A note on eliciting distributive preferences for health.

While in theory the strength of preferences for equity in health can be expressed in an 'inequality aversion parameter', in practice, analysts would have to obtain them from people's choices. We are faced with a number of methodological problems when turning to this type of empirical research. This note investigates which types of preference could explain the choices people make when responding to equity-efficiency questions of this kind. Respondents may be heavily influenced by concerns that are not related to their equity preferences, something which may lead them to choose distributions that are not consistent with models on the equity-efficiency trade-off. Specifically, a threshold effect is identified, which could explain why some people would rather prefer to concentrate than to diffuse health gains. The second aim of this note is to offer some lessons from a survey which was designed for eliciting people's distributive preferences for health gains.