Is more health always better for society? Exploring public preferences that violate monotonicity

There has recently been some literature on the properties of a Health-Related Social Welfare Function (HRSWF). The aim of this article is to contribute to the analysis of the different properties of a HRSWF, paying particular attention to the monotonicity principle. For monotonicity to be fulfilled, any increase in individual health-other things equal-should result in an increase in social welfare. We elicit public preferences concerning trade-offs between the total level of health (concern for efficiency) and its distribution (concern for equality), under different hypothetical scenarios through face-to-face interviews. Of key interests are: the distinction between non-monotonic preferences and Rawlsian preferences; symmetry of HRSWF; and the extent of inequality neutral preferences. The results indicate strong support for non-monotonic preferences, over Rawlsian preferences. Furthermore, the majority of those surveyed had preferences that were consistent with a symmetric and inequality averse HRSWF.