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Public Preferences For Responsibility Versus Public Preferences For Reducing Inequalities

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  • Richard Edlin
  • Aki Tsuchiya
  • Paul Dolan

Abstract

In cost‐utility analysis, the numbers of quality‐adjusted life years (QALYs) gained are aggregated by placing the same weight on each QALY. Deviations from this rubric have been proposed on a number of grounds, including the degree to which persons might be deemed responsible for the illness faced, and inequality in lifetime health between groups. Most research has looked at these factors in isolation. This paper analyses public preferences about the relative importance of these factors. Over 500 members of the general public in the UK are interviewed in their homes. Where “blameworthy” groups experience a moderate drop in quality of life due to their behaviour, they appear to receive higher priority than an otherwise “trustworthy” group if they also experience poorer health prospects because the latter is weighted more heavily than the former. Copyright © 2011 John Wiley & Sons, Ltd.

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  • Richard Edlin & Aki Tsuchiya & Paul Dolan, 2012. "Public Preferences For Responsibility Versus Public Preferences For Reducing Inequalities," Health Economics, John Wiley & Sons, Ltd., vol. 21(12), pages 1416-1426, December.
  • Handle: RePEc:wly:hlthec:v:21:y:2012:i:12:p:1416-1426
    DOI: 10.1002/hec.1799
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    References listed on IDEAS

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    1. Aki Tsuchiya & Richard Edlin & Paul Dolan, 2009. "Measuring the societal value of lifetime health," Working Papers 2009010, The University of Sheffield, Department of Economics, revised May 2009.
    2. Alan Williams, 1997. "Intergenerational Equity: An Exploration of the ‘Fair Innings’ Argument," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 117-132, March.
    3. Dolan, Paul & Tsuchiya, Aki, 2009. "The social welfare function and individual responsibility: Some theoretical issues and empirical evidence," Journal of Health Economics, Elsevier, vol. 28(1), pages 210-220, January.
    4. Dolan, Paul & Tsuchiya, Aki, 2009. "Corrigendum to "The social welfare function and individual responsibility: Some theoretical issues and empirical evidence" [J. Health Econ. 28 (2009) 210-220]," Journal of Health Economics, Elsevier, vol. 28(3), pages 758-759, May.
    5. Nord, Erik & Richardson, Jeff & Street, Andrew & Kuhse, Helga & Singer, Peter, 1995. "Maximizing health benefits vs egalitarianism: An Australian survey of health issues," Social Science & Medicine, Elsevier, vol. 41(10), pages 1429-1437, November.
    6. Dolan, Paul & Olsen, Jan Abel, 2001. "Equity in health: the importance of different health streams," Journal of Health Economics, Elsevier, vol. 20(5), pages 823-834, September.
    7. Aki Tsuchiya, 2000. "QALYs and ageism: philosophical theories and age weighting," Health Economics, John Wiley & Sons, Ltd., vol. 9(1), pages 57-68, January.
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    Cited by:

    1. Matthew Robson & Miqdad Asaria & Richard Cookson & Aki Tsuchiya & Shehzad Ali, 2017. "Eliciting the Level of Health Inequality Aversion in England," Health Economics, John Wiley & Sons, Ltd., vol. 26(10), pages 1328-1334, October.
    2. 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.
    3. McNamara, Simon & Tsuchiya, Aki & Holmes, John, 2021. "Does the UK-public's aversion to inequalities in health differ by group-labelling and health-gain type? A choice-experiment," Social Science & Medicine, Elsevier, vol. 269(C).
    4. Joan Costa-i-Font & Frank Cowell, 2019. "Incorporating Inequality Aversion in Health-Care Priority Setting," CESifo Working Paper Series 7503, CESifo.
    5. 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.
    6. Micaela Pinho & Anabela Botelho, 2018. "Inference Procedures to Quantify the Efficiency–Equality Trade-Off in Health from Stated Preferences: A Case Study in Portugal," Applied Health Economics and Health Policy, Springer, vol. 16(4), pages 503-513, August.
    7. 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.

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