Institute of Health Policy and Management, Erasmus University Rotterdam, The Netherlands.
Health Econ. 2011 Jan;20(1):111-9. doi: 10.1002/hec.1578.
We tested the influence of the growth in life expectancy over time on social time preferences for health. Growing life expectancy of future generations should raise social discount rates for health because of diminishing marginal utility of additional health gains and equity reasons reflecting the desire for a more equitable distribution of benefits over generations. This influence has, however, been largely ignored in empirical studies. We provide a first comprehensive analysis of how time preferences for health gains vary with projected growth rates, indicating the importance of subjective expectations about the growth in life expectancy in the elicitation of social time preference. Six hundred and fifty-six respondents, representative of the Dutch population, completed one of four questionnaires, differing in the projected growth in life expectancy. Results showed that individuals discount future health gains at different rates, depending on the latency period and on the projected or expected growth in life expectancy. As hypothesized, discount rates increased with higher growth rates. The association between observed discount rates and expectations regarding future life expectancy was confirmed, suggesting that discount rates for health may depend on future life expectancy. In light of our results, specifying life expectancy of future generations in time preference exercises appears appropriate.
我们测试了随着时间的推移，预期寿命的增长对健康社会时间偏好的影响。由于额外健康收益的边际效用递减和反映代际间利益更公平分配愿望的公平性原因，未来几代人的预期寿命增长应提高健康的社会贴现率。然而，这种影响在实证研究中基本上被忽视了。我们首次全面分析了健康收益的时间偏好如何随预期增长率而变化，这表明在社会时间偏好的启发中，对预期寿命增长的主观预期的重要性。656 名代表荷兰人口的受访者完成了四份问卷中的一份，这四份问卷在预期寿命的增长方面有所不同。结果表明，个人对未来健康收益的贴现率因潜伏期和预期或预计的预期寿命增长而有所不同。正如假设的那样，贴现率随着增长率的提高而增加。观察到的贴现率与对未来预期寿命的预期之间的关联得到了证实，这表明健康的贴现率可能取决于未来的预期寿命。根据我们的研究结果，在时间偏好练习中指定未来几代人的预期寿命似乎是合适的。
