Health-related externalities: evidence from a choice experiment.

Health-related external benefits are of potentially large importance for public policy. This paper investigates health-related external benefits using a stated-preference discrete-choice experiment framed in a health care context and including choice scenarios defined by six attributes related to a recipient and the recipient's condition: communicability, severity, medical necessity, relationship to respondent, location, and amount of contribution requested. Subjects also completed a set of own-treatment scenarios and a values-orientation instrument. We find evidence of substantial health-related external benefits that vary as expected with the scenario attributes and subjects' value orientations. The results are consistent with a number of hypotheses offered by the general theoretical analysis of health-related externalities and the analysis of externalities specific to health care.

[1]  P. Ubel,et al.  How stable are people's preferences for giving priority to severely ill patients? , 1999, Social science & medicine.

[2]  Henrik Andersson,et al.  Benevolence and the value of road safety. , 2009, Accident; analysis and prevention.

[3]  Erik Schokkaert,et al.  Identifying the warm glow effect in contingent valuation , 2003 .

[4]  Catherine C. Eckel,et al.  Rebates Versus Matching: Does How We Subsidize Charitable Contributions Matter? , 2003 .

[5]  K. Lancaster,et al.  Consumer Demand. A New Approach. , 1972 .

[6]  D. Messick,et al.  Motivational bases of choice in experimental games , 1968 .

[7]  C. Protière Distributing health care. Economic and ethical issues , 2004 .

[8]  J. Sonnemans,et al.  Value Orientations, Expectations and Voluntary Contributions in Public Goods. , 1996 .

[9]  M. Johannesson,et al.  Is Altruism Paternalistic? , 2007 .

[10]  Mark Dickie,et al.  Parental altruism and the value of avoiding acute illness: are kids worth more than parents? , 2004 .

[11]  G. Harrison,et al.  Identifying Altruism in the Laboratory , 2005 .

[12]  Theodore C. Bergstrom,et al.  When is a Man's Life Worth More Than His Human Capital? , 1982 .

[13]  J. Andreoni IMPURE ALTRUISM AND DONATIONS TO PUBLIC GOODS: A THEORY OF WARM-GLOW GIVING* , 1990 .

[14]  S. Gerking,et al.  Altruism and environmental risks to health of parents and their children , 2007 .

[15]  L. Borgquist,et al.  Caring externalities in health economic evaluation: how are they related to severity of illness? , 2005, Health policy.

[16]  Richard D. Smith Use, option and externality values: are contingent valuation studies in health care mis-specified? , 2007, Health economics.

[17]  P. Dolan,et al.  The measurement of individual utility and social welfare. , 1998, Journal of health economics.

[18]  Gregory L. Poe,et al.  Simple Computational Methods for Measuring the Difference of Empirical Distributions: Application to Internal and External Scope Tests in Contingent Valuation , 2001 .

[19]  A. Tsuchiya,et al.  Review of the literature , 1941, International Society of Hair Restoration Surgery.

[20]  M. Pauly Efficiency in the Provision of Consumption Subsidies , 1970 .

[21]  C. Lindsay Medical Care and the Economics of Sharing , 1969 .

[22]  W. Greene,et al.  计量经济分析 = Econometric analysis , 2009 .

[23]  K. Manfreda,et al.  Web Surveys versus other Survey Modes: A Meta-Analysis Comparing Response Rates , 2008 .

[24]  J. Bennett,et al.  Some Fundamentals of Environmental Choice Modelling , 2001 .

[25]  John B. Loomis,et al.  Computational Methods for Measuring the Difference of Empirical Distributions , 2005 .

[26]  L. Eeckhoudt,et al.  The economic value of informal care: a study of informal caregivers' and patients' willingness to pay and willingness to accept for informal care. , 2005, Health economics.

[27]  D. Hensher How do respondents process stated choice experiments? Attribute consideration under varying information load , 2006 .

[28]  A. Culyer,et al.  Externality Models and Health: A Ruckblick over the Last Twenty Years , 1980 .

[29]  R. Dawes,et al.  Linear models in decision making. , 1974 .

[30]  Jeremiah Hurley,et al.  An Overview of the Normative Economics of the Health Sector , 2000 .

[31]  Donald W. Griesinger,et al.  Toward a model of interpersonal motivation in experimental games , 1973 .

[32]  J K Hammitt,et al.  Mother's willingness to pay for her own and her child's health: a contingent valuation study in Taiwan. , 2000, Health economics.

[33]  R. Labelle,et al.  Implications of basing health-care resource allocations on cost-utility analysis in the presence of externalities. , 1992, Journal of health economics.

[34]  J. Richardson,et al.  Severity as an independent determinant of the social value of a health service , 2011, The European Journal of Health Economics.

[35]  임금자 OECD Health Data 2004로 본 우리나라 보건의료 현황 , 2004 .

[36]  E. Nord The trade-off between severity of illness and treatment effect in cost-value analysis of health care. , 1993, Health policy.

[37]  Joel Huber,et al.  A General Method for Constructing Efficient Choice Designs , 1996 .

[38]  Jeremiah Hurley,et al.  The cost-effectiveness of cash versus lottery incentives for a web-based, stated-preference community survey , 2012, The European Journal of Health Economics.

[39]  Robert D. Tortora,et al.  Response rate and measurement differences in mixed-mode surveys using mail, telephone, interactive voice response (IVR) and the Internet , 2009 .

[40]  K. Lancaster A New Approach to Consumer Theory , 1966, Journal of Political Economy.

[41]  T. Bergstrom Benefit-cost in a Benevolent Society , 2006 .

[42]  Stuart Mestelman,et al.  Hypothetical and convenience sample biases in value orientations ring games , 2010 .

[43]  B. Weisbrod Economics of Public Health: Measuring the Economic Impact of Diseases , 1961 .

[44]  D. Hensher,et al.  Stated Choice Methods: Analysis and Applications , 2000 .

[45]  F. Kuhfeld Efficient Experimental Designs Using Computerized Searches Warren , 2001 .

[46]  T. Schroeder,et al.  Are Choice Experiments Incentive Compatible? A Test with Quality Differentiated Beef Steaks , 2004 .

[47]  B. Berg,et al.  Individual responsibility and health-risk behaviour: A contingent valuation study from the ex ante societal perspective , 2011 .

[48]  John M. Rose,et al.  Applied Choice Analysis: A Primer , 2005 .

[49]  W. Viscusi,et al.  Altruistic and private valuations of risk reduction , 1988 .

[50]  Kenneth S. Chan,et al.  Department of Economics Working Paper Series Value Orientations, Income and Displacement Effects, and Voluntary Contributions Value Orientations, Income and Displacement Effects, and Voluntary Contributions , 2000 .

[51]  M. Jones-Lee Paternalistic Altruism and the Value of Statistical Life , 1992 .

[52]  D. Meltzer,et al.  Implications of spillover effects within the family for medical cost-effectiveness analysis. , 2005, Journal of health economics.

[53]  M. Jones-Lee Altruism and the value of other people's safety , 1991 .

[54]  D. McFadden Conditional logit analysis of qualitative choice behavior , 1972 .

[55]  Lana Friesen,et al.  The causes of order effects in contingent valuation surveys: An experimental investigation , 2008 .

[56]  J. Louviere,et al.  The Role of the Scale Parameter in the Estimation and Comparison of Multinomial Logit Models , 1993 .