Why Some People Go Private and Others Do Not: Supplementary Health Insurance in Spain

Abstract

Although the National Health System (NHS) is the main healthcare financing body in Spain, an increasing share of the population ‘goes private’ by obtaining supplementary private healthcare insurance (PHI). Qualitative research is very limited and empirical studies hardly ever provide us with what lies behind the figures. This paper seeks to examine qualitative and quantitative evidence on the individual's motives for the purchase of PHI. We undertook two focus groups together with a representative survey containing open–ended and closed questions among a sample of the Catalan population. Our findings indicate a high degree of heterogeneity in the motives for going private, ranging from the already acknowledged ‘quality motive’ to simple tradition. A certain share of the population reveals ‘captivity’ and satisfaction towards the NHS, as well as being unable to afford private alternatives. Furthermore, risk aversion and income was significantly higher for those purchasing PHI.

Keywords

private health insurance captivity to the NHS satisfaction with the NHS quality of care

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