What justifies public engagement in health financing decisions?

The World Bank's report, represents an important effort to specify the benefits and criteria of fair processes in health financing decisions. Here we argue that the report's justification for increasing public engagement in health financing decisions, one of its most novel contributions, rests on a widely shared but flawed assumption that public engagement will produce more equitable outcomes. Examining evidence from national-level public engagement initiatives cited in the report, we argue that there is no reason to assume that engaged publics will prioritize equity over other relevant values such as the maximization of population health.