How do individuals and societies make such decisions about health in practice, and does economic research provide the right tools to inform and study such decision-making? In his dissertation, Stefan Lipman tries to answer these questions.
In economics, decisions about health are typically studied assuming they are made rationally. However, over the past decades the traditional economic view of rationality has been suggested to be highly unrealistic.
As most work challenging this view is based on financial decision-making, in the first part of his dissertation, Lipman extends some of these findings to health in a series of behavioral experiments. For example, he shows that many individuals are loss averse for health, i.e. they are more sensitive to health losses than to equally sized health gains. However, large differences exist between individuals’ decision-making tendencies. Policy makers aiming to improve decisions about health should, therefore, consider policies tailored to each individual. In his dissertation, Lipman explores such tailoring for exercise behavior.
Societal decisions about health are often informed by comparing the costs and benefits of some health intervention. Assessing these health benefits, however, requires some quantitative measure to express health in and adequate methods to facilitate such quantification. The second part of Lipman’s dissertation explores why two methods used for this valuation of health, typically yield different results. As in the first part of the dissertation, it appears that rather than assuming rationality, taking into account differences in individual decision-making could resolve the differences between methods

QALYs, decisions about health, loss aversion, behavioral experiments, standard gamble, time trade-off, probability weighting, utility curvature, reference-point
W.B.F. Brouwer (Werner) , A.E. Attema (Arthur)
Erasmus University Rotterdam
For copyright reasons there is a partial embargo for this dissertation
Erasmus School of Health Policy & Management (ESHPM)

Lipman, S.A. (2020, October 15). Decisions about Health Behavioral Experiments in Health with Applications to Understand and Improve Health State Valuation. Erasmus University Rotterdam. Retrieved from