a1 Stanford University
In this article, we report results from a new study that surveyed a large, national sample of American adults about their willingness to pay for health reform. As in previous work, we find that self-identified Republicans, older Americans, and high-income Americans are less supportive of reform. However, these basic findings mask three important features of public opinion. First, income has a substantial effect on support for reform, even holding political affiliation constant. Indeed, income is the most important determinant of support for reform. Second, the negative effects of income on support for reform begin early in the income distribution, at annual family income levels of $25,000 to $50,000. Third, although older Americans have a less favorable view of reform than the young, much of their opposition is due to dislike of large policy changes than to reform per se.
David W. Brady is the Bowen H. and Janice Arthur McCoy Professor of Political Science and Leadership Values in the Stanford Graduate School of Business and professor of political science in the School of Humanities and Sciences at the university. He is also the deputy director and Davies Family Senior Fellow at the Hoover Institution. Brady is an expert on the U.S. Congress and congressional decision making. His current research focuses on the political history of the U.S. Congress, the history of U.S. election results, and public policy processes in general.
Daniel P. Kessler is a professor at Stanford Law School and the David S. and Ann M. Barlow Professor in Management at the Stanford Graduate School of Business. He is also a senior fellow at the Hoover Institution. Kessler studies health economics and health policy in the U.S. and internationally. His current research focuses on public opinion in health care and how vertical integration and other shared ownership structures in markets for health services affect the cost and quality of care.
We would like to thank Doug Rivers for his useful input, and Laura Carstensen and the Stanford Center on Longevity for financial support. Kessler gratefully acknowledges support from the National Institute on Aging through the National Bureau of Economic Research. However, any errors or misstatements are our own.