Hostname: page-component-7c8c6479df-r7xzm Total loading time: 0 Render date: 2024-03-19T04:16:42.676Z Has data issue: false hasContentIssue false

Questioning the Conventional Wisdom on Public Opinion Toward Health Reform

Published online by Cambridge University Press:  02 September 2013

Lawrence R. Jacobs
Affiliation:
University of Minnesota
Robert Y. Shapiro
Affiliation:
Columbia University

Extract

Ample evidence confirms that public opinion influences the policy-making process. Research suggests that public preferences are not simply translated into government policy; rather, policymakers' response to public opinion is conditioned or mediated by political and institutional processes (Jacobs, 1993a, 1993b, 1992a, 1992b; Jacobs and Shapiro, 1994a, 1994b; for discussion of this research see PS, March 1994, 9–38).

The passage and designing of health reform will depend in important respects on public attitudes toward health care and health reform. The interpretation of public opinion by the media and other political observers, however, is not a neutral process dictated by scientific methods; it is the product of institutional and political struggles for position and power.

Conventional wisdom regarding the public's health reform attitudes holds that Americans are narrowly self-interested, unambiguously antitax, and unwavering opponents of government regulation. Are these three sets of assumed attitudes supported by the available empirical evidence?

Here we take an historical approach to studying public opinion—one that identifies the patterns and trends of Americans' responses to identically worded questions asked in national opinion surveys.

Type
Research Article
Copyright
Copyright © The American Political Science Association 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The authors recently received an “Investigator Award” from the Robert Wood Johnson Foundation to study the interaction of public opinion, media coverage, and congressional deliberation during the current health reform debate.

References

Blendon, Robert, Maritila, John, Benson, John, Shlter, Matthew, Connolly, Francis, and Kiley, Tim. 1994. “The Beliefs and Values Shaping Today's Health Reform Debate.” Health Affairs 13 (Spring): 274–84.CrossRefGoogle ScholarPubMed
Citrin, Jack, and Green, Donald. 1990. “The Self-interest Motive in American Public Opinion.” In Research in Micropolitics: A Research Annual, ed. Long, Samuel. Greenwich, CT:JAI.Google Scholar
Cook, Fay Lomax, and Barrett, Edith J. 1992. Support for the American Welfare State: The Views of Congress and the Public. New York: Columbia University Press.Google Scholar
Free, Lloyd, and Cantril, Hadley. 1967. The Political Beliefs of Americans: A Study of Public Opinion. New Brunswick: Rutgers University Press.Google Scholar
Jacobs, Lawrence. 1993a. The Health of Nations: Public Opinion and the Making of American and British Health Policy. Ithaca, NY: Cornell University Press.CrossRefGoogle Scholar
Jacobs, Lawrence. 1993b. “Health Reform Impasse: The Politics of American Ambivalence Toward Government.” Journal of Health Politics, Policy, and Law 18(Fall):629–56.CrossRefGoogle ScholarPubMed
Jacobs, Lawrence. 1992a. “Institutions and Culture: Health Policy and Public Opinion in the U.S. and Britain.” World Politics 44 (January): 179209.CrossRefGoogle Scholar
Jacobs, Lawrence. 1992b. “The Recoil Effect: Public Opinion and Policy Making in the United States and Britain.” Comparative Politics 24 (January):199217.CrossRefGoogle Scholar
Jacobs, Lawrence, and Shapiro, Robert Y. 1994a. “Issues, Candidate Image, and Priming: The Use of Private Polls in Kennedy's 1960 Presidential Campaign.” American Political Science Review (September).CrossRefGoogle Scholar
Jacobs, Lawrence, and Shapiro, Robert Y.. 1994b. “Studying Substantive Democracy.” PS: Political Science & Politics 27(1):917 (March).Google Scholar
Jacobs, Lawrence, and Shapiro, Robert Y. 1994c. “Public Opinion's Tilt Against Private Enterprise.” Health Affairs 13 (Spring):285–98.CrossRefGoogle ScholarPubMed
Jacobs, Lawrence, Shapiro, Robert, Schulman, Eli. 1993. “Poll Trends: Medical Care in the United States—An Update.” Public Opinion Quarterly 57 (Fall):394427.CrossRefGoogle Scholar
Jajich-Toth, Cindy, and Roper, Burns. 1990. “Americans’ Views on Health Care: A Study in Contradictions.” Health Affairs (Winter): 149–57.CrossRefGoogle ScholarPubMed
Kiewiet, D. Roderick. 1983. Macroeconomics and Micropolitics: The Electoral Effects of Economic Issues. Chicago: University of Chicago Press.Google Scholar
Kinder, Donald, and Kiewiet, D. Roderick. 1979. “Economic Discontent and Political Behavior.” American Journal of Political Science 23:495527.CrossRefGoogle Scholar
Kosterlitz, Julie. 1993. “Dangerous Diagnosis.” National Journal 16 January:127–30.Google Scholar
Ladd, Carl Everett. 1985. The American Polity: The People and Their Government. New York: W.W. Norton & Co.Google Scholar
McClosky, Herbert, and Zaller, John. 1984. The American Ethos: Public Attitudes toward Capitalism and Democracy. Cambridge, MA: Harvard University Press.CrossRefGoogle Scholar
Page, Benjamin, and Shapiro, Robert. 1992. The Rational Public: Fifty Years of Trends in Americans' Policy Preferences. Chicago: University of Chicago Press.CrossRefGoogle Scholar
Roper Center. The American Enterprise. 1992. (March/April). Roper Center for Public Opinion Research, Storrs, CT.Google Scholar
Sears, David, Lau, Richard, Tyler, Tom, Allen, Harris. 1980. “Self-Interest vs. Symbolic Politics in Policy Attitudes and Presidential Voting.” American Political Science Review 74 (September):670–84.CrossRefGoogle Scholar
Sears, David, and Funk, Carolyn. 1990. “Self-Interest in Americans' Political Opinions.” In Beyond Self Interest, ed. Mansbridge, Jane, Chicago: University of Chicago Press.Google Scholar
Shapiro, Robert, and Gillroy, John. 1984a. “The Polls: Regulation—Part I.” Public Opinion Quarterly 48(Fall):531–42.CrossRefGoogle Scholar
Shapiro, Robert, and Gillroy, John. 1984b. “The Polls: Regulation—Part II.” Public Opinion Quarterly 48(Winter):666–77.CrossRefGoogle Scholar
Shapiro, Robert, and Young, John. 1986. “The Polls: Medical Care in the United States.” Public Opinion Quarterly 50(Fall):418–28.CrossRefGoogle ScholarPubMed
Staub, Ervin. 1989. “Individual and Societal (Group) Values in a Motivational Perspective and their Role in Benevolence and Harmdoing.” In Social and Moral Values: Individual and Societal Perspectives. eds. Eisenberg, N., Reykowski, J., and Staub, E., Hillsdale, NJ: Erlbaum.Google Scholar
Tocqueville, Alexis de. 1969. Democracy in America, ed. Mayer, J.P., Garden City, NJ: Anchor.Google Scholar
Welch, Susan. 1985. “The ‘More for Less’ Paradox: Public Attitudes on Taxing and Spending.” Public Opinion Quarterly 49(Summer):310–16.CrossRefGoogle Scholar