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

Would people be willing to give up affordable healthcare plans and years of their future lives to have a voice in the healthcare decision-making process? Drawing on research on the psychology of justice we claim that the fairness of decision making procedures expressed by availability of voice can be more important than health related outcomes.
To examine the effect of voice vs. favorable health related outcomes we used a forced choice paradigm that requires participants to choose between having voice in the decision making process and desired health related outcomes (more affordable healthcare plans and greater life expectancy). Our findings revealed that voice had a strong influence on healthcare decisions. Participants preferred the health care plan that offered voice over a no voice plan when the no voice plan was cheaper by $3,000 to $21,000 than the voice plan and even when the no voice plan was greater from 5 to 20 years in its life expectancy compared with the voice plan. Moreover, participants preferred the voice plan even when they predicted that they would live longer (on average) under the no voice plan. These findings demonstrate that the psychological importance of voice emerges not only in post hoc interactions with authorities but also in ex-ante policy and political decisions.