Pro-social preferences and self-selection into the public health sector: evidence from an economic experiment

Abstract

Motivational crowding-out theory establishes that the effectiveness of financial incentive schemes, like pay-for-performance, crucially depends on the underlying social preferences of health workers. In this paper we study the extent to which heterogeneity in the strength and structure of social preferences is related to career choices by testing whether preferences vary systematically between Tanzanian health worker students who prefer to work in the private for-profit health sector and those who prefer to work in the public health sector. Despite its important policy implications, this issue has received little attention to date. By combining data from a questionnaire and an economic experiment, we find that students who prefer to work in the public health sector have stronger pro-social preferences than those who prefer to work in the private for-profit sector.

Pro-social preferences and self-selection into jobs: Evidence from South African nurses

“…This raises questions about the potential endogeneity of pro-social attitudes, which might in fact be linked to a nurturing process during training. Seeking to test the predictions of Delfgaauw (2007) in Tanzania, Kolstad and Lindkvist (2012) find that nursing and medical students who report an intention to work in the public sector when they graduate also display more altruistic decisions in two economic games (a dictator game and in a trust game). However, their results may not have been robust to a more comprehensive multivariate analysis 2 and only rely on stated preference for public jobs (not actual choices).…”

“…Recently, efforts have been made to improve the measures of pro-social motives by using decisions made in experimental economic games and triggered by actual financial incentives (Camerer and Fehr, 2002). Two studies closely related to this paper have sought to test empirically whether health care providers displaying more pro-social motivations in economic experiments are likely to be more attracted to public (Kolstad and Lindkvist, 2012) or not-for-profit (Serra et al, 2010) jobs. In a study of actual job choices made by doctors and nurses in Ethiopia, Serra et al (2010) test the predictions of Besley and Ghatak (2005) that workers with more pro-social orientations will seek like-minded employers, which are identified as not-for-profit employers (NGO) in their context.…”

“…In relation to labour supply decisions, some attention has been paid to the role of pro-social preferences to explain the self-selection of individuals into the public sector or into not-for-profit organisations, in particular in the delivery of social services (Besley and Ghatak, 2005;Delfgaauw, 2007;Francois and Vlassopoulos, 2008;Kolstad and Lindkvist, 2012;Serra et al, 2010). However, no attention has been given to the role of pro-social preferences in the decision to take up particular positions associated with low material welfare for the worker and high benefits for others, benefiting from the worker's presence.…”

Hormonal Contraceptives Do Not Impact Economic Preferences: Evidence from a Randomized Trial

“…For example, studies find competitive individuals to be more likely to take a competitive high school exam (Zhang 2013), select more prestigious educational tracks (Buser et al 2014), and to have higher earnings expectations than uncompetitive individuals (Reuben et al 2017). Risk-taking individuals are found to be more likely to select careers with higher earning variation (Dohmen et al 2011, Bonin et al 2007, and prosocial individuals are more likely to select careers in the nonprofit and public sectors (Kolstad and Lindkvist 2013).…”

Coordination Incentives, Performance Measurement, and Resource Allocation in Public Sector Organizations

“…For evidence of motivated agents in public services see e.g. Perry and Wise (1990); Houston (2006); Gregg et al (2011);Kolstad and Lindkvist (2012);Dur and Zoutenbier (2013).…”