A unique feature of health care markets, recognized by Arrow (1963), is that a physician, the supplier of medical services, is expected to act in the patient’s best interest. This relationship is even more complex given the inherent characteristics of health care: the pervading uncertainty, the pronounced asymmetric information between consumer (the patient) and provider, the infrequent nature of certain medical interactions, and the potential for exceptionally high stakes, often concerning life or death. All these factors underscore trust as an indispensable prerequisite in this domain.1 Furthermore, within the United States health care system, patients are expected to place their trust not only in medical providers but also in other critical components like insurers, pharmaceutical companies, and regulators. A breakdown in trust in even just one of these elements can potentially precipitate a cascading erosion of confidence in the entire health care system.

Unfortunately, trust in medical and, more broadly, scientific expertise is increasingly difficult to establish (Baker, 2020). Indeed, with the COVID-19 pandemic, trust has generated significant attention as both a component of culturally competent care and as a broader factor in patients’ willingness to seek care and adhere to a course of treatment (Cope et al., 2022). Yet, despite the increasing focus on the importance of trust in the health care sector, studies in economics analyzing how varying levels of trust can directly influence care-seeking behaviors are scarce.

In this paper, we explore the relationship between trust and health care-seeking behavior. We formulate a theoretical model that expresses health care-seeking behavior as a function of economic and behavioral fundamentals, including expectations, preferences, and constraints. We hypothesize that trust operates through two of these mechanisms: beliefs about the health system’s ability to improve one’s health (i.e., the production technology of health through health care) and the disutility associated with visiting a physician.



Darden, Michael E and Macis, Mario. Trust and Health Care-Seeking Behavior. National Bureau of Economic Research Working Paper Series
No. 32028. January 2024. 10.3386/w32028. http://www.nber.org/papers/w32028