Beyond borders, beyond bills: Unpacking the universal pain of medical expenditures

Medical expenditure poses a significant burden on individuals in developing countries. This study examines the dynamics of the pain of payment in the healthcare sector across India, Bangladesh, Sri Lanka, and Pakistan. The results show that positive price perception, negative price perception, participatory pricing mechanisms, pain at the time of payment, and the intention to avail of preventive measures have a significantly positive effect on the willingness to pay (WTP) medical expenditures. In contrast, perceived risk (PR) shows a significantly negative effect, indicating that WTP increases as PR decreases. This study enriches the existing literature by integrating adaptation level theory, consumer perceived risk theory, and consumer preference theory to explain individuals’ willingness to pay for medical expenses in 360 degrees. It also assists medical service providers in understanding both the WTP and the psychological pain incurred during medical spending, particularly among the middle-income group.