Public healthcare systems face financial challenges due to an increasing number of older individuals. As a result, governments are tasked with encouraging citizens to contribute more towards health insurance. Recent research has explored whether raising awareness about personal future benefits from the healthcare system can lead to greater support for increased health insurance payments. This method was successful among those who weren’t previously aware of financial risks, but its effectiveness diminished once they gained that awareness, suggesting important consequences for public policy makers.
Healthcare plays an essential role in everyone’s life. With aging, the likelihood of health problems and associated costs rise. Many nations establish universal healthcare systems funded by taxes and insurance to ensure that essential health services remain available. However, these systems are currently overwhelmed financially due to a rapidly aging population, which is a result of lower birth rates and longer lifespans. To keep these systems afloat, governments face the challenging task of convincing citizens to increase their health insurance contributions.
A recent study led by Associate Professor Tomoko Matsumoto and Junior Associate Professor Daiki Kishishita from the Tokyo University of Science examined if making individuals aware of the benefits they will receive from the healthcare system in the future could effectively motivate them. This study appeared in the European Journal of Political Economy on August 8, 2024.
The researchers explained their reasoning, stating, “Health risks associated with aging will impact everyone, irrespective of their economic status. Yet, research shows that individuals generally lack knowledge about government financial operations, especially those connected to public healthcare and its benefits. Hence, informing people about future personal benefits from the healthcare system may bolster their willingness to support increased contributions to health insurance for its continuity.”
Thus, the research team created a two-period overlapping generations model and proposed that making individuals aware of future personal benefits might enhance their support for contributing more to health insurance. However, they also hypothesized that this support would wane once individuals became aware of the fiscal issues facing the aging population.
To test these assumptions, researchers conducted an online survey experiment with 4,367 Japanese participants, primarily under the age of 75. Participants were randomly assigned to receive information about either future self-benefits (Framing S) or current benefits for older adults (Framing N). In Framing S, participants were divided into treatment groups that received information about future self-benefits or a control group that did not, with some informed about fiscal risks while others were not. Respondents then provided their support for a 1% increase in health insurance contributions. A similar process was conducted for Framing N, and the outcomes were afterward compared between the two groups to evaluate the effectiveness of framing.
Within Framing S, 81% of participants underestimated the benefits provided by the public healthcare system, indicating their expectations would rise if they were given the accurate information about their future benefits. Consequently, researchers focused their further analysis on these individuals.
Contrary to expectations, the treatment (informing about future benefits) did not significantly impact support for higher health insurance contributions on average. Notably, it increased support by 28.9 percentage points among those previously unaware of financial risks. However, this positive effect vanished once the previously unaware individuals learned about the unsustainable fiscal state of the public healthcare system.
In Framing N, where future self-benefits were not specifically highlighted, the treatment had no effect on those unaware of fiscal risks, while support from informed individuals fell by eight percentage points. “The findings suggest that communicating benefits without presenting them as self-benefits may have limited influence on boosting political support for increased health insurance contributions,” the authors noted.
The results carry significant importance for policymakers, governments, and nations grappling with strained public healthcare systems amid an aging populace.
“To bolster support for health insurance frameworks, informing citizens about their future self-benefits is crucial. However, it’s also essential for people to believe that they will indeed gain from the system in the future. This may be facilitated through implementing fiscal consolidation strategies to enhance trust in public finances,” concluded Dr. Matsumoto and Dr. Kishishita.
