Responsibility-sensitive welfare weights for health

Abstract

We estimate welfare weights for health to facilitate program evaluation allowing for aversion to health inequality and to health inequity by three non-health characteristics. In a UK general population sample, 569 online experiment participants distribute constrained resources to determine the health of hypothetical individuals distinguished by randomly generated resource productivity as well as sex, income and smoking (41,460 observations). We elicit beliefs about responsibility for income and smoking, and use their associations with the allocations to estimate responsibility-sensitive weights for health by those two characteristics. We find weak prioritisation of females' health, moderate prioritisation of the health of poorer individuals and strong prioritisation of the health of non-smokers over that of smokers. Substantial aversion to health inequality lowers weights on females and non-smokers, who are health-advantaged, and raises the weight on the poor, who are health-disadvantaged. As beliefs about responsibility for income and smoking strengthen, weights on the poor decrease and weights on non-smokers significantly increase.

Keywords: Cost-effectiveness analysis; Equity; Ethical preferences; Experiment; Inequality aversion; Prioritisation.