WILLINGNESS TO PAY FOR THE FUTURE NATIONAL HEALTH FINANCING SCHEME
1
Department of Public Health Medicine, Faculty of Medicine, National University Malaysia, Kuala Lumpur, Malaysia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Healthcare financing is one of the most fundamental functions of health systems, essential for achieving universal health coverage. The main concern in many countries is containing the cost of healthcare. The tax-based healthcare financing system in Malaysia is no longer sustainable in the long term. One of the funding options is having a national healthcare financing scheme. This study aimed to determine the willingness to pay (WTP) for essential health services and hypothetical packages to be included in a future national health financing scheme (NHFS) in Malaysia.
METHODS:
A cross-sectional, contingent valuation study was conducted involving 363 respondents from government health facilities in Selangor and Kuala Lumpur. Using a double-bounded dichotomous choice method, WTP values were determined for various health services and NHFS packages.
RESULTS:
The majority of respondents (86.5%) were willing to contribute to the proposed NHFS with hypothetical essential health services in both public and private facilities, and 42.1% of them were willing to deduct 1.0% from their monthly salary for it. Factors significantly associated with WTP included age, education level, ethnicity, respondent status (healthcare worker vs patient), number of dependents, and health insurance ownership. In the final logistic regression model, Malay ethnicity (OR 2.07, 95% CI 1.09-3.95), healthcare worker status (OR 2.54, 95% CI 1.38-4.67), and a greater number of dependents (OR 2.34, 95% CI 1.10-4.95) were significant predictors of WTP.
CONCLUSIONS:
The findings suggest there is broad public support for implementing an NHFS in Malaysia. Policymakers should consider sociodemographic factors in designing contribution schemes. In view of the majority of respondents willing to pay more for access to both public and private health facilities, the government needs to start public-private partnerships in its health planning.
Healthcare financing is one of the most fundamental functions of health systems, essential for achieving universal health coverage. The main concern in many countries is containing the cost of healthcare. The tax-based healthcare financing system in Malaysia is no longer sustainable in the long term. One of the funding options is having a national healthcare financing scheme. This study aimed to determine the willingness to pay (WTP) for essential health services and hypothetical packages to be included in a future national health financing scheme (NHFS) in Malaysia.
METHODS:
A cross-sectional, contingent valuation study was conducted involving 363 respondents from government health facilities in Selangor and Kuala Lumpur. Using a double-bounded dichotomous choice method, WTP values were determined for various health services and NHFS packages.
RESULTS:
The majority of respondents (86.5%) were willing to contribute to the proposed NHFS with hypothetical essential health services in both public and private facilities, and 42.1% of them were willing to deduct 1.0% from their monthly salary for it. Factors significantly associated with WTP included age, education level, ethnicity, respondent status (healthcare worker vs patient), number of dependents, and health insurance ownership. In the final logistic regression model, Malay ethnicity (OR 2.07, 95% CI 1.09-3.95), healthcare worker status (OR 2.54, 95% CI 1.38-4.67), and a greater number of dependents (OR 2.34, 95% CI 1.10-4.95) were significant predictors of WTP.
CONCLUSIONS:
The findings suggest there is broad public support for implementing an NHFS in Malaysia. Policymakers should consider sociodemographic factors in designing contribution schemes. In view of the majority of respondents willing to pay more for access to both public and private health facilities, the government needs to start public-private partnerships in its health planning.
| eISSN: | 2654-1459 |
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