Chapter 11
Public Opinion and Health Policy
Mollyann Brodie and Robert J. Blendon
© 2008 Delmar Cengage Learning.
Some Issues
Are Bigger than Others
• Politicians must be aware of the importance
accorded issues at any given time
• Due to a variety of factors:
– Some issues will achieve greater prominence,
or salience, among those surveyed
2
© 2008 Delmar Cengage Learning.
Some Issues
Are Bigger than Others
• Issue salience can change considerably
over time
– This has particularly been the case when it
comes to health care
3
© 2008 Delmar Cengage Learning.
Public Knowledge
• Analysts of public opinion distinguish
between the relevant form of “public” in any
given political context
• On certain issues, politicians might wish to
focus on the opinions of American voters
who feel strongly about the issue
– Or those meeting certain demographic
characteristics
4
© 2008 Delmar Cengage Learning.
Americans on Health Care:
A Public Opinion Profile
• Americans are broadly dissatisfied with the
current state of the national health care
system
– But an overwhelming majority (87-91 percent
in a recent survey) are happy with the care
they receive from their own physician
5
© 2008 Delmar Cengage Learning.
Americans on Health Care:
A Public Opinion Profile
• As a result:
– Many are reluctant to support any policy of
reform that could in some way change the
nature of care they receive
6
© 2008 Delmar Cengage Learning.
Americans on Health Care:
A Public Opinion Profile
• Many view the lack of national health
coverage as problematic
– But there is considerable disagreement as to
the specific methods desired to treat the
problem
7
© 2008 Delmar Cengage Learning.
Americans on Health Care:
A Public Opinion Profile
• Most Americans are unwilling to bear an
increased tax burden in order to achieve
broader coverage
– This is consistent with a general aversion to
taxation
• Particularly that of a redistributive nature
8
© 2008 Delmar Cengage Learning.
Americans on Health Care:
A Public Opinion Profile
• There is general distrust of government to
successfully resolve issues amongst the
American citizenry
– This holds true when it comes to government
intervention in health care
9
© 2008 Delmar Cengage Learning.
Americans on Health Care:
A Public Opinion Profile
• Skepticism toward government (and
experts):
– Has grown over time
– Particularly post-Vietnam and in the wake of
Watergate
10
© 2008 Delmar Cengage Learning.
Americans on Health Care:
A Public Opinion Profile
• Along with a broad distrust of experts and
leaders
– Comes public disenchantment vis a vis the
medical profession
• “Commercialization” of medicine is one
factor driving dissatisfaction toward
physicians in general
11
© 2008 Delmar Cengage Learning.
Americans on Health Care:
A Public Opinion Profile
• At the same time, the personal/family
physicians of individuals generally receive
high marks
12
© 2008 Delmar Cengage Learning.
Just the Facts
• In the case of the Truman and Clinton
plans to provide comprehensive national
health insurance:
– Initial support for the effort waned once the
public learned details of the respective
schemes
– Opposition interest groups weighed in on the
matter
13
© 2008 Delmar Cengage Learning.
Chapter 11 Summary
• While broadly uninformed on the details of
many policy issues
– Many have strong impressions about policies
that change over time, affecting their salience
• When acting on public opinion data:
– Politicians must distinguish between the
different types of significant “publics”
14
© 2008 Delmar Cengage Learning.
Chapter 11 Summary
• Many Americans believe the national
health care system has serious flaws
– BUT generally approve of the care they
receive as individuals/families
15
© 2008 Delmar Cengage Learning.
Chapter 11 Summary
• While generally supportive of the goal of
expanding health coverage to the
uninsured
– Americans differ profoundly on the desired
means to affect this outcome
16
© 2008 Delmar Cengage Learning.