Sustainability of Publicly Funded Health Care Systems: What Does Behavioural Economics Offer?
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LEADING ARTICLE
Sustainability of Publicly Funded Health Care Systems: What Does Behavioural Economics Offer? Luke B. Connelly1,2 · Stephen Birch1,3
© Springer Nature Switzerland AG 2020
Abstract There has been a rapid increase in the use of behavioural economics (BE) as a tool for policy makers to deploy, including in health-related applications. While this development has occurred over the past decade, health care systems have continued to struggle with escalating costs. We consider the potential role of BE for making improvements to health care system performance and the sustainability of publicly funded health care systems, in particular. We argue that the vast majority of applications in this field have been largely focussed on BE and public health, or the prevailing level of risks to health in populations, and with policy proposals to ‘nudge’ individual behaviour (e.g. in respect of dietary choices). Yet, improvements in population health may have little, if any, impact on the size, cost or efficiency of health care systems. Few applications of BE have focussed on the management, production, delivery or utilisation of health care services per se. The latter is our focus in this paper. We review the contributions on BE and health care and consider the potential for complementing the considerable work on BE and public health with a clear agenda for behavioural health care economics. This agenda should complement the work of conventional microeconomics in the health care sector.
1 Introduction The use of behavioural economics (BE) as a tool for policy makers has rapidly increased over the last decade, with governments introducing BE teams to inform policy proposals for a range of activities across various sectors of the economy, including the health sector [1, 2]. We consider the potential role of BE in improving health care system performance and the sustainability of publicly funded health care systems. We focus exclusively on health care—as opposed to more general ‘public health’ interventions—and the role that BE has played, and could play, in attempts to improve the efficiency and sustainability of health care systems. * Stephen Birch [email protected] Luke B. Connelly [email protected] 1
Centre for the Business and Economics of Health, The University of Queensland, Sir Llew Edwards Building, Level 5, St Lucia, Brisbane, QLD 4072, Australia
2
Department of Sociology and Business Law, The University of Bologna, Strada Maggiore 45, 40126 Bologna, Italy
3
Manchester Centre for Health Economics, The University of Manchester, Oxford Road, Manchester M13 9PL, England, UK
Key Points for Decision Makers Behavioural economics (BE) offers insights that complement those from traditional microeconomics, including health economics. The main insights of BE come from observations of the cognitive biases that may lead people to make choices that are inconsistent with their ‘deliberative preferences’. While there is evidence that policy makers are generally supportive of BE measures, such as
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