# Which Patient do I treat? Economists and Physicians in the Lab Marlies Ahlert University Halle-Wittenberg Stefan Felder Universities of Duisburg-Essen.

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Which Patient do I treat? Economists and Physicians in the Lab Marlies Ahlert University Halle-Wittenberg Stefan Felder Universities of Duisburg-Essen and Basel Bodo VogtUniversity of Magdeburg

2 Research questions Elicitation of social preferences of indi-viduals deciding in allocation problems Choices more in line with utilitarian prin-ciples or more with some egalitarian rules? Framing effects (med vs. neutral)? Professional effects (physicians vs. economists)?

3 Overview 1.The allocation problem and possible solutions 2.Classification of distributors 3.Framing and professional effects 4.Who is being served and how much do they receive? 5.Conclusion

4 Economist / physician i = 0 Endowment: ECU / time R 7 recipients / patients i = 1,...,7 Recipients are differentiated acc. to - minimal needs m i - productivity / effectivity p i 1. Allocation problem

5 Payoff of recipient i The allocator decides about the ration of the resources each of the recipients i receives: r i

6 t: participation rateof the recipients‘ payoffs (20%) c : Fine for every recipient with zero payoff (50 ECU) „Induced“ preferences Payoff of the allocator:

7 Examples for allocation problems (3 out of 10) Ressource Endowments R  {1000, 1600}

8 Own payoff maximizer: Typ S (OPMA) Maximizes his own payoff, acts according to the induced preferences W S (  0,  1,...,  n ) =  0 Be i the most productive person, person k is being served if t  m k  p k > t  m k  p i - c. Residual endowment goes to the most productive individual 2. Classification of allocators (ideal types)

9 Modified dominance criterion for serving k: Hurdle is higher Utilitarian: Typ U (UA)

10 maximizes Priorization acc. to minimal need serves to overcome  i =0 If the residual endowment is not sufficient to serve a further person, the allocator is indifferent as to which person is being served and who receives the residual. Number maximizer: Typ N (NMA)

11 Priorization according ot minimal need (like NMA) Allocates the residual resources according to the leximin-criterion He serves persons with low m i  p i within the set of recipients Rawlsian: Typ R (RA)

12 Experimental design /1 10 treatments 1 distributor 7 potential recipients 10 x 7 choices for each distributor

13 Experimental design /2 17 Sessions with 136 students in total 2 different „framings“: neutral, medical 22 advanced medical students (8 in the neutral, 14 in the medical frame ) 36 students in economics (21 in the neutral, 15 in the medical frame ) MaXLab Magdeburg, elfe Essen

14 2. Classification of allocators Framing Economists neutral med.  Physicians neutral med.  S Max payoff 628112 123112 N Max number 10616246 022235 R Rawls 213347 not classified 224011

15 Type of allocators are more clearly revealed unter familiar conditions: - Economist in the neutral frame, Types S and N - Physicians in the medical frame, types N uad R in both frames, physician more clearly deviate from the induced direction (toward altruistic behavior) Economist deviate more from the induced direction in the neutral frame General observations tested for

16 3. Framing and professional effects

17 Hypothesis set 1 All allocators prioritize persons with low minimal need Typ S has a strong positive interest to serve persons with high productivity 5. Who is being served and by how much?

18 logit-model for positive payoffs of the recipients The endowment has a positive effect on the likelihood of being served All allocator serve those persons more likely who have a low minimial need (holds for types N and R) All allocator serve those persons more likely who have a high productivity (holds for types S and N 5. Who is being served and by how much?

19 5. Who is being served and by how much? Hypotheses set 2 Typ S und Typ N will serve those recipient extra, who show a high productivity Rawlsian will increase the extra ration for those, who have a long initial payoff

20 Size of allocation, given the payoff is positive

21 We are able to identify types, who systematically differ from each other Distributive norms show up more clearly under conditions familiar to the allocators (oec,oec; med,med) Productivity (+) und minimal need (-) influence the probability of being served Conclusion

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