Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/334670 
Year of Publication: 
2025
Series/Report no.: 
IZA Discussion Papers No. 18255
Publisher: 
Institute of Labor Economics (IZA), Bonn
Abstract: 
Health status can alter individuals' social preferences, and specifically individuals' preferences regarding fairness in the access to and financing of health care. We draw on a dataset of 73,452 individuals across 22 countries and a novel instrumental variable strategy that exploits variation in health status resulting from cross-country exposure to the national childhood Bacillus Calmette–Guérin (BCG) vaccination schedules. We document causal evidence consistent with the unhealthy self-interest hypothesis, which indicates that better health increases preferences for a fairer health care system. We estimate that a one-unit increase in self-reported health increases support for fair health care access by 11% and the willingness to support fair financing by 8%. Our findings suggest that improving population health, they may give rise to stronger support for interventions to improve equitable health system access and financing.
Subjects: 
health status
preferences for healthcare financing fairness
willingness to pay
social preferences
BCG vaccine
instrumental variables
JEL: 
I13
I14
I38
Document Type: 
Working Paper

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