The Acceptance of Priority Criteria in Health Care: International Evidence

Abstract

Social health care systems around the world are inevitably confronted with the scarcity of resources and the resulting distributional challenges. Prioritization is applied in almost all countries, implicitly or explicitly, and shapes access to health services. We analyze and compare attitudes towards prioritization of medical treatments in a group of countries. The focus is on the criteria of age, the fact that a patient has or does not have young children or the fact that a patient is a strong smoker or a non-smoker. We use representative data from the International Social Survey Program (ISSP) of the year 2011 for nine countries (DE, US, GB, CH, NL, SE, NO, DK, AU). The empirical analysis reveals strong effects of socio-demographic factors and attitudes towards aspects of the health care system on individual’s acceptance of priority criteria. Among countries, Germans exhibit the highest aversion against priority setting whereas individuals from the US or GB are more in favor to prioritize according to the criteria smoking and age. However, a priority for patients with young children only receives support in Switzerland. Finally, we find evidence of egoistic motives for respondents’ acceptance of priority criteria.