Can willingness to pay capture the value of altruism? An exploration of Sen’s notion of commitment

Amartya Sen’s distinction between sympathy and commitment is used to examine the assertion that willingness to pay (WTP) can capture the value of altruism in health care. Willingness to pay values for a vaccination program stated to benefit only one’s self in the first instance and only other people in the second instance were elicited from a small convenience sample. Qualitative methods were then used to explore the meaning of the responses. Commitment was found to be a motivating factor and drove a wedge between willingness to pay and valuation of the program. The consequences of this for health economic research are discussed.