The Willingness to Pay for Basic Health Insurance in the Netherlands: Quantitative and Qualitative Insights

Background Rising healthcare costs could undermine people's willingness to contribute to the healthcare system. Therefore, we investigated people's willingness to pay (WTP) for basic health insurance. We also studied reasons for the willingness or unwillingness to pay. Methods A mixed methods study was performed. An online survey was sent out to 1500 members of the Dutch Health Care Consumer Panel in May 2023 (51% response rate, N = 760). WTP was assessed using the contingent valuation methodology. Reasons for the willingness or unwillingness to pay were obtained via 15 semi‐structured interviews. Thematic analysis was used to analyse the interviews. Results People were, on average, willing to pay €160 per month for basic health insurance (€153–167 95% CI). Of the respondents, 58% (N = 443) was willing to pay more than the lowest monthly premium of €140 in 2023. WTP was positively correlated to income, age, and education. The interviews indicated that the ability to pay, healthcare consumption, care included in the basic health insurance package, organisation of the health insurance system, coverage of risk, and accessibility of care play a role in people's willingness or unwillingness to pay. Conclusions Most people in the Netherlands were willing to pay more for basic health insurance than the current lowest premium. People valued that health insurance allowed them and others to access healthcare services. As the premium is expected to increase in the coming years, support for the healthcare system may erode, as interviews indicated that the ability to pay is an important condition of the WTP.