Skip to main content
    • Aa
    • Aa

Value congruence in health care priority setting: social values, institutions and decisions in three countries

  • Claudia Landwehr (a1) and Dorothea Klinnert (a1)

Most developed democracies have faced the challenge of priority setting in health care by setting up specialized agencies to take decisions on which medical services to include in public health baskets. Under the influence of Daniels and Sabin’s seminal work on the topic, agencies increasingly aim to fulfil criteria of procedural justice, such as accountability and transparency. We assume, however, that the institutional design of agencies also and necessarily reflects substantial value judgments on the respective weight of distributive principles such as efficiency, need and equality. The public acceptance of prioritization decisions, and eventually of the health care system at large, will ultimately depend not only on considerations of procedural fairness, but also on the congruence between a society’s values and its institutions. We study social values, institutions and decisions in three countries (France, Germany and the United Kingdom) in order to assess such congruence and formulate expectations on its effects.

Corresponding author
*Correspondence to: Prof. Claudia Landwehr, Department of Political Science, Johannes Gutenberg-University Mainz, 55099 Mainz, Germany. Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

K. Böhm , C. Landwehr and N. Steiner (2014), ‘What explains ‘‘generosity’’ in the public financing of high-tech drugs?’, Journal of European Social Policy, 24(1): 3955.

A. J. Culyer and A. Wagstaff (1993), ‘Equity and equality in health and health care’, Journal of Health Economics, 12: 431457.

N. Daniels and J. E. Sabin (1997), ‘Limits to health care: fair procedures, democratic deliberation, and the legitimacy problem for insures’, Philosophy and Public Affairs, 26(4): 303350.

C. Landwehr and K. Böhm (2011), ‘Delegation and institutional design in health care rationing’, Governance, 24(4): 665688.

P. Littlejohns , T. Sharma and K. Jeong (2012), ‘Social values and health priority setting in England: “values” based decision making’, Journal of Health Organization and Management, 26(3): 363371.

P. Littlejohns , K. Yeung , S. Clark and A. Weale (2012), ‘A proposal for a new social values research program and policy network’, Journal of Health Organization and Management, 26(3): 407421.

T. M. Moe (2005), ‘Power and political institutions’, Perspectives on Politics, 3(2): 215233.

E. Nord (1999), Cost Value Analysis in Health Care: Making Sense out of QALYs, Cambridge: Cambridge University Press.

V. A. Schmidt (2013), ‘Democracy and legitimacy in the european union revisited: input, output and ‘‘throughput’’’, Political Studies, 61(1): 222.

A. Sen (2002), ‘Why health equity?’, Health Economics, 11: 659666.

C. Zimmermann (2012), ‘Der Gemeinsame Bundesausschuss: Normsetzung durch Richtlinien sowie Integration neuer Untersuchungs-und Behandlungsmethoden in den Leistungskatalog der GKV’, Berlin/Heidelberg: Springer Verlag.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Health Economics, Policy and Law
  • ISSN: 1744-1331
  • EISSN: 1744-134X
  • URL: /core/journals/health-economics-policy-and-law
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Altmetric attention score

Full text views

Total number of HTML views: 3
Total number of PDF views: 76 *
Loading metrics...

Abstract views

Total abstract views: 306 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 26th September 2017. This data will be updated every 24 hours.