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Canadian Medicare: Is there a Potential for Loyalty? Evidence from Alberta

Published online by Cambridge University Press:  05 August 2005

Daniel Cohn
Affiliation:
Simon Fraser University

Abstract

Abstract. Political-economic theory posits that in the face of a perceived decline in service quality, those who might otherwise seek alternatives will be restrained by feelings of loyalty that are a product of their emotional and physical investment in a situation (Hirschman, 1970). Amartya Sen (1977) describes support for policies that is based exclusively in values—rather than self-interest or a combination of the two—as a commitment. This article sets out to answer two questions: First, what proportion of the supporters of Canadian medicare within the province of Alberta currently expresses self-interest, and what proportion does not? We can describe this latter group as possibly expressing commitment. Second, is it possible that those who support medicare and express self-interest also share the same values as those who might be expressing commitment? If so, feelings of loyalty might help to maintain support for medicare among those who currently express self-interest, should they perceive a decline in service quality. While evidence is found to support this view, care must be taken in generalizing the results to the wider population, given the size and nature of the sample.

Résumé. La théorie politique-économique pose en principe que, face à la perception d'un déclin de la qualité des services, ceux qui seraient normalement susceptibles de chercher d'autres solutions seront restreints par les sentiments de loyauté produits par l'investissement émotif et physique de l'individu dans son environnement (Hirschman, 1970). Sen (1977) décrit l'appui voué à certaines politiques pour des raisons exclusivement idéologiques, plutôt que par intérêt personnel, ou encore pour une combinaison de raisons idéologiques et d'intérêt personnel, comme un engagement. Cet article se propose de répondre à deux questions: en premier, quelle proportion de partisans du système public de santé canadien en Alberta exprime, ou n'exprime pas, des intérêts personnels? On peut probablement décrire le groupe qui n'exprime pas d'intérêts personnels comme témoignant d'un engagement. Deuxièmement, est-il possible que ceux qui soutiennent le système de santé tout en exprimant des intérêts personnels aient les mêmes valeurs que ceux qui expriment leur engagement? Si oui, ces sentiments de loyauté pourraient aider à maintenir le soutien pour le système de santé parmi ceux qui expriment actuellement des intérêts personnels, s'ils avaient l'impression d'un déclin de la qualité des services. Bien que nous ayons trouvé des preuves étayant cet avis, il faut être prudent dans la généralisation des résultats à l'ensemble de la population à cause de la taille et de la nature de l'échantillon.

Type
Research Article
Copyright
© 2005 Cambridge University Press

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