Estimating willingness to pay for public health insurance while accounting for protest responses: A further step towards universal health coverage in Tunisia?

Abstract

Introduction: Developing countries face major challenges in implementing universal health coverage (UHC): a widespread informal sector, general discontent with rising economic insecurity and inequality and the rollback of state and public welfare. Under such conditions, estimating the demand for a health insurance scheme (HIS) on voluntary basis can be of interest to accelerate the progress of UHC-oriented reforms. However, a major challenge that needs to be addressed in such context is related to protest attitudes that may reflect, inter alia, a null valuation of the expected utility or unexpressed demand. Methods: We propose to tackle this by applying a contingent valuation survey to a non-healthcare-covered Tunisian sample vis-à-vis joining and paying for a formal HIS. Our design pays particular attention to identifying the nature of the willingness-to-pay (WTP) values obtained, distinguishing genuine null values from protest values. To correct for potential selection issues arising from protest answers, we estimate an ordered-Probit-selection model and compare it with the standard Tobit and Heckman sample selection models.

Morbidity Cost and Willingness to Pay for Healthcare Insurance among Wheat Farmers in Jigawa State of Nigeria

“…Under objective 3.8 of the Sustainable Development Goals (SDGs), governments and the global community are tasked with achieving universal health coverage (UHC) (Nzowa et al, 2023). Governments must shift from an out-of-pocket healthcare financing model predominately used in Africa to a prepayment model to achieve UHC (Abu-Zaineh et al, 2022). Despite global pressure and numerous national and regional efforts, many African nations still have poor levels of health insurance coverage (Bolarinwa et al, 2021).…”