How to distort priority setting?

Biases distorting priority setting

Why priority setting in health care has so poor outcomes while relevant systems are well developed and readily available? You just have to read this article to understand it.

It starts to identify some rational and structural explanations for the discrepancy between theoretical efforts and practical outcomes in priority setting. However, even if these issues are addressed, practical priority setting may still not obtain its goals. This is because a wide range of irrational effects is hampering priority setting: biases.

Table 1. Overview of various biases and potential implications for priority setting and at which level they may be most prominent.

Bias	Potential Implications	Level
Identifiability and Singularity effect	Undermining principles	Micro
Rejection Dislike	Hamper disinvestment	Micro, meso
Failure Embarrassment effect	Overuse	Micro (primarily)
Prominence Effect (Opportunity Cost Neglect)	Non-warranted use	All
Status Quo Bias	Overuse, Underuse	All
Endowment Effect	Overuse, Underuse	Micro (primarily)
Loss Aversion	Hamper disinvestment	All
Aversion to Risk / Ambiguity	Overuse	Micro, meso
Availability Heuristics	Overuse	Micro, meso
Sacred Values and Taboo trade-offs	Undermining principles	All
Progress bias	Overuse	All
Adoption Addiction	Overuse	Micro, macro
Complexity bias	Undermining principles, overuse	Micro, meso, macro
Extension bias	Overuse	All
Asymmetry of risks and benefits	Overuse	Micro (primarily)
Positive cognitive feedback loops	Undermining principles, overuse	Micro, meso, macro
Prestige bias	Undermining principles, overuse	Micro (primarily)
Imperative of Action	Undermining principles, overuse	Micro (primarily)
Technology Placebo Effect	Undermining principles, overuse	Micro (primarily)
Imperative of Knowledge	Overuse	Micro
Competency Effect	Overuse	Micro
Multiple Replacements	Overuse	Micro
White Elephants	Overinvestment	Micro
Boys and Toys Effect	Unwarranted use	Micro