Working Paper

Public Policies

Alicia Adsera, Andreu Arenas, Carles Boix

2024/17: The value of public health

We estimate the value of a public health system exploiting a conjoint experiment in nationally representative surveys in Brazil, France and the United States in which respondents choose between different societies that randomly vary in their economic outcomes (country income, income inequality, social mobility), political outcomes (public healthcare, democracy), and the level of personal income for each respondent. This allows us to estimate the respondents’ willingness to trade off publicly provided healthcare for individual income as well as other societal attributes. We find that, on average, individuals have a strong preference for a public health system. They would need a large increase, equal to two times the average income of the country in France, and equal to 50% of the average income of the country in Brazil and the US. Most respondents support public healthcare and they do it with more intensity than its opponents. Demand for state-provided healthcare is largely driven by other-regarding preferences. Respondents that think that poverty is the outcome of luck or lack of connections, and those who lean to the political left and believe the world is zero-sum are more likely to support a public health system. Demographic traits seem uncorrelated with support for a public health system – with the exception of household wealth, which is associated with lower levels of support in France and the US.