Involving the general public in priority setting: experiences from Australia

It takes a giraffe to see the big picture – Citizens' view on decision makers in health care rationing

“…Some studies indicate that citizens themselves believe they could have a role in rationing decisions (Bowling et al 1993, McIver 1998, while politicians are seldom mentioned as important actors (Bowling et al 1993, Wiseman et al 2003. Few studies have reported Swedish citizens' views on appropriate decision makers, but they show results similar to those mentioned above (Mossialos & King 1999, Rosén 2006, Werntoft et al 2007.…”

“…The dominant picture in previous research on this topic seems to be that citizens prefer physicians as decision makers for rationing in health care (Richardson et al 1992, Myllykangas et al 1996, Bowling 1996, Kneeshaw 1997, Busse 1999, Litva et al 2002, Wiseman et al 2003. Some studies indicate that citizens themselves believe they could have a role in rationing decisions (Bowling et al 1993, McIver 1998, while politicians are seldom mentioned as important actors (Bowling et al 1993, Wiseman et al 2003.…”

“…Litva et al (2002), distinguishing between three different levels, explained that citizens' views might vary according to the level being addressed. what rationing is all about (Wiseman et al 2003). Litva et al (2002) focus on public involvement in rationing and highlight the importance of specifying the decision level.…”

“…Thirdly, scholars have drawn attention to the differences in questions about citizens' willingness to participate in rationing processes (Bowling 1996, Mossialos & King 1999, Litva et al 2002, Lee et al 2002, Wiseman et al 2003. In the 1960s Arnstein pointed to the importance of clarifying the degree of participation, ranging from manipulation to real control (Arnstein 1969).…”

“…Traditionally, such studies (including those reporting from the Swedish context) have used closed questions where respondents were asked to choose between alternatives, e.g. physicians, politicians, patients, relatives, health service managers, health insurers, and the public (Bowling 1996, Busse 1999, King et al 1999, Dolan et al 1999, Mossialos & King 1999, Wiseman et al 2003, Rosén 2006, Werntoft et al 2007. Arguments…”