How Stable Are Individual Preferences for Health Expenditure in Germany?

TL;DR

This study explores how stable people's preferences for healthcare spending are in Germany, even during the pandemic, and finds that while preferences are stable, they differ from actual spending.

Contribution

The study introduces a novel experimental approach to assess the stability of healthcare expenditure preferences before and during the pandemic.

Findings

Preferences for healthcare expenditure allocation remain stable despite the pandemic.

There are significant discrepancies between individual preferences and actual healthcare spending.

Satisfaction with the healthcare system remains high and stable.

Abstract

Background/Objectives: This study analyzed the stability of individual preferences for the allocation of expenditure in the healthcare system using an experimental setting. Understanding these preferences can support policy decisions aimed at achieving a more needs-based allocation of scarce resources in healthcare systems. Stability in preferences might be essential in order to avoid frequent legislative changes and can potentially enhance public satisfaction with the healthcare system. Methods: Individual preferences were assessed through two questionnaire-based experimental studies conducted before and after the COVID-19 pandemic, each with about 160 participants, in the context of a healthcare seminar in the MaxLab of the Otto-von-Guericke-University Magdeburg, Germany. This study was intended as a preliminary study for a larger follow-up panel study. In particular, the questionnaire contained questions regarding satisfaction with the healthcare system, optimization options, possible maximum contributions, and preferences for the allocation of notional healthcare budget and research funds in order to provide initial evidence regarding the stability of such preferences. As the data were collected both before and after the COVID-19 pandemic, this significant change in the situation helps to provide clear indications of stability. The preferences collected were compared to the actual allocation of expenditure derived from official statistics in order to identify potential areas for policy adjustment. Results: Preferences for the allocation of healthcare expenditure appear to be relatively stable despite the effects of the pandemic. However, noticeable discrepancies exist between individual preferences and actual healthcare spending. Satisfaction with the healthcare system also remains relatively stable at a high level. Conclusions: Overall, the scientific measurement of public preferences could support more informed political decision-making and contribute to sustained satisfaction with the healthcare system. In particular, the distribution of funds to different disease categories should be adjusted on the basis of such preferences, taking into account the respective medical indications after representative regular surveys have been carried out.

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