As is common elsewhere in the world, public health care services in Malaysia are experiencing mounting pressures because of increased demand and limited resources. The current service provides an almost universal health system in which risks are pooled across the entire population, and all civil servants, as well as their dependants and children, and lower income groups are entitled to health care in a public health care facility, whereas the remainder of the population is required to pay a minimal fee for health care. The collected fees constitute only 2% of the cost of the health service. Consequently, the system relies heavily on general taxation for financing. Such a financing plan is unsustainable, particularly in developing countries that have an inefficient tax collection system (only 10% of the Malaysian population pays taxes). Consequently, health service suffers from overcrowding, understaffing, a long waiting time, low accessibility, and a lack of quality and convenience, which drives almost 60% of Malaysians to seek private primary care (Dyah Pitaloka & Rizal, 2006). Despite their preferences, most (73.2%) of the expenditures in private health care are out-of-pocket, and only 18.8% of adult Malaysians are covered by voluntary private health insurance (VPHI) (Yu, Whynes, & Sach, 2008). This trend creates a high risk of catastrophic medical events for Malaysians. The existing social health insurance in Malaysia is restricted to formal sector workers with regular employment, leaving the unemployed without coverage.
This is a preliminary investigation into the role of macro-level demographic factors, namely crude birth rate, crude death rate, total fertility rate and life expectancy at birth, in the new purchase of three different types of life insurance, i.e. whole life, endowment and temporary insurance, using correlational and linear regression analysis. From correlational analysis, both the current and lagged crude birth rates, crude death rates and total fertility rates are found to have significant weak to moderately strong positive relationship, while both the current and lagged variables of life expectancy at birth have significant moderately strong negative relationship with the growth of the new purchase of both whole life and temporary insurance. On the other hand, while none of the current-period demographic factors are found to have any significant relationship but the lags of crude birth rate and crude death rate are found to have significant weak positive relationship with the growth of the new purchase of endowment insurance. From linear regression analysis, only crude birth rate is found to have a significant positive relationship with the growth of the new purchase of whole life insurance. The findings show that demographic factors seem to play a minor role in the purchasing of new life insurance, and crude birth rate appears to be the demographic factor that is important in explaining the new purchase of whole life insurance. As this is a preliminary investigation, further research in this respect is warranted.