Eliciting Preferences for Collectively Financed Health Programmes: the Willingness to Assign Approach

Improving public involvement in health system decision making stands as a primary goal in health systems reform. However, still limited evidence is found on how best to elicit preferences for health care programs. This paper examines a contingent choice technique to elicit preferences among health programs so called, willingness to assign (WTAS). Moreover, we elicited contingent rankings as well as the willingness to pay extra taxes for comparative purposes. We argue that WTAS reveals relative (monetary-based) values of a set of competing public programmes under a hypothetical healthcare budget assessment. Experimental evidence is reported from a deliberative empirical study valuing ten health programmes in the context of the Catalan Health Service. Evidence from a our experimental study reveals that preferences are internally more consistent and slightly less affected by preference reversals as compared to values revealed from the willingness to pay (WTP) extra taxes approach. Consistent with prior studies, we find that the deliberative approach helped to avoid possible misunderstandings. Interestingly, although programmes promoting health received the higher relative valuation, those promoting other health benefits also ranked highly.