Séminaire GREDEG : Florence JUSOT (Université Paris Dauphine)

Title:Social Preferences in Health Care Financing: Evidence from the SOPHEA Survey
Auteurs : Béka Lomidze (Université de Bordeaux), Florence Jusot (Université Paris Dauphine), Jérôme Wittwer (Université de Bordeaux), Clémence Thébaut (Université de Limoges)

Abstract:

Equity in healthcare financing is one important objective of modern healthcare systems. In this regard, the vertical and horizontal equity principles are often considered as the relevant fairness concepts to assess equity in healthcare financing. However, little literature exists on the empirical assessment of the general population’s adherence to vertical and horizontal equity in financing. We aim to fill that gap by assessing the public’s adherence to the principle of horizontal equity in financing (HEHF) according to which healthcare financing must be independent from healthcare use, and vertical equity in healthcare financing (VEHF) which considers that individual contributions to health spending should be related to their ability to pay. Using an experimental survey with 4508 respondents representative of the French population, we measure adherence of the general population to the principle of HEHF and VEHF in the fields of both healthcare and long-term care. Leveraging the randomized nature of the survey, we find a strong preference for the principle of HEHF when healthcare costs differences are due to differences in severity of health status. Respondents deviate when healthcare costs differences are due to differences in hypothetical choices of providers. When hypothetical individuals differ both in healthcare costs and income, we find less adherence to HEHF while a significant share of respondents prefer budget allocation favoring people with low income.

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