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对健康不平等的厌恶——纯粹型、收入相关型与收入引致型

Aversion to health inequality — Pure, income-related and income-caused
Journal of Health Economics · 2024 · Robson, Matthew、O’Donnell, Owen、Van Ourti, Tom

中文摘要

我们设计了一个新颖的实验,将人们对纯粹(单变量)健康不平等的厌恶与对收入相关及收入引致健康不平等的厌恶区分开来加以识别。参与者通过分配资源来决定个体的健康状况。识别来源于资源生产率的随机变异,以及关于收入及其因果效应的信息。我们从英国成年人样本(n = 337)中收集数据(26,286个观测值),并在考虑噪声的情况下估计混合样本与参与者特定的社会偏好。中位数个体对纯粹健康不平等有强烈厌恶,这对经济评估中的健康最大化目标构成了挑战。当健康不平等与收入相关时,对其的厌恶更为强烈。然而,中位数个体对较贫困个体健康的优先考虑程度,低于收入相关健康不平等标准测量中的假设水平。平均而言,当已知低收入会导致健康不良时,对这种不平等的厌恶并不会变得更强。三类不平等厌恶均存在相当大的异质性。

Abstract

We design a novel experiment to identify aversion to pure (univariate) health inequality separately from aversion to income-related and income-caused health inequality. Participants allocate resources to determine health of individuals. Identification comes from random variation in resource productivity and information on income and its causal effect. We gather data (26,286 observations) from a sample of UK adults (n = 337) and estimate pooled and participant-specific social preferences while accounting for noise. The median person has strong aversion to pure health inequality, challenging the health maximisation objective of economic evaluation. Aversion to health inequality is even stronger when it is related to income. However, the median person prioritises health of poorer individuals less than is assumed in the standard measure of income-related health inequality. On average, aversion to that inequality does not become stronger when low income is known to cause ill-health. There is substantial heterogeneity in all three types of inequality aversion.
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