title: Attitudes of Germans towards distributive issues in the German health system.
abstract: Social health care systems are inevitably confronted with the scarcity of resources and the resulting distributional challenges. Since prioritization implies distributional effects, decisions regarding respective rules should take citizens' preferences into account. In this study we concentrate on two distributive issues in the German health system: firstly, we analyze the acceptance of prioritizing decisions concerning the treatment of certain patient groups, in this case patients who all need a heart operation. We focus on the patient criteria smoking behavior, age and whether the patient has or does not have young children. Secondly, we investigate Germans' opinions towards income-dependent health services. The results reveal the strong effects of individuals' attitudes regarding general aspects of the health system on priorities, e.g. that individuals with an unhealthy lifestyle should not be prioritized. In addition, experience of limited access to health services is found to have a strong influence on citizens' attitudes, too. Finally, decisions on different prioritization criteria are found to be not independent.
authors.affiliation: Department of Economics, Microeconomics and Public Finance, Martin-Luther-University of Halle Wittenberg, Halle (Saale), Germany.
authors.forename: Marlies
authors.initials: M
authors.lastname: Ahlert
authors.affiliation: Department of Law and Economics, Institute of Public Finance, University of Bayreuth, Bayreuth, Germany. christian.pfarr@uni-bayreuth.de.
authors.forename: Christian
authors.identifier: http://orcid.org/0000-0003-4828-2732
authors.initials: C
authors.lastname: Pfarr
mesh_terms: D000328:Adult; D000368:Aged; D003695:Delivery of Health Care; D005260:Female; D005858:Germany; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006285:Health Planning; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011787:Quality of Health Care
keywords: Distributive preferences; Health care priority setting; Quality of health care