The Effects of Healthcare Quality on the Willingness to Pay More Taxes to Improve Public Healthcare: Testing Two Alternative Hypotheses from the Research Literature

Abstract

The research literature discusses two opposite hypotheses regarding the possible effects of healthcare quality on the willingness to pay more taxes to improve public healthcare. One hypothesis theorizes that a lower quality of public healthcare may weaken the willingness to pay more taxes towards improving it. Another hypothesis posits that a low quality of public healthcare may strengthen the willingness to pay more taxes towards improving it. We tested both hypotheses on a diverse sample of 27 post-communist countries within Eurasia and Southern and Eastern Europe over a period of five years. We apply a binary logistic model for each country under investigation. The model is estimated by regressing the willingness to pay more taxes on six dimensions of quality, while controlling for covariates and the dummy for 2016.We found empirical support for both hypotheses, and hence none of the hypotheses gleaned from the literature is a clear “winner.” However, we also found that the situation is less straightforward and more nuanced than is usually acknowledged within the literature. Our findings also suggest the effect is specific with respect to both a quality dimension and a country tested.

The welfare state in really hard times: Political trust and satisfaction with the German healthcare system during the COVID-19 pandemic

“…Lynch and Gollust (2010), using survey data from the US, argue that individual beliefs and perceptions of the fairness of the healthcare system matter more as determinants of policy preferences than indicators of self-interesta finding that is most relevant in the context of this article. In a string of articles that focus on Eastern European countries, Habibov and co-authors have shown that prevailing levels of institutional and social trust as well as individual perceptions of the quality of healthcare are systematically related to willingness to pay more taxes for healthcare provision (Habibov et al, 2017(Habibov et al, , 2018a(Habibov et al, , 2018b(Habibov et al, , 2019.…”

How Different Motivations for Making Informal Out-Of-Pocket Payments Vary in Their Influence on Users’ Satisfaction with Healthcare, Local and National Government, and Satisfaction with Life?

“…Second, the reforms were not able to substitute the considerable deficit of public healthcare financing which happened during the transition [25]. Third, expectations of users about quality of healthcare continued to increase substantially during the transition and making IP was often considered the only way to gain access to higher quality and faster healthcare [10,31]. Finally, many healthcare users felt that the state ceased to be responsible for their health and they must use all available ways to get access to healthcare including making IP [32].…”