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Attitudes of Germans towards distributive issues in the German health system

  • Ahlert, Marlies
  • Pfarr, Christian

Social health care systems are inevitably confronted with the scarcity of resources and the resulting distributional challenges. Since prioritization implies distributional effects, decisions on respective rules should take citizens’ preferences into account. Thus, knowledge about citizens’ attitudes and preferences regarding different distributional issues implied by the type of financing health care is necessary to judge the public acceptance of a health system. In this study we concentrate on two distributive issues in the German health system: First, we analyse the acceptance of prioritizing decisions concerning the treatment of certain patient groups, in this case patients who all need a heart operation. Here we focus on the fact that a patient is strong smoker or a non-smoker, the criteria of age or the fact that a patient has or does not have young children. Second, we investigate Germans’ opinions towards income dependent health services. The results reveal strong effects of individuals’ attitudes regarding general aspects of the health system on priorities, e.g. that individuals behaving health demanding should not be preferred. In addition, experiences of limited access to health services are found to have a strong influence on citizens’ attitudes, too. Finally, decisions about different prioritization criteria are found to be not independent.

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Paper provided by University Library of Munich, Germany in its series MPRA Paper with number 56881.

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Date of creation: Jun 2014
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Handle: RePEc:pra:mprapa:56881
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  1. Alberto F. Alesina & Paola Giuliano, 2009. "Preferences for Redistribution," NBER Working Papers 14825, National Bureau of Economic Research, Inc.
  2. Green, Colin, 2009. "Investigating public preferences on 'severity of health' as a relevant condition for setting healthcare priorities," Social Science & Medicine, Elsevier, vol. 68(12), pages 2247-2255, June.
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  7. Elvire Guillaud, 2013. "Preferences for redistribution: an empirical analysis over 33 countries," Journal of Economic Inequality, Springer, vol. 11(1), pages 57-78, March.
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  10. Marlies Ahlert & Katja Funke & Lars Schwettmann, 2013. "Thresholds, productivity, and context: an experimental study on determinants of distributive behaviour," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 40(4), pages 957-984, April.
  11. Luigi Siciliani & Rossella Verzulli, 2009. "Waiting times and socioeconomic status among elderly Europeans: evidence from SHARE," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1295-1306.
  12. Harsanyi, John C, 1978. "Bayesian Decision Theory and Utilitarian Ethics," American Economic Review, American Economic Association, vol. 68(2), pages 223-28, May.
  13. Álvarez, Begoña & Rodríguez-Míguez, Eva, 2011. "Patients' self-interested preferences: Empirical evidence from a priority setting experiment," Social Science & Medicine, Elsevier, vol. 72(8), pages 1317-1324, April.
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  16. Dolan, Paul & Tsuchiya, Aki, 2005. "Health priorities and public preferences: the relative importance of past health experience and future health prospects," Journal of Health Economics, Elsevier, vol. 24(4), pages 703-714, July.
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