Healthcare deservingness: how risk factors and income shape responsibility attribution for health outcomes and healthcare costs

Abstract Amidst the global surge in healthcare expenditures, there is a growing political and academic debate about individual versus collective responsibility for health and healthcare costs. This study explores the causal effects of health risks and income cues on citizens’ attribution of responsibility for health outcomes and healthcare costs. An original vignette experiment was conducted among the German population. Those in need of medical treatment who have been exposed to environmental, institutional, or biological health risks are held less responsible for their health outcomes than those exhibiting behavioural health risks. However, the impact of health risks appears to be somewhat weaker in determining who should bear the costs for the medical treatment. Furthermore, higher-income groups are more likely to be blamed for their health outcomes and are considered less deserving of society’s help in paying for medical treatment. These findings enhance our understanding of how the criteria of control and economic need shape public attribution of responsibility in the health(care) domain.