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Is more health always better for society? Exploring public preferences that violate monotonicity

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  • Ignacio Abásolo
  • Aki Tsuchiya

Abstract

There has recently been some literature on the properties of a Health-Related Social Welfare Function (HRSWF). The aim of this article is to contribute to the analysis of the different properties of a HRSWF, paying particular attention to the monotonicity principle. For monotonicity to be fulfilled, any increase in individual health—other things equal—should result in an increase in social welfare. We elicit public preferences concerning trade-offs between the total level of health (concern for efficiency) and its distribution (concern for equality), under different hypothetical scenarios through face-to-face interviews. Of key interests are: the distinction between non-monotonic preferences and Rawlsian preferences; symmetry of HRSWF; and the extent of inequality neutral preferences. The results indicate strong support for non-monotonic preferences, over Rawlsian preferences. Furthermore, the majority of those surveyed had preferences that were consistent with a symmetric and inequality averse HRSWF. Copyright Springer Science+Business Media, LLC. 2013

Suggested Citation

  • Ignacio Abásolo & Aki Tsuchiya, 2013. "Is more health always better for society? Exploring public preferences that violate monotonicity," Theory and Decision, Springer, vol. 74(4), pages 539-563, April.
    • Handle: RePEc:kap:theord:v:74:y:2013:i:4:p:539-563
    DOI: 10.1007/s11238-011-9292-1
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    References listed on IDEAS

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    Cited by:

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    2. Joan Costa-Font & Frank Cowell, 2025. "Specific egalitarianism? Inequality aversion across domains," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 23(3), pages 749-775, September.
    3. Gibbs, Naomi & Powell, Philip A. & Tsuchiya, Aki, 2019. "Equal access for equal need: Eliciting public preferences for access to health treatment by employment status," Social Science & Medicine, Elsevier, vol. 222(C), pages 246-255.
    4. Daniel Nettle & Joe Chrisp & Elliot A. Johnson & Matthew T. Johnson, 2025. "What Do People Want From a Welfare System? Conjoint Survey Evidence From UK Adults," Poverty & Public Policy, John Wiley & Sons, vol. 17(2), June.
    5. David A Comerford & Angela Tufte-Hewett & Emma K Bridger, 2024. "Public preferences to trade-off gains in total health for health equality: Discrepancies between an abstract scenario versus the real-world scenario presented by COVID-19," Rationality and Society, , vol. 36(1), pages 66-92, February.
    6. Costa-Font, J.; & Cowell, F.;, 2019. "Incorporating Inequality Aversion in Health-Care Priority Setting," Health, Econometrics and Data Group (HEDG) Working Papers 19/04, HEDG, c/o Department of Economics, University of York.
    7. Attema, Arthur E. & Brouwer, Werner B.F. & l’Haridon, Olivier & Pinto, Jose Luis, 2015. "Estimating sign-dependent societal preferences for quality of life," Journal of Health Economics, Elsevier, vol. 43(C), pages 229-243.
    8. McNamara, Simon & Tsuchiya, Aki & Holmes, John, 2025. "Corrigendum to ‘Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment’ [Soc. Sci. Med. Volume 269, January 2021, 113573]," Social Science & Medicine, Elsevier, vol. 370(C).
    9. Anita Lal & Mohammad Siahpush & Marjory Moodie & Anna Peeters & Robert Carter, 2018. "Weighting Health Outcomes by Socioeconomic Position Using Stated Preferences," PharmacoEconomics - Open, Springer, vol. 2(1), pages 43-51, March.
    10. Gu, Yuanyuan & Lancsar, Emily & Ghijben, Peter & Butler, James RG & Donaldson, Cam, 2015. "Attributes and weights in health care priority setting: A systematic review of what counts and to what extent," Social Science & Medicine, Elsevier, vol. 146(C), pages 41-52.
    11. Richard Cookson & Shehzad Ali & Aki Tsuchiya & Miqdad Asaria, 2018. "E‐learning and health inequality aversion: A questionnaire experiment," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1754-1771, November.
    12. Simon McNamara & John Holmes & Abigail K. Stevely & Aki Tsuchiya, 2020. "How averse are the UK general public to inequalities in health between socioeconomic groups? A systematic review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(2), pages 275-285, March.
    13. Thomas Kourouxous & Thomas Bauer, 2019. "Violations of dominance in decision-making," Business Research, Springer;German Academic Association for Business Research, vol. 12(1), pages 209-239, April.

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    JEL classification:

    • D39 - Microeconomics - - Distribution - - - Other
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • I10 - Health, Education, and Welfare - - Health - - - General

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