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Attitudes of Germans towards distributive issues in the German health system

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  • Ahlert, Marlies
  • Pfarr, Christian

Abstract

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.

Suggested Citation

  • Ahlert, Marlies & Pfarr, Christian, 2014. "Attitudes of Germans towards distributive issues in the German health system," MPRA Paper 56881, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:56881
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    References listed on IDEAS

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    1. Corneo, Giacomo & Gruner, Hans Peter, 2002. "Individual preferences for political redistribution," Journal of Public Economics, Elsevier, vol. 83(1), pages 83-107, January.
    2. Timothy Smeeding & Gunther Schmaus & Brigitte Buhmann & Lee Rainwater, 1988. "Equivalence Scales, Well-Being, Inequality and Poverty: Sensitivity Estimates Across Ten Countries Using the LIS Database," LIS Working papers 17, LIS Cross-National Data Center in Luxembourg.
    3. Mathias Kifmann, 2005. "Health insurance in a democracy: Why is it public and why are premiums income related?," Public Choice, Springer, vol. 124(3), pages 283-308, September.
    4. Alberto Alesina & George-Marios Angeletos, 2005. "Fairness and Redistribution," American Economic Review, American Economic Association, vol. 95(4), pages 960-980, September.
    5. 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.
    6. Allan Meltzer & Scott Richard, 1983. "Tests of a rational theory of the size of government," Public Choice, Springer, vol. 41(3), pages 403-418, January.
    7. John C. Harsanyi, 1955. "Cardinal Welfare, Individualistic Ethics, and Interpersonal Comparisons of Utility," Journal of Political Economy, University of Chicago Press, vol. 63(4), pages 309-309.
    8. Alberto F. Alesina & Paola Giuliano, 2009. "Preferences for Redistribution," NBER Working Papers 14825, National Bureau of Economic Research, Inc.
    9. Greene,William H. & Hensher,David A., 2010. "Modeling Ordered Choices," Cambridge Books, Cambridge University Press, number 9780521194204, January.
    10. Elvire Guillaud, 2011. "Preferences for redistribution : an empirical analysis," Post-Print halshs-00594072, HAL.
    11. Harsanyi, John C, 1978. "Bayesian Decision Theory and Utilitarian Ethics," American Economic Review, American Economic Association, vol. 68(2), pages 223-228, May.
    12. Brigitte Buhmann & Lee Rainwater & Guenther Schmaus & Timothy M. Smeeding, 1988. "Equivalence Scales, Well‐Being, Inequality, And Poverty: Sensitivity Estimates Across Ten Countries Using The Luxembourg Income Study (Lis) Database," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 34(2), pages 115-142, June.
    13. 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.
    14. Miguel Gouveia, 1997. "Majority rule and the public provision of a private good," Public Choice, Springer, vol. 93(3), pages 221-244, December.
    15. repec:bla:revinw:v:34:y:1988:i:2:p:115-42 is not listed on IDEAS
    16. 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, November.
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    Cited by:

    1. Ahlert, Marlies & Pfarr, Christian, 2015. "The acceptance of priority criteria in health care: international evidence," MPRA Paper 64760, University Library of Munich, Germany.

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    Keywords

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    JEL classification:

    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
    • D71 - Microeconomics - - Analysis of Collective Decision-Making - - - Social Choice; Clubs; Committees; Associations
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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