Preferences for Containing Growing Health Care Costs: Evidence from Four OECD Countries

Background: Growing health care cost has been a crucial issue for the governments of advanced democracies in the past decades. Policymakers can decide to allocate more resources to health care to pay for these rising costs or to impose cost containment measures within the health care sector to constrain them. Objectives: This article analyzes public preferences for reforms surrounding growing health care costs. Methods: The study relies on an original survey conducted in four OECD countries representing different types of health care systems. Respondents were asked to choose between the allocation of more resources to the health care system (with higher taxes or contributions or user fees) or cutbacks in curative care or prevention. Results: We find that in the four countries, respondents who are satisfied with health care are more likely to accept increasing taxes or contributions to avoid cuts. Our comparative analysis reveals interesting cross-country differences. We find strong associations between support for center-left parties and preferences for higher taxes to avoid cutbacks to the health sector. However, this association is present only in the two National Health Services systems of Canada and England and not in the two Social Health Insurance systems of Germany and Switzerland. Conclusions: A regressive health care funding system reduces support for the allocation of additional resources to avoid cutbacks, while contributory funding reduces the politicization of health care. Increasing satisfaction with health care should increase public support for the allocation of more ressources into the health care system.