Finding sustainable means of financing health care in Ghana : are the people willing to pay?
This study seeks to improve the knowledge of health care financing issues in Ghana as the country seeks a sustainable means of financing health care. To this end an empirical study of Ghanaians' willingness to pay for health services and for health insurance is undertaken thereby applying the contingent valuation model of estimating willingness to pay in a different context (health care financing and demand) from the usual applications reported in the literature, which value the benefit component of cost-benefit analysis. Firstly, the study examines the three main methods of raising funds to finance health care (namely, government through taxes, user payments at the point of use, and health insurance) and discusses their advantages and disadvantages. Ghana's experiences in health care financing are considered with particular reference to the introduction of user charges by the government in 1992 and the issues raised concerning revenue generation, health service utilisation and equity, especially those affecting people with lower income levels. The empirical study was undertaken in two district capitals and their immediate environs in the Eastern region of Ghana with a sample of 487 heads of household interviewed in their own homes. The study shows that, overall, Ghanaians are willing to pay for their health care whether delivered by government or private hospitals and they are also willing to contribute into a national health insurance scheme. However, one's willingness to pay does not necessarily mean one will be able to pay for one's health care, since this depends on ability to pay. Since Ghana's per capita income is US$390 and the daily minimum wage is less than US$1, many Ghanaians may find it difficult to pay for their health care at the time of use given the uncertain nature of health care needs. Consequently, this study proposes the establishment of a national/social health insurance scheme, which if properly implemented, could be of immense benefit in raising adequate funds to improve upon health care delivery in the country.