Abstract
BackgroundDecision makers often assume they know the public’s standpoints and see themselves as capable of representing them.The aim of this study is to assess the level of acquaintance that senior decision-makers in the Israeli health system have concerning the priorities of the public in whose name they act.MethodsA phone survey was conducted with a representative population sample and face-to-face interviews were conducted with senior decision-makers.ResultsThe decision-makers did predict correctly the public’s desired level of government involvement in health care; but only some of them correctly predicted the public’s preferences on allocation of funds—to health versus other areas. They had difficulty foreseeing public priorities for allocating additional monies to health, and even greater difficulty ascertaining preferences of the public for their own health insurance.ConclusionsGovernment decision-making processes should include evidence about public preferences. The findings of this study indicate that decision makers need to be provided with reliable, systematic information on public preferences.
Highlights
Decision makers often assume they know the public’s standpoints and see themselves as capable of representing them
Priority setting in a state of limited resources is an economic challenge, as well as a political conundrum
Politicians tend to avoid explicit rationing of social services, health services, or tend to transfer responsibility to others in order to avoid taking responsibility for unpopular choices [4]. Both priority setting and health care decisions related to rationing require making difficult choices between noble alternatives that may result in denying
Summary
Decision makers often assume they know the public’s standpoints and see themselves as capable of representing them. Politicians tend to avoid explicit rationing of social services, health services, or tend to transfer responsibility to others (such as expert committees or HMOs) in order to avoid taking responsibility for unpopular choices [4]. Both priority setting and health care decisions related to rationing require making difficult choices between noble alternatives that may result in denying. Decision makers should be interested in understanding the public’s priorities, both because in a democracy public policy should serve the public and because a policy that is not acceptable to the public will be more difficult to implement. Policymakers and politicians must find ways of gauging, interpreting, and maneuvering within or around public opinion
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