The Mediating Effect of Public Opinion on Public Policy: Exploring the Realm of Health Care

Front Cover
SUNY Press, Jul 15, 2004 - Political Science - 179 pages
Using health care policy to develop a theory of how public opinion influences public policy outcomes, Richard E. Chard draws on data ranging from presidential approval ratings to polls conducted during the debate over the Health Security Act. Over the last five decades the relationship has been a complex one, yet there are clear indications that health care policy development has been controlled to a great extent by public opinion. Chard argues that policy change is either static or dynamic because public opinion, the underlying force, is itself dynamic at times and static at others, and concludes that this model of change is applicable to all policy areas, not just health care.
 

Contents

Health Policy Change
1
EXPLANATIONS FROM SOCIAL SCIENCE
4
Exploring the Foundations of Dynamic Policy Change
AMERICAN HEALTH CARE POLICY
THE DYNAMIC NATURE OF HEALTH CARE REFORM?
INCREMENTALISM VERSUS DYNAMISM IN HEALTH CARE
Path Dependence and Policy Change
3
SOCIAL CONSTRUCTIONS AND MEDICARE
7
Examining the Impact of Countervalent Messages on Policy Support
67
NEGATIVE ADVERTISING AND HARRY AND LOUISE
68
THE MEDIA AND THE HEALTH SECURITY ACT
71
TESTING THE STRENGTH OF THE COUNTERVALENT INFORMATION MESSAGE
73
UNDERSTANDING THE EFFECTS OF POLITICAL SOPHISTICATION
75
DISCUSSION
78
CONCLUSION
81
Media Effects and Policy Opinions
83

ANALYZING CHANGE
9
DOES THE MOOD REALLY MATTER?
18
CONCLUSION
20
Presidents as Advocates Entrepreneurs and Agenda Setters
21
PRESIDENTS AS ADVOCATES AND ENTREPRENEURS
23
POLICY CHANGE RESEARCH
24
THE PRESIDENTS AND THEIR POLICIES
26
DATA AND METHODS
35
RESULTS
40
DISCUSSION
43
CONCLUSION
46
Healthy Wealthy and Wise?
49
THEORIES OF INFORMATION
51
THE FAILURE OF THE HEALTH SECURITY ACT
55
INFORMATION AND POLICY SUPPORT
57
MEASURING AND TESTING KNOWLEDGE
58
A MODEL OF RECIPROCAL CAUSATION
59
RESULTS
63
CONCLUSION
64
MEDIA PRIMING
84
MEDIA COVERAGE AND INFORMATION ABOUT THE HEALTH SECURITY ACT
87
DATA AND METHODS
88
A MODEL OF PRIMING EFFECTS ON 1996 PRESIDENTIAL VOTE INTENTIONS
89
RESULTS AND DISCUSSION
90
AN EXPERIMENTAL TEST OF MEDIA PRIMING OF HEALTH CARE IN THE 2000 PRESIDENTIAL RACE
91
RESULTS AND DISCUSSION
94
CONCLUSION
96
Dynamic Health Policy Change
99
THE PUBLIC MOOD AND NATIONAL HEALTH CARE SPENDING
103
HEALTH POLICY HISTORY AND PRESIDENTIAL ACTIVITY
104
THE RISE AND THE DEMISE OF THE HEALTH SECURITY ACT
105
CONCLUSION
107
Methodological Appendix
109
Notes
129
References
133
Index
149
Copyright

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About the author (2004)

Richard E. Chard is a Senior Research Associate at the Association of American Medical Colleges.

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