a payment card.RESULTS: Mean monthly WTP per capita for health insurance amounted to 260. This corresponded to about 20 % of individual disposable income. Regression analyses showed that WTP increased significantly with higher income, male gender, higher educational level, and privately insured status. In contrast, neither increasing morbidity level nor higher individual health care costs influenced WTP significantly.DISCUSSION: The relatively large extent of average WTP for health insurance indicates that the elderly would probably accept higher contributions to SHI rather than policy efforts to reduce contributions. The identified determinants of WTP might indicate that elderly generally approve the principle of solidarity of the SHI with contributions depending on income rather than morbidity.

AB - INTRODUCTION: All elderly Germans are legally obliged to have health insurance. About 90 % of this population are members of social health insurances (SHI) whose premiums are generally income-related and independent of health status. For most of these members, holding social health insurance is mandatory. As a consequence, genuine information about preferences for health insurance is not available. The aim of this study was therefore to determine and analyze the willingness to pay (WTP) for health insurance among elderly Germans.METHODS: Data from a population-based 8-year follow-up of a large cohort study conducted in the Saarland, Germany was used. Participants aged 57-84 years passed a geriatric assessment and responded to a health economic questionnaire. Individuals' WTP was elicited based on a contingent valuation method with a payment card.RESULTS: Mean monthly WTP per capita for health insurance amounted to 260. This corresponded to about 20 % of individual disposable income. Regression analyses showed that WTP increased significantly with higher income, male gender, higher educational level, and privately insured status. In contrast, neither increasing morbidity level nor higher individual health care costs influenced WTP significantly.DISCUSSION: The relatively large extent of average WTP for health insurance indicates that the elderly would probably accept higher contributions to SHI rather than policy efforts to reduce contributions. The identified determinants of WTP might indicate that elderly generally approve the principle of solidarity of the SHI with contributions depending on income rather than morbidity.

U2 - 10.1007/s10198-014-0663-8

DO - 10.1007/s10198-014-0663-8

M3 - SCORING: Journal article

C2 - 25526928

VL - 17

SP - 149

EP - 158

JO - EUR J HEALTH ECON

JF - EUR J HEALTH ECON

SN - 1618-7598

IS - 2

ER -