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Attribute framing affects the perceived fairness of health care allocation principles


  • Eyal Gamliel
  • Eyal Peer


Health care resource allocation is a central moral issue in health policy, and opinions about it have been studied extensively. Allocation situations have typically been described and presented in a positive manner (i.e., who should receive medical aid). On the other hand, the negative valence allocation situation (i.e., who should not receive medical aid) has been relatively neglected. This paper demonstrates how positive versus negative framing of the exact same health care resource allocation situation can affect the perceived fairness of allocation principles. Participants usually perceived non-egalitarian principles (i.e., need, equity and tenure) to be fairer in positively framed situations (i.e., to deliver health care resources to certain patients) than negatively framed situation (i.e., not to deliver health care resources to other patients). However, framing did not affect the perceived fairness of the equality principle (i.e., a random draw). The paper offers a theoretical explanation for the effect of framing on the perceived fairness of health care resource allocation and discusses implications for both researchers and policy makers.

Suggested Citation

  • Eyal Gamliel & Eyal Peer, 2010. "Attribute framing affects the perceived fairness of health care allocation principles," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 5(1), pages 11-20, February.
  • Handle: RePEc:jdm:journl:v:5:y:2010:i:1:p:11-20

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    References listed on IDEAS

    1. Xavier Cuadras-Morató & José-Luis Pinto-Prades & José-María Abellán-Perpiñán, 2001. "Equity considerations in health care: the relevance of claims," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 187-205.
    2. Kahneman, Daniel & Tversky, Amos, 1979. "Prospect Theory: An Analysis of Decision under Risk," Econometrica, Econometric Society, vol. 47(2), pages 263-291, March.
    3. Levin, Irwin P & Gaeth, Gary J, 1988. " How Consumers Are Affected by the Framing of Attribute Information before and after Consuming the Product," Journal of Consumer Research, Oxford University Press, vol. 15(3), pages 374-378, December.
    4. Elster, Jon, 1989. "Social Norms and Economic Theory," Journal of Economic Perspectives, American Economic Association, vol. 3(4), pages 99-117, Fall.
    5. Ubel, Peter A. & Loewenstein, George, 1996. "Distributing scarce livers: The moral reasoning of the general public," Social Science & Medicine, Elsevier, vol. 42(7), pages 1049-1055, April.
    6. Julie Ratcliffe, 2000. "Public preferences for the allocation of donor liver grafts for transplantation," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 137-148.
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    Cited by:

    1. Ganegoda, Deshani B. & Folger, Robert, 2015. "Framing effects in justice perceptions: Prospect theory and counterfactuals," Organizational Behavior and Human Decision Processes, Elsevier, vol. 126(C), pages 27-36.


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