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

Marcello Antonini and Joan Costa-Font
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Marcello Antonini: LSE

No 18255, IZA Discussion Papers from Institute of Labor Economics (IZA)

Abstract: Health status can alter individuals’ social preferences, and specifically individuals' preferences regarding fairness in the access to and financing of health care. 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: willingness to pay; social preferences; instrumental variables; BCG vaccine; preferences for healthcare financing fairness; health status (search for similar items in EconPapers)
JEL-codes: I13 I14 I38 (search for similar items in EconPapers)
Date: 2025-11
New Economics Papers: this item is included in nep-hea and nep-ltv
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Published - published in: Journal of Economic Behaviour and Organsiation , 28 November 2025

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Working Paper: Healthy Self-Interest? Health Dependent Preferences for Fairer Health Care (2025)
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