医療とケアにおける多様性と平等 オープンアクセス

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Inequalities in Willingness to Pay for Zambia’s National Health Insurance Scheme

Mulenga Kabaso*, Frederik Booysen

This paper investigates socioeconomic inequalities in household willingness to pay for national health Insurance. The paper used data from the nationally representative Zambia household health expenditure and utilization survey. Contingent valuation was used to elicit willingness to pay using a bidding game technique. A concentration curve and a concentration index were used to measure inequalities in willingness to pay, while Wagstaff, et al. decomposition was used to identify the factors that contribute to these inequalities. The concentration index for socioeconomic inequalities in willingness to pay was estimated at 0.161, indicating that willingness to pay was concentrated among affluent households. The Wagstaff, et al. decomposition results suggested that the ability to pay, proxied by per capita expenditure, contributed most to the inequalities in willingness to pay. Thus, policy makers should target programs that create employment and income generating activities that absorb everyone regardless of their socioeconomic status.