Older people's views on how to finance increasing health-care costs

Abstract

The aims of this paper are to investigate both older people's views about ways in which to finance health-care costs and their willingness to pay for treatment themselves, along with variations in these views by age and gender. The data are from the Good Ageing in Skåne (GAS) prospective longitudinal cohort study in Sweden, which involved medical examinations and a survey of living arrangements and socio-economic conditions. For the analysis reported in this paper, 930 GAS respondents aged 60-93 years were invited to participate in an additional structured interview, and 902 (97 %) accepted. The sample was divided into the ' young-old ' (aged 60-72 years), ' old-old ' (78-84 years) and ' oldest-old ' (87-93 years). It was found that the participants recommended increasing health-care funding by higher taxes and that they were willing to pay themselves for specific treatments, e.g. cosmetic surgery and medication to combat impotence and obesity. Many were also willing to pay privately for cataract surgery, to shorten the wait, although the respondent's financial circumstances associated with this willingness. Significantly more men than women, and of the ' young-old ' than of the other two age groups, would pay for cataract surgery. The views of people aged 85 or more years differed from those of the young-old, e.g. significantly fewer believed that older people's health care received too little resource. Views about how to finance health care thus differed among the age groups and between men and women.

Older People's Reasoning About Age-Related Prioritization in Health Care

“…Studies have shown that people aged 60 and over are willing to pay for treatment to avoid waiting lists if they are in a financial situation that allows them to do so (6,14). The results of Werntoft et al (6) nevertheless showed that the oldest-old, 85 years and over, were more likely to chose staying on waiting lists than people under 85, although their financial situation was considered equal to that of the others.…”

“…This is in line with the results from earlier studies involving people aged 60 and over, based on a structured questionnaire concerning prioritisation and resource allocation. The participants did not want age to be a criterion in prioritisation, and if they could afford it, they were willing to pay to get treatment at once instead of being on a waiting list (5,6). In order to increase the understanding of their standpoints it seems important to investigate how older people reason about prioritisation in health care.…”

Decision makers’ experiences of prioritisation and views about how to finance healthcare costs

“…In the case of women, there seemed to be an association with their poorer financial situation. The result also showed that 72 % of the participants wanted to increase general taxation and taxes on alcohol and tobacco to finance increasing healthcare costs [7]. However, we still have limited knowledge about decision makers' views on this topic.…”

“…The questions were developed in relation to diseases occurring in old age that fall within the scope of feasible treatments, and diseases related to lifestyle. The questionnaire was tested in a pilot study [10] and was earlier used to explore older people's views concerning prioritisation and resource allocation in healthcare [7]. Some adjustments were made for this study to fit the target group, for instance regarding the question about being on a waiting list or paying to receive immediate surgery.…”

“…The centre also suggests that individuals should take a certain amount of financial responsibility for public healthcare. When older people between the ages of 60 and 93 years were asked about such issues it was found, for example, that they were willing to pay to receive treatment at once and avoid waiting lists, if they could afford it [7].…”