Health Care as Social Investment? Public Opinion on Trade-Offs Between Curative and Preventive Care in Four OECD Countries

Context: The COVID-19 pandemic highlighted the importance of public health programs in preventing diseases and providing health security for entire populations. Yet, governments invest very little in preventive health care. While it is generally assumed that this lack of public investment reflects individuals' lack of interest in public health, few studies have actually studied the public's preferences on this issue. Drawing on the literature on social investments, this article brings politics into the study of individuals' preferences for public health and curative care. Methods: We rely on an original survey conducted in four OECD countries among 8,000 respondents to assess how citizens trade off preventive and curative care. Findings: We show that higher trust and liberal social values are associated with support for preventive health care, as both variables correlate with support for policies whose benefits unfold in the long term. By contrast, individuals with poor self-rated health and low satisfaction with health care services prioritize expenditures in curative care that are beneficial to them in the short term. Conclusions: These findings advance previous research by identifying the groups that demand additional investments in public health and those who prefer to allocate more resources towards curative care.