WILLINGNESS TO PAY FOR SOCIAL HEALTH INSURANCE AMONG INFORMAL AND PRIVATE SECTOR WORKERS IN KANO METROPOLIS: A CONTINGENT VALUATION STUDY

Abstract

In sub-Saharan Africa substantial a level of out-of-pocket expenditure for health care by the population causes policy makers to draw particular attention to the proposal of a social health insurance for uninsured members of the society. Hence in essence, it is essential to collect and compile reliable information about the amount of Willingness To Pay (WTP) for healthcare insurance. This study assessed the WTP for health insurance in Nigeria in order to suggest an affordable social health insurance using Kano Metropolis as case study. The study sample included 270 employees from organised private and informal sector organisations. The double bounded dichotomous choice approach was used to elicit the WTP. The average WTP for social health insurance per emloyees’ per month was N2626.90.via contingent valuation bids, while about 80% of the selected respondent were willing to join and to pay for the proposed state health insurance scheme. Employees with higher levels of education, those with serious illnesses and those who experienced high and catasterophic medical expenditure had more WTP for the healthcare insurance compared to others. Findings from the study demonstrated that, level of education, presence of serious illness, present health condition, family size and medical expenditure per month have practical, economic and significant impact on WTP for both first and second bids. While health insurance awareness and level of income demonstrated a mixed result, as were only significant in WTP the first bid. Also the study consistently demonstrated the presence of adverse selection and potential moral hazard subsequent to positive relationship between health risk and willingness to pay for both first and second bid, as measured by marginal effect predicted probabilities, its therefore recommended as a solution to adverse selection and potential moral hazard  that government as a pioneer of health insurance scheme, can encourage private and informal sector employees participation through mass awareness campaign, because People are willing to join and pay for health insurance if they are made aware of the principles of insurance and properly understand the concept of risk pooling.