Health Seeking behavior

I have been thinking about the possibility of doing a health seeking behavior experiment. Mainly inspired by an interesting powerpoint presented by Ben Olken from JPAL MIT Indonesia at TNP2K around august 2011. He was showing the result of a follow up research to health seeking behavior. Basically he showed that the intervention works very well at the intial year follow up, however further exploration after one year indicate a delining magnitude in treatment effects.

I think some behavioral reasonings can be useful to understand such anomalies. The study show that both demand and supply of health service has been declining several years after the interventions. To my view this to some extent is related to the interactions between medical practitioners-patient. Behavioral economics has been showing the emergence of cooperative behavior, non-self interest inequality aversions, people hate to be treated unequally. Fairness notion then is considerably important to the decision making of homo economicus.

Thaler (1981) shows that Fairness put a constraint/limitation to self interest maximizing utility behavior, as a doctor/ practitioners hold their holy oath to help the poor in need and the sick and vulnerable. This put them into higher pressure if they are in an environment with constant poverty and bad environment condition. Market based intervention then will be useless as people are still contrained to independent factor that is not related to the market.

Doctor-patient relationship could also offer interesting explanation, people go to the doctor often resort for advice and suggestions, for uncertain risk and unknown desease patient will rely to the Doctor to make the final decision, Due to Regret aversions (responsibility cost of decision making), in order to decide a cancer treatements, or surgery people will avoid to make their own choices . The doctor on the other hand had to have an instant list of choices of a practical advice in the middle of complex situation and stressful time pressures. If the Doctor is sufficiently risk averse they will prefer to avoid risky patients

Declining demand of Patient on health service also probably due to the fact that seeking information about doctor advice is costly, information affect beliefs and in turn mental states that diminishes utility. The gesture of seeking information will lead to either (1) bad news, creating anxiety and loss of utility (we used to have the same feeling when we are about to go the lab to take a medical check up). Or (2) more information to enable doctor and patient for an optimal treatment strategy. If patient is risk averse and discounted their health benefit in the future very high, Sick people will not come to hospital/medical practitioner on time.