Abstract
BackgroundSince the introduction in 1984 of Australia’s publicly-funded universal healthcare system, Medicare, healthcare financing has relied on a mix of public and private sources to meet the needs of the population (Sowa et al., Appl Health Econ Health Policy 15:31–41, 2018). However, in recent years, there has been a decline in the number of Australians choosing to purchase private health insurance (PHI), particularly within the young adult age group with the proportion of insurance customers aged 20 to 29 falling from 10.3 to 9.4% between 2012 and 2017 (Sivey, The Conversation, 2017). Young adults are critical to private health insurance funding models as their involvement offsets the drawdown by older adults (Dalzell and Borys, ABC News, 2019). While this issue is widely reported in the Australian media, few empirical studies have explored the factors that enable or constrain young adults’ enrolment in PHI.MethodsTo address the scarcity of research about the motivational factors behind young adult decision-making, this study conducted a survey of 594 Australian young adults aged between 18 and 30 years. Within this age group, the survey sought an equal split of participants who were members and non-members of PHI schemes.ConclusionThe findings identified perceived value and trust in insurers as additional motivational factors alongside traditional measures of recognition of the problem and involvement in the problem. Differences between the insured and uninsured groups were identified which help to shape a more holistic understanding of the key motivational factors and barriers in relation to Australian young adults’ enrolment in PHI.
Highlights
Since the introduction in 1984 of Australia’s publicly-funded universal healthcare system, Medicare, healthcare financing has relied on a mix of public and private sources to meet the needs of the population (Sowa et al, Appl Health Econ Health Policy 15:31–41, 2018)
Given the focus of current and future-oriented health behaviours noted in studies around health consciousness, this study proposed the following hypothesis: H1o: Australian young adults with and without private health insurance (PHI) show no statistical difference in health consciousness
For the group without PHI, problem recognition (β = .388, p < .001), involvement recognition (β = .320, p < .001), perceived value (β = −.184, p < .001) and trust (β = .140, p < .001) were all associated with attitude, but the null hypothesis for H6b failed to be rejected as constraint recognition had no relationships with attitude
Summary
Since the introduction in 1984 of Australia’s publicly-funded universal healthcare system, Medicare, healthcare financing has relied on a mix of public and private sources to meet the needs of the population (Sowa et al, Appl Health Econ Health Policy 15:31–41, 2018). Young adults are critical to private health insurance funding models as their involvement offsets the drawdown by older adults (Dalzell and Borys, ABC News, 2019) While this issue is widely reported in the Australian media, few empirical studies have explored the factors that enable or constrain young adults’ enrolment in PHI. Existing research on PHI in Australia has been driven from an economic perspective, focusing on the effectiveness of government initiatives to incentivise and reduce barriers to enrolment in PHI [4, 8,9,10,11] It is compulsory for most Australian taxpayers to pay an annual Medicare Levy to fund the public health system and single people earning above A$90,000 or families earning above A$180,000 have to pay an additional Medicare Levy Surcharge (MLS) if they do not have PHI. There is a need to examine wider motivational factors and barriers to enrolling in and maintaining PHI [11]
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