Even the adults who are rational enough to know that vaccines are a good thing (as opposed to the horribly misguided anti-vaccination movement) are still susceptible to the irrationalities of our own psychology. A study published earlier this month from Tulane University in New Orleans, America, has found that the cost of getting vaccinated influences people’s perception of how likely they are to contract a virus.
Researchers conducted surveys which presented various health messages regarding the flu shot. Half of those messages emphasized risk to the individual, while the other half emphasized risk to the general public. Also, half of the time the vaccine cost $25 whereas the other half had the vaccine priced at $125 – five times more expensive.
Here’s the interesting thing about the experiment: The participants were all told that the cost would be covered by insurance. But despite the fact that they would pay the same amount in each case (i.e., nothing), the participants in the high-price group believed that they were not as likely to get the flu virus. From the paper itself:
Four studies reveal that consumers believe that lifesaving health goods are priced according to perceived need (i.e., communal-sharing principles) and that price consequently influences risk perceptions and intentions to consume care.
Specifically, consumers believe that lower medication prices signal greater accessibility to anyone in need, and such accessibility thus makes them feel that their own self-risk is elevated, increasing consumption. The reverse is true for higher prices.
Importantly, these effects are limited to self-relevant health threats and reveal that consumers make inconsistent assumptions about risk, prevalence, and need with price exposure. These findings suggest that while greater price transparency may indeed reduce consumption of higher-priced goods, it may do so for both necessary and unnecessary care.
“Your chance of winning at blackjack has nothing to do with how big the payout is and most people know that,” said Janet Schwartz, who co-authored the study with Adriana Samper. “But when it comes to understanding what prices reflect for medicine, people look at the price and they do think that it somehow tells them something about their own risk of getting a disease. In reality, those two factors are completely independent.”
So how can we explain this irrationality? Science Daily puts it this way: “When priced high and perceivably out of reach for some, consumers inferred that the medicine must not be all that necessary and the risk of getting the illness must be lower.” But I don’t think consumers really perceive $125 to be “out of reach,” and that isn’t really a full explanation. Rather, when I look at this study, the first thing I think of is cognitive dissonance.
The first step is from looking at the $125 and thinking “that’s really expensive, I wouldn’t want to pay that.” That’s when the cognitive dissonance starts to kick in. “The price shouldn’t make a difference in my decision to vaccinate… If I believe in vaccinations – which I do – then I should get it regardless. …But the price is still so expensive!”
That last sentence is the key. Presumably, this doesn’t occur so much in the low-cost group, which explains the difference in results between groups. In order to alleviate the dissonance, the mind quickly changes course and argues “Well it’s probably not even necessary to get one, so I won’t need to pay so much anyways.” This kind of thinking would of course not happen consciously.
I admit, I don’t know if this explanation is true; but one way to test my hypothesis would be to replicate the study with a comparison of rich and poor participants. If I’m right, there would be no big difference between the $25 and the $125 groups among the rich people – for whom $125 is presumably not perceived as a lot of money.
And if my hypothesis is correct, that would have serious implications for public health measures. That would suggest that if we want to eradicate diseases like measles and polio (like we did with smallpox), it would be best to keep the price of vaccines very low, if not free.
Personally, the most interesting aspect of this research was the fact that the participants knew they would be insured… and it didn’t matter. I would have thought that would be a confounding variable that would screw up the whole study, but it wasn’t at all.
So what does all of this mean? It means something important for the future. The next time you have a chance to get a vaccination that could prevent suffering and stay healthy, think about your decision to vaccinate before you look at the price.
Or think of it this way: How much would you pay to stay healthy?