Estimating Public Preferences on Population Health Ethics

We develop a social choice experiment to estimate public preferences on population ethics. Our experiment poses three within-subject treatments in which participants allocate scarce resources to determine the health-related quality-of-life, and existence, of two population groups. Within a flexible social welfare function, we estimate participant-level preferences for inequality aversion, average vs total welfare maximisation, and minimum `critical level' thresholds. By combining random behavioural and random utility models we also explicitly model `noise' in decision making. Using a sample of British adults (n=115, obs.=5,060), we find that 98.7% of respondents are inequality averse, prioritising the worst-off at the expense of efficiently maximising overall health. The modal group of participants (39.2%) maximise total welfare and have a critical level threshold of zero, however there is extensive heterogeneity in participants' population preferences. We then demonstrate how these preferences can aid policymaking, where difficult trade-offs emerge between equity and efficiency, average and total welfare, and population size.