People's positions regarding social security's health insurance programs: The case of Romania

Background. - In Romania, the passage from a culture in which healthcare were freely available to a culture in which people must contribute financially, at least in part, has generated controversies among the population. We examined and mapped the views of people living in Romania regarding social security's health insurance programs. Methods. - A convenience sample of 271 adults aged 18-80 who lived in big cities in Romania or in the rural areas around these cities were presented with realistic vignettes that depicted a health insurance program and asked to rate its goodness. The vignettes were created by combining orthogonally the levels of five factors: amount of employers' contribution to the program, amount of workers' contribution, extent of coverage of ordinary medical and dental care, extent of coverage of chronic or severe illness, and identity of health insurance recipients. Results. - Five qualitatively different positions were found. They were called Private insurance (8%), Health insurance only for contributors (14%), Health insurance for contributors and for everyone with severe or chronic illness (12%), Health insurance for everyone (29%), and Any insurance program is better than nothing (37%). Conclusion. - Overall, most participants (78%) favored a health insurance program that would protect all citizens in case of severe or chronic illness or injury, and 66% favored the protection of all citizens in all cases. (c) 2021 Elsevier Masson SAS. All rights reserved.