Decision-makers' acquaintance with the public's priorities in health services

Background: Decision makers often assume they know the public's standpoints and see themselves as capable of representing them. The aim of this study is to assess the level of acquaintance that senior decision-makers in the Israeli health system have concerning the priorities of the public in whose name they act. Methods: A phone survey was conducted with a representative population sample and face-to-face interviews were conducted with senior decision-makers. Results: The decision-makers did predict correctly the public's desired level of government involvement in health care; but only some of them correctly predicted the public's preferences on allocation of funds-to health versus other areas. They had difficulty foreseeing public priorities for allocating additional monies to health, and even greater difficulty ascertaining preferences of the public for their own health insurance. Conclusions: Government decision-making processes should include evidence about public preferences. The findings of this study indicate that decision makers need to be provided with reliable, systematic information on public preferences.