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American Journal of Public Health Research. 2016, 4(3), 98-106
DOI: 10.12691/AJPHR-4-3-4
Original Research

Health Insurance Technology in Ethiopia: Willingness to Pay and Its Implication for Health Care Financing

Birku Reta Entele1 and Nnaemeka Vincent Emodi2,

1Department of Technology Management, Economics and Policy Program, Room 312, Building 37, 1 Gwanak-ro, College of Engineering, Seoul National University, Seoul, 151-744, South Korea

2College of Business, Law and Governance, James Cook University, P. O. Box 6811, Cairns Qld 4870, Australia

Pub. Date: May 03, 2016

Cite this paper

Birku Reta Entele and Nnaemeka Vincent Emodi. Health Insurance Technology in Ethiopia: Willingness to Pay and Its Implication for Health Care Financing. American Journal of Public Health Research. 2016; 4(3):98-106. doi: 10.12691/AJPHR-4-3-4

Abstract

Low-income households in rural areas of Ethiopia are facing catastrophic out-of-pocket health care expenditure due to lack of proper financing mechanism complemented with unexpected health related shock. However, to smooth their health care consumer spending, they need to have a cost-effective health insurance. This study analyzes' Households Willingness to Pay (WTP) for health insurance and the potential market for this cost effective health insurance products. The data used in this study was collected from rural households in East Shewa zone, Adama Woreda, which constitutes about 500 household heads respondents. The Contingent Valuation Method (CVM) with double bounded dichotomous choice (DBDC) elicitation method was used to estimate respondents WTP for proposed health insurance technology. The result of the study shows that households' average WTP (considering their ability to pay) is higher than their cost of public health care and self-treatment per year at a national level on average. Variables such as farm income, frequent visit to the health center, age, education, and insurance cost (premium) are significant determinants of households' willingness to pay. For the hypothetical health insurance scenario, households do have enough willingness to pay to cover cost for public health care consumption expenditure if the payment mode is planned, conducive and once per year. The study implies valuable information for policy makers and concerned stakeholders such as the Ministry of health and different private insurance provider in health care financing.

Keywords

Health insurance, willingness to pay, logit model, Ethiopia

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Mehrotra A, Adams JL, Armstrong K, Eibner C, Hussey PS, Lave J, Liu H, McGlynn EA, Pollack CE, Ridgely MS, Rudavsky R. Health care on aisle 7: The growing phenomenon of retail clinics. Santa Monica, Calif.: RAND Corporation, RB-9491-1. 2010.
 
[2]  (FMH) Ethiopia Federal Ministry of Health. April 2014. Ethiopia’s Fifth National Health Accounts 2010/2011. Addis Ababa, Ethiopia.
 
[3]  Asfaw A, von Braun J. Innovations in health care financing: new evidence on the prospect of community health insurance schemes in the rural areas of Ethiopia. International journal of health care finance and economics. 2005 Sep 1;5(3):241-53.
 
[4]  Asenso-Okyere WK, Osei-Akoto I, Anum A, Appiah EN. 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 Dec 31;42(3):223-37.
 
[5]  Jung J, Liu Streeter J. Does health insurance decrease health expenditure risk in developing countries? The case of China. Southern Economic Journal. 2015 Oct 1;82(2):361-84.
 
[6]  Dalinjong PA, Laar AS. The national health insurance scheme: perceptions and experiences of health care providers and clients in two districts of Ghana. Health economics review. 2012 Jul 23;2(1):1.
 
[7]  Panda P, Chakraborty A, Dror DM. Building awareness to health insurance among the target population of community‐based health insurance schemes in rural India. Tropical Medicine & International Health. 2015 Aug 1;20(8):1093-107.
 
[8]  Mladovsky, Philipa. Social capital and enrolment in community-based health insurance in Senegal. Diss. The London School of Economics and Political Science (LSE), 2014.
 
[9]  Carrin G, Waelkens MP, Criel B. Community‐based health insurance in developing countries: a study of its contribution to the performance of health financing systems. Tropical medicine & international health. 2005 Aug 1;10(8):799-811.
 
[10]  Kruk ME, Goldmann E, Galea S. Borrowing and selling to pay for health care in low-and middle-income countries. Health Affairs. 2009 Jul 1;28(4):1056-66.
 
[11]  Macha J, Harris B, Garshong B, Ataguba JE, Akazili J, Kuwawenaruwa A, Borghi J. Factors influencing the burden of health care financing and the distribution of health care benefits in Ghana, Tanzania and South Africa. Health policy and planning. 2012 Mar 1;27(suppl 1):i46-54.
 
[12]  Newhouse JP, Manning WG, Morris CN, Orr LL, Duan N, Keeler EB, Leibowitz A, Marquis KH, Marquis MS, Phelps CE, Brook RH. Some interim results from a controlled trial of cost sharing in health insurance. New England Journal of Medicine. 1981 Dec 17;305(25):1501-7.
 
[13]  Robyn PJ, Hill A, Liu Y, Souares A, Savadogo G, Sié A, Sauerborn R. Econometric analysis to evaluate the effect of community-based health insurance on reducing informal self-care in Burkina Faso. Health policy and planning. 2012 Mar 1;27(2):156-65.
 
[14]  Liu X, Tang S, Yu B, Phuong NK, Yan F, Thien DD, Tolhurst R. Can rural health insurance improve equity in health care utilization? A comparison between China and Vietnam. Int J Equity Health. 2012 Feb 29;11(10):1-9.
 
[15]  Asgary A, Willis K, Taghvaei AA, Rafeian M. Estimating rural households’ willingness to pay for health insurance. The European Journal of Health Economics, formerly: HEPAC. 2004 Sep 1;5(3):209-15.
 
[16]  Wagstaff A, Nguyen HT, Dao H, Bales S. Encouraging Health Insurance for the Informal Sector: A Cluster Randomized Experiment in Vietnam. Health economics. 2015 Jan 1.
 
[17]  Cohodes SR, Grossman DS, Kleiner SA, Lovenheim MF. The effect of child health insurance access on schooling: Evidence from public insurance expansions. Journal of Human Resources. 2015 Nov 30.
 
[18]  Adams R, Chou YJ, Pu C. Willingness to participate and Pay for a proposed national health insurance in St. Vincent and the grenadines: a cross-sectional contingent valuation approach. BMC health services research. 2015 Apr 9;15(1):1.
 
[19]  Mitchell RC, Carson RT. Using surveys to value public goods: the contingent valuation method. Resources for the Future; 1989.
 
[20]  Cameron TA, Quiggin J. Estimation using contingent valuation data from a “dichotomous choice with follow-up” questionnaire. Journal of environmental economics and management. 1994 Nov 30;27(3):218-34.
 
[21]  Haab TC, McConnell KE. Valuing environmental and natural resources: the econometrics of non-market valuation. Edward Elgar Publishing; 2002.
 
[22]  Hanemann WM, Kanninen B. The statistical analysis of discrete-response CV data. Valuing environmental preferences: theory and practice of the contingent valuation method in the US, EU, and developing countries. 1999;441.
 
[23]  Krinsky and Robb. Mean and median willingness to pay measures, updated version 2002.