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This review aims to clarify free-rider dynamics in healthcare across various domains and their implications for policy.

June 13, 2026HealthcareOpen Access

Free Riding in Healthcare Through a Game-Theoretic Lens: A Cross-Domain Narrative Review and Conceptual Synthesis

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Narrative review examines free riding dynamics in healthcare, highlighting implications for policy and cooperation.

This review aims to clarify free-rider dynamics in healthcare across various domains and their implications for policy.
Conducted a narrative review with conceptual synthesis of literature from PubMed and Scopus.
Incorporated foundational sources in economics, game theory, public-health ethics, and market design.
Mapped sources by domain, actors, strategies, payoff structure, and policy relevance.
Identified different game types influencing free riding: threshold games in vaccination, adverse-selection games in insurance, and repeated public-goods games in global health.
Outlined three policy functions for addressing free riding: altering payoffs, enhancing information, and modifying game structure.
Emphasized that game theory's usefulness depends on empirical context, ethical legitimacy, and consideration of equity.

Ntais et al. (2026) studied this question.

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