Willingness to Pay for National Health Insurance: A Contingent Valuation Study Among Patients Visiting Public Hospitals in Melaka, Malaysia

Robin Tiow Heng Tan (), Siti Zaleha Abdul Rasid, Wan Khairuzzaman Wan Ismail, Janiza Tobechan, Edwin Tiow Yong Tan, Alia Natasha Yusof and Jia Hui Low
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Robin Tiow Heng Tan: Ministry of Health
Siti Zaleha Abdul Rasid: Universiti Teknologi Malaysia
Wan Khairuzzaman Wan Ismail: Sulaiman AlRajhi University
Janiza Tobechan: Melaka General Hospital, Ministry of Health
Edwin Tiow Yong Tan: Bukit Katil Clinic
Alia Natasha Yusof: Alor Gajah Hospital, Ministry of Health
Jia Hui Low: Jasin Hospital, Ministry of Health

Applied Health Economics and Health Policy, 2022, vol. 20, issue 2, No 11, 255-267

Abstract: Abstract Background The Malaysian public healthcare system is tax funded, with healthcare costs highly subsidized by the Government. The current health financing is not sustainable to cover all the healthcare resources. Introducing a national health insurance (NHI), a prepayment method, would protect the population from financial hardship by reducing out-of-pocket payment, minimizing the barrier to accessing health and achieving equitable healthcare. Studies on the willingness to pay (WTP) for NHI are available in different contexts; however, little was found in Malaysia. In addition, factors affecting the WTP for NHI have been less researched in the Malaysian context. Objective This study investigates the WTP for NHI and factors influencing it in Melaka, Malaysia. Method Using the contingent valuation method, the researchers distributed a pre-tested self-administered questionnaire to 489 respondents in three leading public hospitals from 1 to 9 November 2019. Multi-stage sampling forms the selection of respondents. Respondents were presented with a hypothetical scenario on NHI and asked whether they would be willing to pay for NHI. Chi-square was used to examine the association between categorical independent variables and WTP for NHI, and binary logistic regression was applied to determine the variables with the most predictive effect towards WTP for NHI. Results Out of 462 usable responses, 344 respondents (74.5%) were willing to pay for NHI. The majority (51.3%) of the respondents were willing to pay 15 Malaysian Ringgit (3.70 US dollars) or more for the NHI scheme. Chi-square analysis revealed that age, marital status, education level, employment status, chronic diseases, and perception towards NHI were significantly associated with WTP for NHI. Binary regression analysis found that marital status and perception towards NHI have the most predictive effect on respondents’ WTP for NHI. Conclusion This study revealed that the majority of the respondents are willing to pay for NHI if implemented in Malaysia. The findings lay a foundation for implementing a future NHI framework in Malaysia and reference future health financing research.

Date: 2022
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DOI: 10.1007/s40258-021-00691-z

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