Willingness to pay for voluntary health insurance in Tanzania.

Objective(s): To assess how willing people would be to join a voluntary health insurance scheme and to see how they respond to changes in the benefit package. We also examined willingness to cross-subsidise the poor.

Design: Cross-sectional study.

Subjects: Two thousand two hundread and twenty four households comprising of 1,163 uninsured household heads asked about their willingness to pay for insurance in seven districts/councils (three urban and four rural) and 1,061 insured households were asked about their willingness to pay for insurance premiums for the poor in their community. Uninsured respondents were presented with two scenarios, the first reflected the current design of the Community Health Fund/Tiba Kwa Kadi (CHF/TIKA), the second offered expanded benefits, and included inpatient care in public facilities and transport.

Results: Only 30% of uninsured rural households were willing to pay more than Tsh 5,000 the current premium level, their average amount was Tsh 10,741, while in urban areas one percent of households were willing to pay more than Tsh 5,000. There was very limited willingness to pay more than 5,000 Tsh, even with an expanded package in rural areas. Household from rural areas were more willing to cross-subsidise the poor, but contribution levels were higher in urban areas.

Conclusion: Communities need to be sensitised about the existence of the CHF/TIKA to encourage enrollment. Expanding the benefit package would further increase enrollment. However, few people would be willing to pay more than the current premium.