Pengaruh Pendapatan, Pengetahuan Dan Kerentanan Penyakit Terhadap Willingness To Pay (WTP) Premi Jaminan Kesehatan Pada Pekerja Sektor Informal

2021 ◽  
Vol 7 (1) ◽  
pp. 48-59
Author(s):  
Anom Dwi Prakoso
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Informal Sector ◽  
Low Income ◽  
Disease Susceptibility ◽  
Universal Coverage ◽  
Health Coverage ◽  
Cross Sectional ◽  
Susceptibility Data ◽  
Central Java

  Background: The Indonesian Government's target of Universal Coverage or 100% Health Insurance participation by 2019 failed to be achieved, even until the end of October 2020. The failure of universal coverage resulted in BPJS Health's finances getting worse after experiencing a deficit. Informal sector workers are the most dominant sector that has not participated in the Health Insurance scheme, totaling 30,487,891 workers. Low income, uncertainty each month, and the increase in contributions resulted in a decrease in Willingness to pay Health Insurance contributions. Research purposes: The purpose of this study is to analyze the effect of income, knowledge, and disease susceptibility to the willingness to pay (WTP) of health insurance contributions to informal sector workers. Method: This cross-sectional research was conducted in Kudus Regency, Central Java in January-February 2020. Sampling used purposive sampling with a total of 200 informal sector workers who had not yet participated in BPJS Kesehatan. The dependent variable is a willingness to pay. The independent variables are income, knowledge, and disease susceptibility. Data collection using a questionnaire and data analysis with logistic regression. Result: Willingness To Pay health insurance contributions for informal sector workers increased in income ≥Rp 2,218,451 (b = 2.02; 95% CI = 1.01-3.55; p = 0.044), high knowledge (b = 4.64; 95% CI = 2.36-8.31; p <0.001), high disease susceptibility (b = 3.01; 95% CI = 0.26-5.75; p = 0.031). Conclusion: Income, knowledge, and disease vulnerability have a significant effect on the willingness to pay for health insurance contributions for informal sector workers.   Keywords: Universal Health Coverage; Willingness To Pay; Health Insurance; informal sector workers.

scholarly journals Awareness and Willingness to Pay for Health Insurance: A Study on Selected Government and Non-Government Employees of Bangladesh

2021 ◽  
Vol 16 (2) ◽  
pp. 9-13
Author(s):  
Mohammad Mohsin ◽  
Md Ziaul Islam ◽  
Mohsen Uddin Ahmed
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Willingness To Pay ◽  
Contingent Valuation Method ◽  
Scientific Data ◽  
Easy Access ◽  
Health Coverage ◽  
Formal Sector ◽  
Government Employees ◽  
Cross Sectional

Introduction: The high cost of health services along with the unpredictability of health needs and the inadequacy of personal savings is the primary reason for the growing importance of insurance as a means of financing health services. Health insurance ensures easy access, high quality, sustainability and affordability of care. This study was undertaken in an attempt to generate some scientific data on awareness and willingness to pay (WTP) for health insurance in our country perspective. Objective: To determine awareness and demand or willingness to pay for health insurance in order to ascertain the feasibility of such schemes and establishing prices. Materials and Methods: This descriptive cross-sectional study was carried out from 1st July 2015 to 30th June 2016 in two governments and two non-government organizations. Randomly 200 government and 200 non-government employees were taken in the sample. A semi structured questionnaire designed to elicit WTP by Contingent Valuation Method (CVM) was used to collect data. Results: Among 400 respondents, 82.8% were male and 17.2% were female. Most of them (85.5%) heard about health insurance earlier and 2.5% subscribed for health insurance. Majority (58.7%) expressed WTP Tk 100-200 (Mean Tk 261.3 ± 196.3) and by percentage of monthly income, average WTP of a formal sector employee was 1.2%. Coverage of health expenditure from employer (10.6%) or insurance (1.1%) side was less and 88.8% of employees had to spend 100% from out of pocket (OOP). Conclusion: Introduction of health insurance, appropriately designed for each population group is imperative for achieving Universal Health Coverage. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 9-13

scholarly journals Influence of mental health perception and willingness-to-pay towards intention-to-support inclusion of mental health coverage in health insurance schemes: a cross sectional study in Malaysia

2021 ◽  
Vol 8 (9) ◽  
pp. 4174
Author(s):  
Maaheend R. Kumaran ◽  
Amuthaganesh Mathialagan ◽  
Kayilvezhi Katheravan ◽  
Kumaraswamy Kadamane ◽  
Priyananthini Rajagopal ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Insurance ◽  
Willingness To Pay ◽  
Mental Health Disorders ◽  
Health Perception ◽  
Health Coverage ◽  
Multiple Choice Questions ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Health Disorders

Background: Across the globe, there have been many mental health disorders and one of the suggested ways of financing mental health disorders is mental health insurance coverage. This study is aimed at determining the influence of mental health perception (MHP) and willingness- to-pay (WTP) towards supporting inclusion of mental health coverage in health insurance schemes in Malaysia.Methods: A validated questionnaire was utilized for this study whereby three variables of the study (MHP, WTP and intention-to-support) were measured. The structured questionnaire contained closed ended questions where present of dichotomous (yes/no), multiple choice questions and 7-point Likert scale questions. 800 questionnaires were distributed to target respondents through online platforms. The inclusion criteria were local citizen of Malaysia, those who gave consent to take part in the study, literate in English, aged 21 years old and above. The data were analysed utilizing statistical package for the social sciences (SPSS) software version 23.0.Results: More than half (87.7%) of the respondents agreed to pay for monthly mental health insurance premiums. Among those who were unwilling to pay (12.4%), were unable to afford the mental health insurance. Similarly, majority of respondents had favourable perception of mental health disorders. Correlation and regression analysis revealed that both WTP and influence of MHP were significant predictors of intention to support.Conclusions: WTP and influence of MHP are important predictors that should be highlighted in creating equitable mental health care for all.

scholarly journals Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

2021 ◽  
Vol 6 (2) ◽  
pp. e004117
Author(s):  
Aniqa Islam Marshall ◽  
Kanang Kantamaturapoj ◽  
Kamonwan Kiewnin ◽  
Somtanuek Chotchoungchatchai ◽  
Walaiporn Patcharanarumol ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Civil Servant ◽  
Social Health ◽  
Health Coverage ◽  
Medical Benefit ◽  
The Social ◽  
Universal Health ◽  
Universal Coverage Scheme

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

scholarly journals Willingness to pay for health insurance in the informal sector of Sierra Leone

PLoS ONE ◽  
2018 ◽  
Vol 13 (5) ◽  
pp. e0189915 ◽  
Author(s):  
Mireia Jofre-Bonet ◽  
Joseph Kamara
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Sierra Leone ◽  
Informal Sector

scholarly journals Willingness and ability to pay for healthcare insurance: A cross-sectional study of Seven Communities in East and West Africa (SevenCEWA)

2021 ◽  
Vol 1 (11) ◽  
pp. e0000057
Author(s):  
Oladimeji Akeem Bolarinwa ◽  
Soter Ameh ◽  
Caleb Ochimana ◽  
Abayomi Olabayo Oluwasanu ◽  
Okello Samson ◽  
...  
Keyword(s):  
Health Insurance ◽  
Secondary Education ◽  
West Africa ◽  
Willingness To Pay ◽  
Healthcare Expenditure ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional ◽  
Ability To Pay ◽  
East And West

Willingness and ability to pay for insurance that would cover primary healthcare services has not been evaluated consistently in different African communities. We conducted a cross-sectional community health survey and examined willingness and ability to pay in 3676 adults in seven communities in four countries: Nigeria, Tanzania, Uganda and Kenya. We used an open-ended contingency valuation method to estimate willingness to pay and examined ability to pay indirectly by calculating the ratio of healthcare expenditure to total household income. Slightly more than three quarters (78.8%) of participants were willing to pay for a health insurance scheme, and just a little above half (54.7%) were willing to pay for all household members. Across sites, median amount willing to pay was $2 per person per month. A little above half (57.6%) of households in Nigeria were able to pay the premium. The main predictors of likelihood of being unwilling to pay for the health insurance scheme were increasing age [aOR 0.99 (95% CI 0.98, 1.00)], being female [0.68 (0.51, 0.92], single [0.32 (0.21, 0.49)], unemployment [0.54 (0.34, 0.85)], being enrolled in another health insurance scheme [0.45 (0.28, 0.74)] and spending more on healthcare [1.00 (0.99, 1.00)]. But being widow [2.31 (1.30, 4.10)] and those with primary and secondary education [2.23 (1.54, 3.22)] had increased likelihood of being willing to pay for health insurance scheme. Retired respondents [adjusted mean difference $-3.79 (-7.56, -0.02)], those with primary or secondary education [$-3.05 (-5.42, -0.68)] and those with high healthcare expenditure [$0.02 (0.00, 0.04)] predicted amount willing to pay for health insurance scheme. The willingness to pay for health insurance scheme is high among the seven communities studied in East and West Africa with socio-demography, economic and healthcare cost as main predictive factors.

scholarly journals Narrowing the Gap of Inequity in the Indonesia’s National Social Health Insurance Scheme, 2014-2018

2021 ◽  
Author(s):  
Hasbullah Thabrany ◽  
Ryan R. Nugraha ◽  
Ery Setiawan ◽  
Farah Purwaningrum
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
Universal Health Coverage ◽  
Low Income ◽  
National Health Insurance Scheme ◽  
Income Group ◽  
Health Insurance Scheme ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Universal Health

Abstract Background. Indonesia is nearing its 7-year implementation of its national health insurance scheme, or the Jaminan Kesehatan Nasional (JKN), as a facilitator for achieving universal health coverage (UHC). Despite its long-running system, it is contentious as to whether JKN has been narrowing the gap of inequity in its delivery. This paper aims to explore on whether the national health insurance scheme in Indonesia have been promoting equity of access towards health services.Methods. This study analyzes findings from JKN statistic data of 2014-2018 published by Government of Indonesia. Using a retrospective design, this study identified membership and utilization of health services within JKN, based on different membership enrollment groups as proxy for income.Results. JKN has been expanding its enrollment significantly within 5 years, during year 2014 to 2018. Moreover, the study concludes that there was increased access for outpatient in all membership groups. Inpatient care was increased in low-income group, but not in high-income group. Result also showed inpatient access was correlated with adequate supply side intervention, particularly hospital beds.Conclusion. JKN has been successful in narrowing the inequity gap, particularly by serving the low-income group better in terms of access. Going forward, equity needs to be incorporated into JKN achievement indicator, particularly to accelerate Indonesia’s effort to realize universal health coverage.

Health

Getting By ◽  
2019 ◽  
pp. 329-428
Author(s):  
Helen Hershkoff ◽  
Stephen Loffredo
Keyword(s):  
United States ◽  
Health Care ◽  
Health Insurance ◽  
Low Income ◽  
The United States ◽  
Health Coverage ◽  
Eligibility Criteria ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Child Health Insurance

This chapter addresses the issue of health care for low-income people. The United States, virtually alone among developed nations, does not offer universal access to health care, leaving many millions of individuals without health insurance or other means of obtaining necessary medical services. In 2010, Congress enacted the landmark Patient Protection and Affordable Care Act (ACA)—popularly known as “Obamacare”—marking an important but incomplete response to the nation’s health care crisis. This chapter examines the ACA in detail, including its impact on Medicaid and Medicare, the major government health programs in the United States, its creation of Health Insurance Exchanges and tax credits to help low-income households obtain private health coverage, and the reform of private health insurance markets through a patient’s bill of rights, which, among other measures, prohibits insurance companies from refusing coverage for preexisting medical conditions. Perhaps the most critical aspect of the ACA was its expansion of Medicaid to cover virtually all low-income citizens (and certain immigrants) who do not qualify for other health coverage. Although several states opted out of the ACA’s Medicaid expansion, the Medicaid program nevertheless remains the largest single provider of health coverage in the United States. This chapter also provides a detailed description of Medicaid, its eligibility criteria and scope of coverage; the Child Health Insurance Program (CHIP), a government-funded health insurance program for children in households with too much income to qualify for Medicaid; and Medicare, the federal health insurance program for aged, blind, and disabled individuals.

scholarly journals Public health insurance and birth outcomes: evidence from Punjab, Pakistan

2020 ◽  
Author(s):  
Najam uz Zehra Gardezi
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Low Income ◽  
Fixed Effects ◽  
Insurance Coverage ◽  
Birth Certificate ◽  
Household Survey ◽  
Public Health Insurance ◽  
Health Seeking ◽  
Cross Sectional

Abstract Public health insurance targeted towards low-income households has gained traction in many developing countries. However, there is limited evidence as to the effectiveness of these programs in countries where institutional constraints may limit participation by the eligible population. This paper evaluates a recent health insurance initiative introduced in Pakistan and discusses whether eligibility for the programme improves maternal health seeking behaviour. The Prime Minister National Health Program provides free insurance coverage to low-income families. The programme is in the early phases of implementation and has, since 2016, only been rolled out in a few eligible districts within the country. This allows for a comparison of eligible households in districts where the programme has been introduced to those that are eligible to receive insurance at a future date. Using repeated cross-sectional data from multiple rounds of representative household survey, a difference-in-difference model has been estimated. Results show that at least for a specific beneficiary group (i.e. pregnant women), there has been a positive increase in utilization of hospital services. Furthermore, we provide evidence using mother fixed effects that the programme increased the likelihood of a child’s birth being documented. Since possession of a birth certificate can secure civic rights for a child, this is an unintended but positive outcome of the programme.

How Single-payer Stacks Up: Evaluating Different Models of Universal Health Coverage on Cost, Access, and Quality

2018 ◽  
Vol 48 (3) ◽  
pp. 568-585 ◽  
Author(s):  
Ashley Fox ◽  
Roland Poirier
Keyword(s):  
United States ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Universal Coverage ◽  
The United States ◽  
Health Coverage ◽  
Single Payer ◽  
Access And Quality ◽  
Universal Health

Described as “universal prepayment,” the national health insurance (or single-payer) model of universal health coverage is increasingly promoted by international actors as a means of raising revenue for health care and improving social risk protection in low- and middle-income countries. Likewise, in the United States, the recent failed efforts to repeal and replace the Affordable Care Act have renewed debate about where to go next with health reform and arguably opened the door for a single-payer, Medicare-for-All plan, an alternative once considered politically infeasible. Policy debates about single-payer or national health insurance in the United States and abroad have relied heavily on Canada’s system as an ideal-typical single-payer system but have not systematically examined health system performance indicators across different universal coverage models. Using available cross-national data, we categorize countries with universal coverage into those best exemplifying national health insurance (single-payer), national health service, and social health insurance models and compare them to the United States in terms of cost, access, and quality. Through this comparison, we find that many critiques of single-payer are based on misconceptions or are factually incorrect, but also that single-payer is not the only option for achieving universal coverage in the United States and internationally.

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