My Life for a Voice: The Influence of Voice on Health-Care Decisions

Abstract

Are people willing to give up affordable healthcare and future years of their lives in exchange for having a voice in healthcare decision-making? Drawing upon research on the psychology of justice, we claim that the fairness of healthcare decision-making procedures, expressed by the availability of voice, can be more important than critical health related outcomes. We examined this proposition using a forced choice paradigm that required participants to choose between voice and better healthcare outcomes (affordable healthcare and greater life expectancy). Findings from three studies revealed that people maintain a strong preference for voice even at the expense of tangible healthcare outcomes. In study 1, participants preferred a healthcare plan that offered them a voice when it was $3,000 to $12,000 more costly than a plan that did not offer such voice privileges. In study 2, participants preferred a voice plan to a no-voice plan when the no-voice plan was 5 to 20 years greater in its average life expectancy compared with the voice plan. In study 3, which used a more demographically diverse, non-student sample, the preference for the voice plan persisted across all conditions, even when the no-voice plan was 25 years greater in its life expectancy, and even when participants expected to personally live longer under the no-voice plan. These results are explained by participants’ expectation to enjoy better personal healthcare outcomes and greater autonomy when afforded voice. These findings demonstrate the importance of voice in hypothetical decision-making relevant to policy-making.

Keywords: Procedural Justice; Voice; Tradeoffs; Healthcare