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Investigating the Willingness to Pay for a Contributory National Health Insurance Scheme in Saudi Arabia: A Cross-sectional Stated Preference Approach

Author

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  • Mohammed Khaled Al-Hanawi

    (King Abdulaziz University
    Aston University)

  • Kirit Vaidya

    (Aston University)

  • Omar Alsharqi

    (King Abdulaziz University)

  • Obinna Onwujekwe

    (University of Nigeria Enugu-Campus)

Abstract

Background The Saudi Healthcare System is universal, financed entirely from government revenue principally derived from oil, and is ‘free at the point of delivery’ (non-contributory). However, this system is unlikely to be sustainable in the medium to long term. This study investigates the feasibility and acceptability of healthcare financing reform by examining households’ willingness to pay (WTP) for a contributory national health insurance scheme. Methods Using the contingent valuation method, a pre-tested interviewer-administered questionnaire was used to collect data from 1187 heads of household in Jeddah province over a 5-month period. Multi-stage sampling was employed to select the study sample. Using a double-bounded dichotomous choice with the follow-up elicitation method, respondents were asked to state their WTP for a hypothetical contributory national health insurance scheme. Tobit regression analysis was used to examine the factors associated with WTP and assess the construct validity of elicited WTP. Results Over two-thirds (69.6%) indicated that they were willing to participate in and pay for a contributory national health insurance scheme. The mean WTP was 50 Saudi Riyal (US$13.33) per household member per month. Tobit regression analysis showed that household size, satisfaction with the quality of public healthcare services, perceptions about financing healthcare, education and income were the main determinants of WTP. Conclusions This study demonstrates a theoretically valid WTP for a contributory national health insurance scheme by Saudi people. The research shows that willingness to participate in and pay for a contributory national health insurance scheme depends on participant characteristics. Identifying and understanding the main influencing factors associated with WTP are important to help facilitate establishing and implementing the national health insurance scheme. The results could assist policy-makers to develop and set insurance premiums, thus providing an additional source of healthcare financing.

Suggested Citation

  • Mohammed Khaled Al-Hanawi & Kirit Vaidya & Omar Alsharqi & Obinna Onwujekwe, 2018. "Investigating the Willingness to Pay for a Contributory National Health Insurance Scheme in Saudi Arabia: A Cross-sectional Stated Preference Approach," Applied Health Economics and Health Policy, Springer, vol. 16(2), pages 259-271, April.
    • Handle: RePEc:spr:aphecp:v:16:y:2018:i:2:d:10.1007_s40258-017-0366-2
    DOI: 10.1007/s40258-017-0366-2
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    References listed on IDEAS

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    1. Donfouet, Hermann Pythagore Pierre & Mohamed, Shukri F. & Otieno, Peter & Wambiya, Elvis & Mutua, Martin Kavao & Danaei, Goodarz, 2020. "Economic valuation of setting up a social health enterprise in urban poor-resource setting in Kenya," Social Science & Medicine, Elsevier, vol. 266(C).
    2. Agbaya Stéphane Serge Oga & Akissi Régine Attia-konan & Fulgence Vehi & Jérôme Kouame & Kouamé Koffi, 2019. "Diabetic and cardiovascular patients’ willingness to pay for upcoming national health insurance scheme in Côte d’Ivoire," Health Economics Review, Springer, vol. 9(1), pages 1-8, December.
    3. Halah Saleh Hawsawi & Mustapha Immurana & Mohammed Khaled Al-Hanawi, 2022. "Socioeconomic Determinants of Willingness to Pay for Emergency Public Dental Services in Saudi Arabia: A Contingent Valuation Approach," IJERPH, MDPI, vol. 19(22), pages 1-12, November.
    4. Mohd Zuhair & Ram Babu Roy, 2022. "Eliciting relative preferences for the attributes of health insurance schemes among rural consumers in India," International Journal of Health Economics and Management, Springer, vol. 22(4), pages 443-458, December.
    5. Micaela Pinho & Mara Madaleno, 2024. "Willingness to pay more health taxes? The relevance of personality traits and situational effects," Mind & Society: Cognitive Studies in Economics and Social Sciences, Springer;Fondazione Rosselli, vol. 23(1), pages 1-31, December.
    6. Mohammed Khaled Al-Hanawi & Sarh Almubark & Ameerah M N Qattan & Agnieszka Cenkier & Ewa Agnieszka Kosycarz, 2020. "Barriers to the implementation of public-private partnerships in the healthcare sector in the Kingdom of Saudi Arabia," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-15, June.

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