# Determinants of willingness to pay for health insurance in later stages of the Covid-19 pandemic: findings based on the general adult population in Germany

## TL;DR

This study explores what factors influence people's willingness to pay for health insurance in Germany during the later stages of the Covid-19 pandemic.

## Contribution

The study identifies socioeconomic and political factors as significant predictors of willingness to pay for health insurance, contrasting with health-related factors.

## Key findings

- Higher willingness to pay is associated with being male, older, having higher income, and being politically right-wing.
- Socioeconomic and political factors are more significant than health-related factors in predicting willingness to pay for health insurance.
- Average willingness to pay suggests dissatisfaction with current statutory health insurance contributions during the pandemic.

## Abstract

The aim was to examine which factors contribute to the willingness to pay (WTP) for health insurance in Germany.

Cross-sectional data are taken from a large, population-based study (GESIS panel, wave 50, n = 4,447; November 2022 to January 2023). Willingness to pay for health insurance served as outcome measure. Socioeconomic, health-related, coronavirus-related, and political spectrum-related factors were included as independent variables. Multiple linear regressions with cluster-robust standard errors were used.

Monthly average WTP for health insurance was €258 (SD: €210). A higher WTP for health insurance was associated with being male (female vs. male: β = −0.56.6, 95% CI: −67.7 to −45.5), being older (β = 2.1, 95% CI: 1.6–2.6), higher education (e.g., intermediary school leaving certificate vs. general/subject-specific university entrance qualification: β = −67.3, 95% CI: −80.7 to −53.8), higher income group (e.g., 1,700–2,300 € vs. under 900 €: β = 79.8, 95% CI: 36.1–123.5), not being married and living together with spouse (e.g., single vs. married/partner living together: β = 28.9, 95% CI: 12.4–45.4) as well as being politically more right-wing oriented (e.g., right-wing vs. left-wing: β = 33.4, 95% CI: 4.5–62.3).

In contrast to health- and coronavirus-related factors, socioeconomic and political spectrum-related factors were significantly associated with WTP for health insurance in Germany. Moreover, based on the average WTP, one can conclude that individuals do not fully agree with the present contributions to statutory health insurance in Germany as a whole during the Covid-19 pandemic. Future research could focus on cross-country comparisons (with varying healthcare systems and also between individualistic and collectivistic cultures).