scholarly journals Why did informal sector workers stop paying for health insurance in Indonesia? Exploring enrollees’ ability and willingness to pay

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252708
Author(s):  
Muttaqien Muttaqien ◽  
Hermawati Setiyaningsih ◽  
Vini Aristianti ◽  
Harry Laurence Selby Coleman ◽  
Muhammad Syamsu Hidayat ◽  
...  
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Informal Sector ◽  
Qualitative Interviews ◽  
Social Health Insurance ◽  
Informal Worker ◽  
Informal Workers ◽  
Large Groups ◽  
Ability And Willingness ◽  
Do So

Indonesia faces a growing informal sector in the wake of implementing a national social health insurance system—Jaminan Kesehatan Nasional (JKN)—that supersedes the vertical programmes historically tied to informal employment. Sustainably financing coverage for informal workers requires incentivising enrolment for those never insured and recovering enrolment among those who once paid but no longer do so. This study aims to assess the ability- and willingness-to-pay of informal sector workers who have stopped paying the JKN premium for at least six months, across districts of different fiscal capacity, and explore which factors shaped their willingness and ability to pay using qualitative interviews. Surveys were conducted for 1,709 respondents in 2016, and found that informal workers’ average ability and willingness to pay fell below the national health insurance scheme’s premium amount, even as many currently spend more than this on healthcare costs. There were large groups for whom the costs of the premium were prohibitive (38%) or, alternatively, they were both technically willing and able to pay (25%). As all individuals in the sample had once paid for insurance, their main reasons for lapsing were based on the uncertain income of informal workers and their changing needs. The study recommends a combination of strategies of targeting of subsidies, progressive premium setting, facilitating payment collection, incentivising insurance package upgrades and socialising the benefits of health insurance in informal worker communities.

Family-Based Social Health Insurance for Informal Workers in Vietnam: Willingness to Pay and Its Determinants

2018 ◽  
Vol 30 (6) ◽  
pp. 512-520 ◽  
Author(s):  
Nguyen Thi Thuy Nga ◽  
Gerard FitzGerald ◽  
Michael P. Dunne
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Effective Means ◽  
Household Head ◽  
Social Health Insurance ◽  
Social Health ◽  
Quality Improvements ◽  
Informal Workers ◽  
Determining Factors ◽  
Family Based

The study aimed to assess willingness to pay for family-based social health insurance and its determining factors among informal workers in Vietnam. A double-bounded dichotomous choice approach was used to elicit the willingness to pay of 391 heads of uninsured households. The study indicates that 48.8% of 391 uninsured households were willing to pay for family-based health insurance. The households were willing to pay about 921.9 thousand Vietnamese dongs per household per year (US$42). The factors that significantly affected willingness to pay were household income, number of uninsured members in a household, and sickness of the household head. The study suggests that a feasible premium for family-based health insurance supported by government subsidy, along with attention to the quality improvements of health services, could be an effective means to increase coverage among the informal sector workers.

scholarly journals DAMPAK KEPESERTAAN BPJS BAGI PEKERJA INFORMAL DI BOGOR

2017 ◽  
Vol 3 (1) ◽  
pp. 1-15
Author(s):  
Fredi Andria ◽  
Nandang Kusnadi
Keyword(s):  
Health Insurance ◽  
Informal Sector ◽  
Small Firms ◽  
Social Health Insurance ◽  
Economic Sectors ◽  
Informal Workers ◽  
The Impact ◽  
Group Health Insurance ◽  
Personal Insurance

ABSTRACTHealth insurance available in Indonesia is still very limited in scope, given to a small proportion of the Population of Beneficiaries (PBI) and formal workers. This is also the case in the Bogor region, whereas the informal sector population in Bogor dominates more than 70%. The participation of the informal sector population in Bogor City is still low, reaching only 30% of the total population. Informal sector workers working in small firms, entrepreneurs in the informal and underemployed or elderly economic sectors, will rely on personal insurance or assistance from close and distant relatives and local communities, resulting in a very limited sustainability of group health insurance. In order to increase membership and coverage of health insurance can be expanded, the groups of informal sector workers in the area of Bogor must be recognizable and at the same time can be distinguished by their characteristics. It is necessary to define various segments of informal sector workers. More specifically, it is necessary to establish the mechanisms of the population engaged in the informal sector to be optimized for their participation in the health insurance program coordinated by the BPJS. Therefore it is necessary to analyze the needs of social health insurance system based on identification of informal workers (case study in Bogor city), so that the impact of health insurance (BPJS) partnership can be constructed for informal sector people.Keywords: BPJS, Health Insurance, Informal Sector, Partnership

scholarly journals Factors that affect social health insurance enrollment and retention of the informal sector in the Philippines: a qualitative study

2020 ◽  
Author(s):  
Reneepearl Kim Sales ◽  
Gladys Kaye Reyes ◽  
Timothy Ting ◽  
Dante Salvador
Keyword(s):  
Health Insurance ◽  
Informal Sector ◽  
Social Protection ◽  
Group Discussion ◽  
Social Health Insurance ◽  
The Philippines ◽  
Social Health ◽  
Factors Affecting ◽  
Informal Workers ◽  
Insurance Enrollment

Abstract Background. The primary goal of providing social protection to informal sector workers is to guarantee a minimum level of income and dignity that allows for better protection against income shocks and other vulnerabilities. With the passage of the Universal Health Care Act in the Philippines, the determination of factors affecting enrollment and retention into social health insurance among informal sector workers in the Philippines is crucial to design appropriate policies and programs fit to their needs. Methods. This study aimed to identify factors that affect social health insurance enrollment and retention of the informal sector in the Philippines through qualitative research methods of face-to-face, semi-structured focus group discussion and key informant interviews. Results. The analysis identified five broad themes that affect informal sector enrollment and retention in social health insurance: 1) overlaps in categorization, 2) insufficient or inappropriate social health insurance initiatives for the informal sector, 3) awareness and understanding of social health insurance, 4) supply side factors, and 5) convenience and amount of premium payment. Conclusion. Informal workers are individuals who are not covered by protective labor laws and tend to not belong or contribute to a national health insurance scheme. In the case of the Philippines, the diversity of informal work and dynamic nature of the sector works against an ideal one-size-fits-all solution to increasing informal sector enrollment and retention to social health insurance.

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

Willingness to pay for health insurance in a developing economy. A pilot study of the informal sector of Ghana using contingent valuation

Health Policy ◽  
1997 ◽  
Vol 42 (3) ◽  
pp. 223-237 ◽  
Author(s):  
W.Kwadwo Asenso-Okyere ◽  
Isaac Osei-Akoto ◽  
Adote Anum ◽  
Ernest N Appiah
Keyword(s):  
Health Insurance ◽  
Pilot Study ◽  
Willingness To Pay ◽  
Contingent Valuation ◽  
Informal Sector ◽  
Developing Economy

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.

Factors associated with willingness to pay for health insurance and pension scheme among informal economy workers in low- and middle-income countries: a systematic review

2020 ◽  
Vol 48 (1) ◽  
pp. 17-37
Author(s):  
Jairous Joseph Miti ◽  
Mikko Perkio ◽  
Anna Metteri ◽  
Salla Atkins
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Social Security ◽  
Willingness To Pay ◽  
Informal Economy ◽  
Middle Income ◽  
Content Type ◽  
Informal Workers ◽  
Middle Income Countries ◽  
Pension Schemes

PurposeThe purpose of this paper is to establish the main factors influencing willingness to pay for health insurance and pension schemes among informal workers in low- and middle-income countries (LMICs). Historically, informal economy workers have been excluded from social protection coverage. There is a growing need, interest and policy discourse in LMICs to extend social security to informal economy workers. However, little is known about informal workers' willingness to pay (WTP) for social security services in different LMIC settings.Design/methodology/approachThe authors conducted a systematic review and searched five databases from 1987 to 2017. Included papers focused on “social security”, “social insurance”, “pension”, “informal economy”, “informal sector” and “informal workers” in LMICs. Authors conducted independent data appraisal and data extraction. A total of 1790 papers were identified. After exclusion, 34 papers were included in the analysis. Given the heterogeneous results, the authors performed a narrative synthesis to consolidate the findings of the different studies.FindingsIn total, 34 studies from 17 countries were included in the review, out of which 23 studies focused on health insurance, 7 studies on pension schemes and 4 studies on social security in general. The study showed that income and trust were associated with WTP for both health insurance and pension schemes. In addition, family size, age, education and residential area were common factors for both forms of social security. For health insurance, experience of sickness, attitude and presence of medical doctors as well as distance from the healthcare facility all played a role in determining WTP. For pension schemes, low and flexible contribution rates, benefit package, government subsidies and quality of administration of the schemes influenced enrolment and contributions.Research limitations/implicationsMore evidence is needed for WTP for pensions among informal workers.Practical implicationsThe findings show that socio-economic differences, scheme-type (health or pension) and level of trust influence WTP for health insurance or pension among informal sector workers. The review results suggest that the factors influencing WTP for health insurance and pensions interplay in a complex web of relations. More evidence is needed on WTP for pensions among informal workers.Social implicationsFurther studies are particularly needed on the interrelationship of the influences to WTP, including gender issues, access barriers and socioeconomic factors, among program design issues for social security.Originality/valueThis paper is based on a systematic review methodology and contributes to the discourse on extending social security to informal economy workers based on evidence from various countries.

scholarly journals Willingness to Join and Pay for Social Health Insurance Scheme Among employees in Debere Berhan Town, Ethiopia

2019 ◽  
Author(s):  
Wassie Negash Mekonnen ◽  
Mesfin Wondaferew ◽  
Adugnaw Birhane Mekonen
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Contingent Valuation Method ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Social Health ◽  
P Value ◽  
Multivariable Logistic Regression Analysis ◽  
Insurance Scheme ◽  
The Government

Abstract Back ground: Social Health Insurance improves access to health services among civil servants by removing catastrophic health expenditure. In Ethiopia, only 7.3% of the population covered by health insurance. Due to this fact the government of Ethiopia initiated Social Health Insurance scheme to be applied in the formal employers and employees with compulsory membership of the scheme. This study therefore aimed to assess willingness to join and pay for social health insurance scheme among government and private employees in Debere Berhan Town, Ethiopia .Methods: Cross-sectional study was conducted .At mean time Stratified sampling technique was used to select 619 employees. A modified dichotomous contingent valuation method (CVM) was applied to elicit employees’ willingness to pay. Bi-variant and multivariable logistic regression analysis was done . Then the result at 95% CI and P value <0.05 was declared as variables have statistically significant association. Results: A total of 619 employees with response rate of 97.8% were participated in the study. About 406 (65%) of the respondents were willing to join to Social Health Insurance scheme. Of which 113 (27.8%) of employees were willing to pay the government proposed 3% premium. The employee’s average willingness to pay for social health insurance scheme was 1.88% of their monthly salary. In this study the odds of respondents who had degree and above (AOR=3.608, 95%CI 1.177-11.061), employees good perception on quality health service (AOR=3.150, 95% CI 1.140-8.699) and employees who perceive benefit packages of social health insurance as enough (AOR=5.229, 95%CI: 2.230-12 .594) were higher than the counter parts. Conclusion: Employees willingness to join of the Social Health Insurance scheme(SHIS) is low and very low number of employees agree to pay the government proposed premium for SHIS. So decision-makers should emphasize to revise the benefit packages and the premiums to be contributed. likewise insurance agency and all responsible bodies should aware the society about the importance of social health insurance for the employees.

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