Eliciting preferences for collectively financed health programmes: the 'willingness to assign' approach

Improving public involvement in health system decision making stands as a primary health policy goal. However, still limited guidance is available on how best to elicit preferences for health care programmes. This study examines a contingent choice technique to elicit preferences among health programmes, and named 'willingness to assign' (WTAS). WTAS reveals relative (monetary-based) values of a set of competing public programmes under a hypothetical healthcare budget assessment. Experimental evidence is reported from a deliberative empirical study valuing ten health programmes in the context of the Catalan Health Service. Evidence from this experimental study reveals that within the context of multiple programmes, preferences are internally more consistent and slightly less affected by 'preference reversals' as compared to values revealed from an adapted technique eliciting the willingness to pay (WTP) extra taxes. Another finding suggests that although programmes promoting health received the higher relative valuation, those promoting other health benefits were valued highly.