Consumers’ evaluation of allocation policies for s

Authors: Tim M Benning Els Breugelmans Benedict G C Dellaert

Publish Date: 2012/01/26

Volume: 23, Issue: 3, Pages: 531-543

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Abstract

The allocation of scarce health care service resources often requires tradeoffs between individual and collective outcomes eg when some individuals benefit more strongly from a given policy than others Based on construal level theory one would expect that consumers cognitively represent the individual and collective outcomes of an allocation policy at different levels of abstraction and that they evaluate allocation policies more positively when there is congruency between the cognitive representation of the policy’s focal outcome and the spatial and temporal distance inherently present in the policy’s decision context eg allocation decisions on a future policy However we hypothesize that this congruency effect can be overruled by a high vested interest mindset that is activated by an individual’s recent personal experience with a health care service provider Since a high vested interest mindset increases the relevance of the allocation policy implementation for the individual because s/he perceives strong personal consequences we propose that for consumers with recent experience the evaluation of an allocation policy that focuses on individual outcomes is higher than that of a policy that focuses on collective outcomes irrespective of the spatial and temporal distance in the decision context Results of a hypothetical experiment among a representative sample of the general population confirm the congruency effects in the new domain of health care service allocation policies and provide support for the proposed overruling effect of the activation of a high vested interest mindset by recent personal experience on spatial and temporal distanceThe scarcity of service resources in important domains such as health recreation and education often demands that service providers implement allocation policies to assign service access to consumers Kahneman et al 1986 Persad et al 2009 We define a service allocation policy as a set of rules used to decide on the allocation of access to a scarce service resource among potential recipients eg based on price time of arrival or medical urgency Allocation policies are adopted in many domains where service resources are scarce eg doctors may use urgency indicators to decide on the order in which patients are treated music or sport fans may be asked to wait in line to obtain access to tickets for special events and aptitude test scores may be used to grant students access to educational programs Typically managers and allocation policy decision makers that need to decide on the type and specification of an allocation policy focus on both individual and collective outcomes because the maximization of one outcome may come at the expense of the other Lindholm et al 1997 For example in health care the use of an allocation policy based on urgency may maximize the number of life years saved for society collective outcome but not for each specific participant him or herself individual outcomeBased on construal level theory CLT one would expect that consumers mentally represent these different allocation policy outcomes at different levels of abstraction Liberman and Trope 1998 Trope and Liberman 2003 Policy outcomes that benefit society collective outcomes are likely to be seen as more distant and construed at a more abstract level than policy outcomes that directly benefit the individual him or herself individual outcomes because others in society are seen as distal social targets whereas the self is seen as a proximal social target Kim et al 2008 Liviatan et al 2008 Zhao and Xie 2011 In addition prior research has shown that congruency between the consumer’s mental representation and the construal level caused by the decision context results in greater processing fluency Kim et al 2009 White et al 2011 and enhanced evaluations Sanna et al 2010 Zhao and Xie 2011 Using these insights we expect that allocation policy evaluations are more positive when there is congruency between the temporal and spatial distance that is inherently present in the policy’s decision context eg an allocation policy implementation in the near future or close vicinity vs distant future or far vicinity Milkman et al 2010 Soman et al 2005 and a consumer’s mental representation of the policy’s focal outcomeThe main contribution of this study is to investigate the potential overruling effect of the activation of a high vested interest mindset on this CLTbased congruency effect Contexts that are of very high relevance to the consumer and where perceived personal stakes are large can potentially activate a high vested interest mindset Thornton and Knox 2002 Often the implementation of an allocation policy where individual and collective outcomes are traded off is such a context The implementation of health care service allocation policies where such individual vs collective outcome tradeoffs are prominent is also an interesting and important domain to investigate whether CLTbased congruency effects hold This constitutes the second contribution of this studyWe propose that a high vested interest mindset can be activated by a consumer’s recent personal experience with the service resource because consumers with recent experience are better able to assess the pros and cons of a particular behavior there is more at stake are more aware of the effects of an action upon oneself the action is more salient and can better assess the chances that a specific event will take place the results are more certain Crano 1995 Morwitz 1997 Vested interest theory predicates that participants with a high vested interest mindset have wellestablished and consistent preferences for personal ie individual consequences eg Lehman and Crano 2002 Consequently we expect them to expend more cognitive effort and produce issuerelevant thoughts Crano 1995 Crano and Prislin 1995 Lehman and Crano 2002 and to be more likely to activate concrete egocentric “not in my backyard” thoughts that overrule the CLTbased congruency effect We hypothesize that this results in a more positive evaluation of an allocation policy that focuses on individual rather than collective outcomes regardless of the temporal or spatial distance To the best of our knowledge we are the first to show that there can be boundaries of an internal mindset to the previously found CLTbased congruency effectManagement decisions on how to allocate scarce service resources may create conflicts between collective interests and interests of different individuals Not only managers and policy makers typically trade off these interests when deciding on the mechanism for an allocation policy but also the recipients of the allocation policy ie consumers actively take into account the interests of others along with their own selfinterest when evaluating allocation policies Agerström and Björklund 2009a b Such a context where perceived personal consequences for the daily life of consumers are significant and important ie high hedonic relevancy and high perceived stake can be considered as a context where a high vested interest mindset can potentially be activated Crano 1995 Thornton and Knox 2002 Little is known about how consumers evaluate allocation policies in such a decision context and—using construal level theory as a base—we anticipate that it depends on their mental representation of the focal outcome presented in the policy CLT posits that individuals focus on more concrete lowlevel construals when the psychological distance is close whereas focus is placed on more abstract highlevel construals when the psychological distance is far Kardes et al 2006 Liberman et al 2007 Trope and Liberman 2003 Lowlevel construals represent information that is concrete and subordinate and highlight the ‘how’ aspects of an object/action while highlevel construals represent abstract and superordinate information and highlight the ‘why’ aspects of an object/action Trope and Liberman 2003 Trope et al 2007 Although CLT originated with the temporal distance perspective near vs distant future Liberman and Trope 1998 it has been extended to other dimensions such as spatial hypothetical or social distance as well Trope and Liberman 2010 Trope et al 2007 The latter social distance is especially relevant in the context of selfish hedonistic individual vs altruistic moral collective allocation policy outcomes where prior research has shown that distal social targets eg others are represented on a more abstract level than proximal social targets eg self Kim et al 2008 Liviatan et al 2008 Zhao and Xie 2011 As a consequence we expect that collective more altruistic outcomes are construed at a more abstract level than individual more selfish outcomes when consumers evaluate an allocation policyH1 Consumers’ evaluation of a collective outcome allocation policy ie one with a high collective outcome focal outcome and a low individual outcome increases relative to an individual outcome allocation policy ie one with a high individual outcome focal outcome and a low collective outcome in spatially and temporally more distant situationsA context where consumers compare individual vs collective allocation policy outcomes is one that may potentially activate a high vested interest mindset since the outcome can be of high relevance to the consumer and perceived stakes can be large Crano 1995 Thornton and Knox 2002 According to vested interest theory contextual manipulations of persuasion processes become less influential and attitude–behavior correspondence often increases when vested interest is high Crano 1995 Crano and Prislin 1995 Lehman and Crano 2002 We propose that an individual’s recent personal experience with a scarce service resource can trigger the activation of a high vested interest mindset by increasing a consumer’s ability to assess the pros and cons of a particular behavior stake a consumer’s likelihood to be aware of the effects of an action upon oneself salience and a consumer’s assessment of the chances that a specific event will take place certainty Crano 1995 Morwitz 1997

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