Citizens' views on health insurance in Croatia.
OBJECTIVE
To examine the citizens' attitudes toward health insurance and its reform in Croatia, and their views on private payments for health care services.


METHODS
In 1999 and 2000, we surveyed 500 randomly selected adults from all regions of Croatia, aged 40 years and over. The questionnaire included questions on social health insurance, private payments for health care, and background information. The net response was 393 (79%). The analysis of the data collected included univariate and multivariate analyses to test the differences in the attitudes among sociodemographic and socioeconomic groups.


RESULTS
Most interviewed Croatian citizens (83.2%) expressed the opinion that everybody should have access to health care services, irrespective of the health insurance contributions. However, 32.1% agreed that the utilization of services should depend on the payment of contribution; 39.1% believed that the money they contributed to health insurance corresponded to health care services they received; 60.1% agreed that insurance rate should increase proportionally to income. When asked about reforms, more than half (53.4%) thought that the current health insurance covered less benefits than 10 years earlier, whereas more than a third believed that changes offered more choice (36.9%) but less equity (37.7%), and 46% disagreed with the introduction of the basic package of health care benefits and supplementary insurance. About the same percentage of respondents thought that they had already been paying too much for health care out of their own pockets.


CONCLUSIONS
Citizens in Croatia do not hold a positive opinion on health insurance reform. They fear the changes would bring about limitations in their social rights and increase their financial burden.
Mastilica
Miroslav
M
Department of Medical Sociology, Andrija Stampar School of Public Health, Zagreb University School of Medicine, Rockefellerova 4, 10000 Zagreb, Croatia. mmastil@andrija.snz.hr
Babić-Bosanac
Sanja
S
D000328:Adult; D001294:Attitude to Health; D017523:Croatia; D005260:Female; D005380:Financing, Government; D018166:Health Care Reform; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000331:legislation & jurisprudence*; D007407:Interviews as Topic; D008297:Male; D009313:National Health Programs / Q000191:economics / Q000331:legislation & jurisprudence*; D017149:Private Sector; D011639:Public Opinion; D011795:Surveys and Questionnaires