How Increased Transparency in Decision-making Affects Perceived Legitimacy ΠThe Case of Priority Setting in Public Health Care

This paper explores, theoretically and empirically, the common assumption that transparency enhances perceived legitimacy, i.e. willingness to accept decisions and trust in decisionmakers. Special attention is given to the case of priority setting in health care, a typical example of a policy area with contentious decisions where increased transparency is often called on as a cure against declining public trust. The empirical analysis employs original data from a two wave web-based experiment with 1049 subjects. Manipulations included degree of information provided concerning the decision-making process and the reasons behind the decision, the type of decision-maker and degree of conflict. The results indicate that the relationship between transparency and perceptions of legitimacy is more complicated than often assumed. Implications and future research are discussed. Jenny de Fine Licht University of Gothenburg Sweden