Are people in the SADC region willing to pay more tax to fund public healthcare?

ABSTRACT

For Africa to develop and achieve sustainable development, African governments have to prioritise spending on public health. However, the current spending data shows that health spending is a continuing struggle for African countries. Many researchers have the view that African governments have to collect more tax to spend enough on public healthcare. The question here is what extent people are willing to pay more tax to increase spending on public healthcare? Employing a multilevel regression model on Afrobarometer survey data, this paper examined to what extent individual and country level factors influence people’s willingness to pay more tax to increase spending on public healthcare in 12 Southern African Development Community (SADC) member states. This study found that peoples’ trust in their government is an important determinant of willingness to pay more tax, while factors such as the country’s quality of democracy, economic condition, and current per capita health expenditure have no influence.

KEYWORDS:

• Healthcare
• taxation
• government
• democracy
• SADC

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1 For an analysis of the main focus of the Social and Human Development and Special Programmes, visit: http://www.sadc.int/sadc-secretariat/directorates/office-deputy-executive-secretary-regional-integration/socialhuman-development-special-programmes/.

2 These studies measured support for democracy from questions in the world value survey (see e.g. Torgler, 2005).

3 Quality of democracy calculated by the Economist Intelligence Unit. The Economist Intelligence Unit’s index of democracy, on a 0 to 10 scale, is based on the ratings for 60 indicators, grouped into five categories: electoral process and pluralism; civil liberties; the functioning of government; political participation; and political culture. Each category has a rating one 0 to 10 scale, and the overall Index is the simple average of the five category indexes(https://www.eiu.com/topic/democracy-index).

4 The Economist Intelligence Unit’s index of democracy, on a 0 to 10 scale, is based on the ratings for 60 indicators, grouped into five categories: electoral process and pluralism; civil liberties; the functioning of government; political participation; and political culture. Each category has a rating one 0 to 10 scale, and the overall Index is the simple average of the five category indexes.

5 This round has all the data available for this analysis.

6 Please note that Swaziland changed its name to Eswatini on 9 April 2018.

7 The difference in sample size has no major influence on the conclusions.

8 It is important to note that this was a closed ended question. The respondents were not presented with other options such as; (a) if other taxes were reduced (i.e. a balanced budget approach) - which would mean a reprioritisation of government spending; (b) if a new tax is introduced without reducing any other taxes (i.e. the total tax burden is increased) and that is progressive or regressive or neutral with reference to taxable income, and; (c) if the additional tax revenue were to be earmarked (given that it would be possible), etc.

9 Gross Domestic Product is included in the regression model taking into consideration income variation.

10 The Economist Intelligence Unit’s index of democracy, on a 0 to 10 scale, is based on the ratings for 60 indicators, grouped into five categories: electoral process and pluralism; civil liberties; the functioning of government; political participation; and political culture. Each category has a rating on a 0 to 10 scale, and the overall Index is the simple average of the five category indexes: https://www.eiu.com/topic/democracy-index.