Personal needs versus national needs: public attitudes regarding health care priorities at the personal and national levels

Self Cite

BackgroundDecision makers often assume they know the public’s standpoints and see themselves as capable of representing them.The aim of this study is to assess the level of acquaintance that senior decision-makers in the Israeli health system have concerning the priorities of the public in whose name they act.MethodsA phone survey was conducted with a representative population sample and face-to-face interviews were conducted with senior decision-makers.ResultsThe decision-makers did predict correctly the public’s desired level of government involvement in health care; but only some of them correctly predicted the public’s preferences on allocation of funds—to health versus other areas. They had difficulty foreseeing public priorities for allocating additional monies to health, and even greater difficulty ascertaining preferences of the public for their own health insurance.ConclusionsGovernment decision-making processes should include evidence about public preferences. The findings of this study indicate that decision makers need to be provided with reliable, systematic information on public preferences.

“…The phone interviews were conducted during June-August 2008 and were carried out in Hebrew, Arabic and Russian. The total response rate was 36 % [ 6 , 7 ].…”

Section: Methodsmentioning

confidence: 99%

Decision-makers’ acquaintance with the public’s priorities in health services

Kaplan

Baron‐Epel

2016

Self Cite

“…With the help of technocratic evaluative approaches [ 5 ], together with visible political mechanisms for decision making [ 6 , 7 ], politicians have, in some countries, bitten this large size bullet. The media and the public, while not always happy with the predicament or the decisions, is becoming accustomed and accepting of the need to set limits [ 6 – 8 ]. It is in this context that the appearance of a drug that is hugely expensive but also highly effective for a sizeable group of patients, is dealt with by national health systems.…”

mentioning

confidence: 99%

Expensive lifesaving treatments: allocating resources and maximizing access

Nissanholtz-Gannot

Chinitz

2018

Avisar et al. present an exemplary model for outreach aimed at ensuring that a maximum of patients eligible for expensive Hepatitis C (HPC) drugs receive treatment. We enlarge the picture to put their model in the political, economic and regulatory framework for financing and providing these drugs in Israel and a number of other countries. We then return to delivery system level and consider issues such as cost of outreach, the need for health care coordinators and dealing with Hepatitis C patients not yet entitled to receive the drugs under national health coverage determinations.Regarding national coverage decisions, we find that countries such as Australia, New Zealand, the United Kingdom and Israel all extended coverage for Hepatitis C drugs, given the clear high effectiveness of the latter. However, to limit budget impact, all these countries target coverage to patients based on disease genotype and stage.The model presented by Avisar et al., while impressive, leaves some items to address. These include: whether all resources allocated to HPC drugs are actually used for this purpose, the roles of outreach to HPC patients who do not meet the guidelines for treatment, and a comparison of the effectiveness of the model vs. a variety of costs associated with it.

Public attitudes and values in priority setting

Peacock

2015

There is growing recognition that critical decisions concerning investments in new health care technologies and services should incorporate society’s values along with the scientific evidence. From a normative perspective, public engagement can help realize the democratic ideals of legitimacy, transparency, and accountability. On a more pragmatic level, public engagement can help stakeholders understand the degree of popular support for policy options, and may enhance public trust in decision-making processes. To better understand public attitudes and values relating to priority setting in health care, researchers and decision-makers will have to employ a range of quantitative and qualitative approaches, drawing on different disciplines and methodological traditions.