Att människor förmår relatera emotionellt till och bry sig om andra accepteras numera även av de flesta nationalekonomer, som talar om ”prosociala preferenser”. Men styrkan i sådana preferenser varierar människor emellan, vilket tas som utgångspunkt för den nya studien ”Pro-Social Preferences and Self-Selection into the Public Health Sector: Evidence from Economic Experiments”:

In this paper we study the extent to which these differences are related to career choices, by testing whether preferences vary systematically between Tanzanian health worker students who prefer to work in the private health sector and those who prefer to work in the public health sector. Despite its important policy implications, this issue has received hardly any attention to date. By combining data from a questionnaire and two economic experiments, 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 sector.

Är slutsatsen att enbart offentlig hälsovård ska erbjudas, så att de med svagare prosociala tendenser söker sig till andra sysselsättningar? Inte nödvändigtvis. Forskarna skriver:

A systematic self-selection of pro-socially motivated health workers into the public sector suggests that it is a good idea to have two sectors providing health services: this can ensure efficient matching of individuals and sectors by allowing employers in the two sectors to use different payment mechanisms tailored to attract and promote good performance from different types of health workers.

Om man utgår från att alla har samma typer av preferens och organiserar och ersätter hälsovårdsarbetet utifrån ett sådant homogenitetsantagande kan det alltså fungera sämre i närvaro av faktisk heterogenitet.