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Risky Behaviours and Responsibility-Sensitive Fairness in a Non Life-Threatening Health Case: A European Study

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  • Christine Le CLAINCHE
  • Jerome WITTWER

Abstract

Risky behaviours are found to substantially increase medical and social costs and mortality. In this paper, we document the extent to which a sample of European students (from Denmark, France, Italy and Sweden) consider that individuals should assume the financial burden of paying the costs of risky behaviour. Using an empirical social choice methodology, we test in a positive manner the acceptability of different ways of financing costs due to ill-health more or less associated with risky behaviour in accordance with a normative framework relating to responsibility-sensitive fairness. We particularly check the sensitivity of our sample to responsibility in a health context with questions that make it possible to clearly distinguish between risky behaviour under an individual’s control and circumstances beyond the individual’s control. The health conditions chosen in this study are not life-threatening, but the specific disease varies in different parts of the survey. We find that the majority of students approve of responsibility-sensitive fairness but that the specific health context, the type of risky behaviours involved, and the framing all matter as determinants of the choices made by the individuals of our sample in the financing of health care. We also find that students’ nationality has a small influence.

Suggested Citation

  • Christine Le CLAINCHE & Jerome WITTWER, 2012. "Risky Behaviours and Responsibility-Sensitive Fairness in a Non Life-Threatening Health Case: A European Study," Working Papers 12-18, LAMETA, Universtiy of Montpellier, revised Jun 2012.
  • Handle: RePEc:lam:wpaper:12-18
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    File URL: http://www.lameta.univ-montp1.fr/Documents/DR2012-18.pdf
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    References listed on IDEAS

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    1. Bossert W., 1996. "Redistribution mechanisms based on individual characteristics," Mathematical Social Sciences, Elsevier, vol. 31(1), pages 51-51, February.
    2. Schokkaert, Erik & Van de Voorde, Carine, 2004. "Risk selection and the specification of the conventional risk adjustment formula," Journal of Health Economics, Elsevier, vol. 23(6), pages 1237-1259, November.
    3. Cappelen, Alexander W. & Norheim, Ole Frithjof, 2006. "Responsibility, fairness and rationing in health care," Health Policy, Elsevier, vol. 76(3), pages 312-319, May.
    4. Fleurbaey, Marc, 2012. "Fairness, Responsibility, and Welfare," OUP Catalogue, Oxford University Press, number 9780199653591, June.
    5. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    6. Wulf Gaertner & Lars Schwettmann, 2007. "Equity, Responsibility and the Cultural Dimension," Economica, London School of Economics and Political Science, vol. 74(296), pages 627-649, November.
    7. Viscusi, W. Kip & Hersch, Joni, 2008. "The mortality cost to smokers," Journal of Health Economics, Elsevier, vol. 27(4), pages 943-958, July.
    8. Schokkaert, Erik & Capeau, Bart, 1991. "Interindividual Differences in Opinions about Distributive Justice," Kyklos, Wiley Blackwell, vol. 44(3), pages 325-345.
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