People with lower education level and poorer health are more likely to support spending more money on public health care. Illustration photo: Shutterstock, NTB

Sickest people support health services the most

Healthy and successful people are the least willing to contribute more to the public health care system.

A recent article addresses the views of various social groups on health policy priorities.

“The goal was to see how self-interest and ideology are connected with unified support for a comprehensive health policy,” says Pål E. Martinussen, a professor in NTNU’s Department of Sociology and Political Science.

He concluded that healthy and successful people are the least willing to pay more for public health services.

The results of the study are presented in the journal Health Policy.

Scant majority against paying more

The professor addressed three main factors: the willingness to spend more public money on health care; opposition to higher deductibles (both in general and for so-called “self-inflicted diseases” such as smoking); and opposition to increased use of private health insurance.

Support for the public health service in Norway remains strong and spans political positions, age and level of education. Illustration photo: Shutterstock, NTB

Martinussen believes that if the pandemic has shown us anything, it would be that more money is needed for the health care service, including intensive care units and nurses.

However, his recent survey shows that a narrow majority – among people who have decided – believe Norway spends enough money on health care as it is.

Young, healthy, well-educated and financially well-off individuals more often prefer private responsibility and financing.

“This kind of shift in policy could of course increase social health inequalities, since the hardest hit would be people who are already the least privileged and have the worst health,” says Martinussen.

Massive support for the public service

Support for the public health service is nevertheless huge in Norway and spans political positions, age and level of education.

  • 44 per cent of survey participants want the government to spend more money on the public health service.
  • Almost as many, 43 per cent, want the government to spend the same amount as now, but try to spend the money more efficiently. In addition, just over 3 per cent think that how the money is spent now is just fine. Thus, a narrow majority supports not increasing the current budget, with just over 46 per cent versus 44 per cent.

It is worth noting that only one percent of those surveyed think Norway spends too much money or want to cut back the public health service budget and try new health service forms.

The rest of the survey participants, approximately nine per cent, are undecided and say they do not know what should be done.

Self-interest ranks highest

The survey used education level and finances as indicators of success. Martinussen also examined the significance of the party people voted for.

However, self-interest seems to be the most important factor determining whether people were willing to increase spending on the public health service from current levels.

“A lower education level and poorer health significantly increases the probability that a person wants to spend more money on public health,” says Martinussen.

A total of 2688 people participated in the survey.

Health spending is up

Norway has never spent more money on health care than it does now, approaching € 38.7 billion in 2020. This corresponds to just over 10 per cent of Norway’s gross domestic product, and almost € 7 200 per capita.

Adjusting for price growth, total expenses have increased by about 34 per cent in the last 15 years, according to figures reviewed by the Aftenposten newspaper.

Administrative expenses have increased by as much as 80 per cent in the same time period. On the other hand, the number of available hospital beds per 1 000 inhabitants has halved in the same period, from four beds to two, which may have contributed to the problems that arose in connection with the pandemic.

Reference: Pål E. Martinussen. Let’s stick together: The role of self-interest and ideological beliefs for supporting a ‘solidaristic’ health policy in Norway. Health Policy. Received 3 September 2021, Revised 11 January 2022, Accepted 13 January 2022, Available online 15 January 2022. https://doi.org/10.1016/j.healthpol.2022.01.005