ISSUE: PATIENT-CENTERED MEDICAL CARE: WHAT DOES IT MEAN FOR THE WELFARE STATES OF EUROPE? OVERVIEW: Neustadt and Zweifel report on a preference-elicitation study designed to estimate marginal willingness to pay, in terms of percentage of GDP devoted to redistribution in Switzerland[i]. They estimate that the maximum WTP to reduce income inequality was 21% of GDP, below the 25% value in 2008, indicating that the welfare state is not sustainable. In another paperii (to be resubmitted shortly), they find substantial WTP for redistribution away from people in ill health in favor notably of families with children. These findings seem to place the burden of proof on those who argue that the continuing increase in healthcare expenditure (and new medical technology in particular) is in accordance with the preferences of the citizenry. What they do suggest is that using health care as the vehicle for income redistribution may meet with future resistance in the welfare states of Europe. Yet another experimental studyiii finds substantial WTP for a hypothetical drug designed to treat terminal cancer even though it adds only six months to life – provided it does not reduce quality of life. Therefore, the real challenge confronting governments seems to be to exclude therapies with a low WTP-to-cost ratio from their list of benefits. [1] Is the Welfare State Sustainable? Experimental Evidence on Citizens' Preferences for Redistribution. CESifo Working Paper No. 3148. Posted: 12 Aug 2010 . Available at: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1656788. ii Redistribution in Whose Favor? Preferences with Regard to Nationality and Type of Beneficiaries, to be resubmitted to Eur J Pol Ec. iii Fischer B, Telser H, Zweifel P (2017), End-of-life Healthcare Expenditure: Testing Economic Explanations Using a Discrete Choice Experiment, resubmitted to JHE.