Relationship Between Total Incomes with Willingness to Pay in National
Health Insurance on Coffee Farmer in Jember
Eri Witcahyo
Health Policy and Administration Department, Faculty of Public Health,University of Jember;
Jalan Kalimantan I/93 Kampus Tegal Boto, Jember 68121
Keywords: Willingness to pay, National healthi, Coffee farmer.
Abstract: Based on formative study in 2015, there were 98% of inhabitants who haven’t register as a participant in
National Health Insurance (NHI) at Silo Sub district. From unregistered participant, 46.9% haven’t received
information about NHI, while 29.2% showed their dissatisfaction about primary health services. In general,
incomes still to be main factor of NHI participation. The objectives of the study were analyze correlation
between total incomes with Willingness to Pay (WTP) and based on their education level and socialization
they had. The type of study was analytic and involved 98 respondents. The result showed there were
positively correlated between total incomes with WTP (r
s
= 0.462; p=0.000), even though relationship
statistically was only shown in uneducated level group (r
s
= 0.704; p=0.002), senior high school and higher
(r
s
= 0.716; p=0.003) and also socialized group (r
s
= 0.571; p=0.000). The recommendations are optimize
socialization of NHI to informal groups, middle groups and also empowering available resources in the
community
1 INTRODUCTION
Jember is the one of districts in East Java that has
great potential in coffee plantation. The subdistrict
area which is gives high contribution in robusta
plantation is Silo. In 2013, there was broad enough
space for coffee plantation area, it was 2.288,70
hectares by coffee production of 9.336,01 quintal
(BPS Jember, 2014). These flagship commodity are
expected to improve the welfare and financial
capability of coffee farmers as we know that coffee
farmer have become main livelihood of the
community, thereby reducing poverty and financial
incapacity in the community.
In 2004 the government issued Law Number
40/2004 on the National Social Insurance System
(SJSN) which explains that social and health
insurance are compulsory for the entire population
and managed by a Social Insurance Agency (BPJS).
This policy then then resulted in a program which
called National Health Insurance (NHI). This
coverage system has been implemented since
January 1
st
, 2014. In order to succeed of NHI, the
government targets the entire population of
Indonesia must become participant no later than
January 1
st
, 2019 or known as Universal Health
Coverage (UHC).
Based on formative study in 2015, there were
98% of inhabitants who haven’t register as a
participant in National Health Insurance (NHI) at
Silo Sub district. From unregistered participant,
46.9% haven’t received information about NHI,
while 29.2% showed their dissatisfaction about
primary health services. In general, incomes still to
be main factor of NHI participation although at the
time of harvest, some coffee farmers’ income were
quite good. This condition will be an obstacle to
UHC achievement.
In paying for health services, the Willingnes to
Pay (WTP) aspect becomes important thing, because
it is a combination of perception and intention in
making payments, in another side, WTP is the
maximum willingness of consumers to buy a product
(Herfert, 2007). WTP can be influenced by a person
predisposing factor because predisposition either
directly or indirectly affects the person's attitude and
behaviour. Main factors affecting the WTP in health
insurance include the products which offer; quality
and quantity of services provided; user utility or
Witcahyo, E.
Relationship Between Total Incomes with Willingness to Pay in National Health Insurance on Coffee Farmer in Jember.
In Proceedings of the 4th Annual Meeting of the Indonesian Health Economics Association (INAHEA 2017), pages 265-267
ISBN: 978-989-758-335-3
Copyright © 2018 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
265

intent to services and user income (Permata, 2012).
The objectives of the study were analyze correlation
between total incomes with Willingness to Pay
(WTP) and based on their education level and
socialization they had.
2 METHODS
The type of study was analytic, based on timing of
the implementation; it was cross sectional study and
involved 98 respondents. The selection respondents
was done by multistage random sampling technique
while the analysis used was spearman analysis..
3 RESULT
3.1 Distribution of Respondents
The education level in the study was categorized in
four category, there were uneducated level,
elementary school level, junior high school level and
senior high school or higher. Eventhough the data of
total income in the study was ratio, in the table
below is categorized in three category. The
distribution of respondents in this study is shown in
the table below.
Table 1: Distribution of the percentage of respondents
Variables
N
%
Education Level
Uneducated
16
16.3
Elementary school
42
42.9
Junior high school
25
25.5
Senior high school or
higher
15
15.3
Total
98
100.0
Total Income
<1.500.000
33
33.67
1.500.00 – 3.000.000
55
56.12
>3.000.000
10
10.20
Total
98
100.00
Socialization
Socialized
53
54.1
Unsocialized
45
45.9
Total
98
100.0
WTP
0 – 25.000
88
89.8
25.500 – 42.400
8
8.2
42.500 – 59.400
2
2.0
Total
98
100.0
3.2 Correlation Analysis
The result showed there was positively correlated
between total incomes with WTP (r
s
= 0.462;
p=0.000), even though relationship statistically was
only shown in uneducated level group (r
s
= 0.704;
p=0.002), senior high school and higher (r
s
= 0.716;
p=0.003) and also socialized group (r
s
= 0.571;
p=0.000). Distribution of correlation between total
income and willingness to pay is shown in graph
below.
Figure 1: Correlation between Total Income and
WTP
4 DISCUSSION
The result showed there was positively correlated
between total incomes with WTP. It is according to
ho much on essential and non essential food
expenditure they had. These result are in accordance
with Binnendijk et., al (2013) who stated in their
study that hel on rural poor community in India that
level of WTP could be estimated based on each
community's food expenditures. Based on the results
obtained, all research variables were positively
correlated, but statistically related was only found in
uneducated and senior high school or higher. This
shows that the level of education has a relationship
to the willingness to pay. This confirms that higher
the educational level of a person will give more
information obtained (Notoatmojo, 2002). The
results showed that that higher educational level has
r
s
= o.462
p= 0.000
INAHEA 2017 - 4th Annual Meeting of the Indonesian Health Economics Association
266

a relationship to WTP and this finding is consistent
with Dror et., al (2007) that stated education is
secondary factor which has relationship to WTP in
India as well as on the results obtained from research
conducted in Nigeria by Onwujekwe et., al (2009)
that males and people with more education stated
higher WTP values than females and those with less
education.
Information gained will affect a person's
perception to be more positive causing the expected
behaviour because it is able to absorb and
understand the knowledge they gain. Similarly, the
information obtained, the more information
obtained, the more increase the knowledge of a
person. Higher total income also causes a person to
increase his willingness to pay.
5 CONCLUSIONS
Some of these results show that to improve
willingness, improving education levels, improving
socialization and improving income are main key to
improving willingness to pay. This can be done by
involving a key group in the community to become
an NHI socialization agency. Increasing the welfare
of farmer groups becomes a necessity that must be
achieved. This can be done by developing a group of
coffee farmers. The development of small medium
enterprises become one of the alternative that can be
done which of course need support and attention
from local government
REFERENCES
Binnendijk, E, Dror, D, Gerelle, E & Koren, R 2013,
Estimating Willingness to Pay for health insurance
among rural poor in India by reference to Engel’s
Law, Journal of Social Science and Medicine, vol. 76,
pages 67-73.
BPS Jember. 2014. Kabupaten Jember dalam Angka 2014.
Jember: Badan Pusat Statistik Kabupaten Jember.
Dror, D, Radermacher, R & Koren, R 2007, Willingness to
pay for health insurance among rural and poor
persons: Field evidence from seven micro health
insurance units in India, Journal of Health Policy, vol.
82, issue 1, pages 12-27.
Herfert, Mathis. 2007. Nonparametric Inference of
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Consumer Theory. Humburg: Diplomde.
Onwujekwe, O, Okereke, E, Onoka, C, Uzochukwu, B,
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community-based health insurance in Nigeria: do
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Permata, M.R. 2012.Analisa Ability To Pay dan
Willingness To Pay Pengguna Jasa Kereta Api
Bandara Soekarno Hatta – Manggarai. Unpublished.
Tesis. Jakarta: Program Pascasarjana Universitas
Indonesia.
Notoatmojo, S. Pendidikan dan Perilaku Kesehatan.
Rineka Cipta, Jakarta: 2002
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