IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v17y2016i2d10.1007_s10198-014-0663-8.html
   My bibliography  Save this article

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

Author

Listed:
  • Jens-Oliver Bock

    () (University Medical Center Hamburg-Eppendorf)

  • Dirk Heider

    (University Medical Center Hamburg-Eppendorf)

  • Herbert Matschinger

    (University Medical Center Hamburg-Eppendorf
    University of Leipzig)

  • Hermann Brenner

    (German Cancer Research Center
    University of Heidelberg)

  • Kai-Uwe Saum

    (German Cancer Research Center)

  • Walter E. Haefeli

    (University of Heidelberg)

  • Hans-Helmut König

    (University Medical Center Hamburg-Eppendorf)

Abstract

Abstract 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.

Suggested Citation

  • Jens-Oliver Bock & Dirk Heider & Herbert Matschinger & Hermann Brenner & Kai-Uwe Saum & Walter E. Haefeli & Hans-Helmut König, 2016. "Willingness to pay for health insurance among the elderly population in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(2), pages 149-158, March.
  • Handle: RePEc:spr:eujhec:v:17:y:2016:i:2:d:10.1007_s10198-014-0663-8
    DOI: 10.1007/s10198-014-0663-8
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-014-0663-8
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Dong, Hengjin & Kouyate, Bocar & Cairns, John & Sauerborn, Rainer, 2005. "Inequality in willingness-to-pay for community-based health insurance," Health Policy, Elsevier, vol. 72(2), pages 149-156, May.
    2. Dong, Hengjin & Kouyate, Bocar & Snow, Rachel & Mugisha, Frederick & Sauerborn, Rainer, 2003. "Gender's effect on willingness-to-pay for community-based insurance in Burkina Faso," Health Policy, Elsevier, vol. 64(2), pages 153-162, May.
    3. Dror, David Mark & Radermacher, Ralf & Koren, Ruth, 2007. "Willingness to pay for health insurance among rural and poor persons: Field evidence from seven micro health insurance units in India," Health Policy, Elsevier, vol. 82(1), pages 12-27, June.
    4. Ali Asgary & Ken Willis & Ali Taghvaei & Mojtaba Rafeian, 2004. "Estimating rural households’ willingness to pay for health insurance," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(3), pages 209-215, September.
    5. Richard D. Smith, 2003. "Construction of the contingent valuation market in health care:a critical assessment," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 609-628.
    6. Cameron, Trudy Ann, 1992. "The impact of grouping coarseness in alternative grouped-data regression models," Journal of Econometrics, Elsevier, vol. 52(3), pages 419-421, June.
    7. Hengjin Dong & Bocar Kouyate & John Cairns & Frederick Mugisha & Rainer Sauerborn, 2003. "Willingness-to-pay for community-based insurance in Burkina Faso," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 849-862.
    8. Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June.
    9. Breyer, Friedrich & Felder, Stefan, 2006. "Life expectancy and health care expenditures: A new calculation for Germany using the costs of dying," Health Policy, Elsevier, vol. 75(2), pages 178-186, January.
    10. Klose, Thomas, 1999. "The contingent valuation method in health care," Health Policy, Elsevier, vol. 47(2), pages 97-123, May.
    11. Gustafsson-Wright, Emily & Asfaw, Abay & van der Gaag, Jacques, 2009. "Willingness to pay for health insurance: An analysis of the potential market for new low-cost health insurance products in Namibia," Social Science & Medicine, Elsevier, vol. 69(9), pages 1351-1359, November.
    12. Shafie, A.A. & Hassali, M.A., 2013. "Willingness to pay for voluntary community-based health insurance: Findings from an exploratory study in the state of Penang, Malaysia," Social Science & Medicine, Elsevier, vol. 96(C), pages 272-276.
    13. Xiao-Hua Ying & Teh-Wei Hu & Jane Ren & Wen Chen & Ke Xu & Jin-Hui Huang, 2007. "Demand for private health insurance in Chinese urban areas," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1041-1050.
    14. Asenso-Okyere, W. Kwadwo & Osei-Akoto, Isaac & Anum, Adote & Appiah, Ernest N., 1997. "Willingness to pay for health insurance in a developing economy. A pilot study of the informal sector of Ghana using contingent valuation," Health Policy, Elsevier, vol. 42(3), pages 223-237, December.
    15. Jan Abel Olsen & Richard D. Smith, 2001. "Theory versus practice: a review of 'willingness-to-pay' in health and health care," Health Economics, John Wiley & Sons, Ltd., vol. 10(1), pages 39-52.
    Full references (including those not matched with items on IDEAS)

    More about this item

    Keywords

    WTP; Contingent valuation method; Elderly; Health insurance;

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:eujhec:v:17:y:2016:i:2:d:10.1007_s10198-014-0663-8. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Sonal Shukla) or (Rebekah McClure). General contact details of provider: http://www.springer.com .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.