Using attitudinal information to explore preferences toward compulsory public health programmes: a willingness to pay study

Contingent valuation studies continue to be controversial due to easily identifiable biases and applied work failing simple tests of validity. One avenue of work that has shown some promisng results, however, is the examination of attitudes within contingent valuation. Whilst a few studies have investigated the role and impact of respondent attitudes on willingness to pay responses, these have not been brought together within a single framework, nor applied to health-related goods. In this study, a framework is developed that generates attitude statements from qualitative research and then applies them to a contingent valuation study. The attitude statements are used to generate factors that are then used in explanatory analyses of respondents‘ support for one of four public health schemes and their associated willingness pay (WTP). Collecting attitude data before preference elicitation increases protests and decision uncertainty. The factors, including "warm glow", have an explanatory effect on respondent WTP although some scale insensitivity remains. A different pattern of factor involvement is observed between the policy vote for or against the programme compared to that for WTP. These differences are consistent with a view of bounded rationality that suggests that the WTP responses are based on reasoning, as opposed to being affective or intuitive.