MR Microinsurance_2012_03_29.indd - International Labour ...

Willingness to pay for health microinsurance
affiliation with income-rated premium; 3 and 2) health insurance that is based on
voluntary affiliation with risk-rated premium. 4 Although when subjects were
asked about their willingness to affiliate with either of these insurance products
there was a slight preference for the compulsory affiliation, the mean WTP for
both products was practically the same despite the fact that each household was
presented with both options.
Dror et al. (2007) also examined the sensitivity of WTP to being packaged in
a different way: each third of the sample was offered a different benefit package. 5
In that experiment, there was no difference in WTP for the three packages. This
could be due to the different elicitation method, in which respondents were
offered only one option and were not given a choice between options that they
could compare or prefer. This suggests that WTP can, at least sometimes, be used
as a tool for package design only when the same respondent can choose between
options. This would work when the number of options is relatively small, but
would be impracticable with the very many options that health insurance packages
usually contain. Other methods were developed for benefit package design
that enable respondents to choose from 10 or more options, but this is done
within a finite budget, i.e. without soliciting the respondents’ WTP. The methods
that were applied in the context of CBHI in low-income countries include
simulation exercises (Dror et al., 2007), focus group discussions and structured
interviews (De Allegri et al., 2006). We conclude that the available information
on the impact of package composition on WTP is inconclusive.
3 All households in the district are obliged to pay an annual premium to a local healthcare fund when
crops are sold. The fee is based on the households’ income. The higher the income, the higher the fee.
All members in the household are entitled to free health care at the Communal Health Station or
District Health Centre and free medicine if it is prescribed by a doctor. If care at higher levels is
needed, the insured patient will be supported by an amount based on the cost per bed-day at the
District Health Centre level. The fund will be managed by the Commune People Committee (or
elected representative).
4 Each household can choose to voluntarily pay an annual premium to a local healthcare fund when
crops are sold. The fee is based on the number of people in the household and the fee is higher for
children under five and elderly over 65 because they are expected to use more health care.
5 Version 1 included hospitalization expenses up to INR 5 000 (US$115) per year and person and
reimbursement of costs for prescribed drugs up to INR 1 000 (US$22.50) per year and person; version 2
included hospitalisation expenses up to INR 5 000 (US$115) per year and person and reimbursement
of costs for general practitioners up to INR 1 000 (US$22.50) per year and person; version 3 included
reimbursement of costs for prescribed drugs up to INR 1 000 (US$22.50) per year and person and
reimbursement of costs for general practitioners up to INR 1 000 (US$22.50) per year and per person.
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