Healthcare is essential for all individuals and becomes increasingly critical as people age due to heightened health risks and associated costs. Many nations have implemented universal healthcare systems, funded predominantly through taxes and insurance, to ensure everyone can access necessary health services. However, with an ageing population resulting from declining fertility rates and extended life expectancy, the financial strain on these systems has intensified significantly. This scenario poses a formidable challenge to governments: convincing citizens to increase their contributions towards health insurance to maintain system viability.
The pivotal study conducted by Associate Professor Tomoko Matsumoto and Junior Associate Professor Daiki Kishishita at the Tokyo University of Science, Japan, and published in the European Journal of Political Economy on 8 August 2024, holds significant implications for policymakers and governments. The study explores the potential of informing individuals about the personal future benefits they might reap from the healthcare system as a strategy for persuasion. The researchers were driven by the understanding that ageing-related health risks are universal, cutting across all socioeconomic groups. Despite this, there is a notable lack of public awareness about government fiscal policies related to healthcare and the personal advantages these policies provide. The team posited that enhancing individual knowledge about these personal benefits could bolster political support for higher healthcare contributions.
To investigate this, the researchers designed a two-period overlapping generations model. They hypothesized that increased awareness about future personal benefits could heighten public willingness to pay more towards health insurance. This hypothesis was tested against concerns about the fiscal sustainability of healthcare systems burdened by an ageing demographic. An online survey experiment was conducted with 4,367 participants in Japan, predominantly under the age of 75. Participants were randomly assigned to receive information about future personal benefits (Framing S) or current benefits to older adults (Framing N). Those in Framing S were further divided, with some receiving additional information about fiscal risks.
The results of the survey were revealing. In Framing S, where the focus was on future personal benefits, 81% of participants initially underestimated the benefits of the public healthcare system, indicating that their expectations might rise upon receiving accurate benefit information. However, overall, providing information about future benefits did not significantly sway participants towards supporting an increase in health insurance contributions. Notably, for those initially unaware of the fiscal challenges facing the system, learning about these challenges negated any initial increase in support caused by awareness of personal benefits.
In contrast, Framing N, which did not emphasize personal benefits, showed that merely informing participants about benefits without a personal focus had minimal impact on their willingness to support higher health insurance contributions. This was especially true for those aware of the system’s fiscal difficulties, where support decreased.
These findings have profound implications for policymakers and governments, especially in countries grappling with the challenges posed by an ageing population and strained public healthcare systems. The research suggests that for public support to increase for higher health insurance contributions, individuals must not only be informed about the future benefits they stand to gain but must also trust in the fiscal sustainability of the healthcare system. This trust could potentially be fostered through the implementation of robust fiscal consolidation policies aimed at stabilizing public finances. Drs. Matsumoto and Kishishita conclude that building confidence in the future benefits of the healthcare system, underpinned by sound fiscal policies, is crucial for securing broader public support for sustaining healthcare funding. This research provides a hopeful and optimistic guide for future policy decisions in the healthcare sector.
More information: Daiki Kishishita et al, Self-benefits, fiscal risk, and political support for the public healthcare system, European Journal of Political Economy. DOI: 10.1016/j.ejpoleco.2024.102597
Journal information: European Journal of Political Economy Provided by Tokyo University of Science
