Willingness to pay more taxes to improve public healthcare in the COVID-19 era

The objective of this study is to examine the factors that influence willingness to pay more taxes to improve public healthcare (WTP) during the COVID-19 era. The multilevel regression model is employed in an international survey conducted across 19 countries to test several hypotheses about the factors predicting WTP. An increase in COVID-19 mortality reduces WTP. Our findings suggest, therefore, that the citizenry views the increase in COVID-19 mortality as a failure of public healthcare. Such an increase signifies problems in public healthcare that lead to a sense of disappointment with the healthcare system, which does not bolster WTP to improve it but rather reduces WTP. Trust in the COVID-19 vaccine and healthcare, as well as higher satisfaction with healthcare, strengthens WTP. Believing that severe health problems originate in poverty and environmental factors beyond sick individuals’ control also strengthens WTP. Conversely, believing that people have severe health problems because they behaved in ways that damaged their health weakens WTP. Pro-health behavior bolsters WTP, while anti-health behavior reduces WTP.