Healthy Self-Interest? Health Dependent Preferences for Fairer Health Care

Marcello Antonini and Joan Costa-i-Font
Authors registered in the RePEc Author Service: Joan Costa-i-Font

No 12243, CESifo Working Paper Series from CESifo

Abstract: Health status can alter individuals’ social preferences, and specifically individuals' preferences regarding fairness in the access to and financing of health care. If individuals follow a healthy self-interested rationale, health improvements are expected to weaken individuals' support for fairer health care financing and access, as they perceive reduced need for healthcare services. Conversely, if healthier people face a higher opportunity cost of deteriorating health, they may endorse fairer financing and access in anticipation of future health challenges—which we label as the 'unhealthy self-interest' hypothesis. We draw on a dataset of 73,452 individuals across 22 countries and a novel instrumental variable strategy that exploits variation in health status resulting from cross-country exposure to the national childhood Bacillus Calmette–Guérin (BCG) vaccination schedules. We document causal evidence consistent with the unhealthy self-interest hypothesis, which indicates that better health increases preferences for a fairer health care system. We estimate that a one-unit increase in self-reported health increases support for fair health care access by 11% and the willingness to support fair financing by 8%. Our findings suggest that improving population health, they may give rise to stronger support for interventions to improve equitable health system access and financing.

Keywords: health status; preferences for healthcare financing fairness; willingness to pay; social preferences; BCG vaccine; instrumental variables (search for similar items in EconPapers)
JEL-codes: I13 I14 I38 (search for similar items in EconPapers)
Date: 2025
New Economics Papers: this item is included in nep-hea and nep-ltv
References: Add references at CitEc
Citations:

Downloads: (external link)
https://www.ifo.de/DocDL/cesifo1_wp12243.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:ces:ceswps:_12243

Access Statistics for this paper

More papers in CESifo Working Paper Series from CESifo Contact information at EDIRC.
Bibliographic data for series maintained by Klaus Wohlrabe ().