The Mediating Effect of Public Opinion on Public Policy

Exploring the Realm of Health Care

By Richard E. Chard

Subjects: Public Opinion, Public Policy, Health And Society, American History
Series: SUNY series in Public Policy
Paperback : 9780791460542, 190 pages, July 2004
Hardcover : 9780791460535, 190 pages, July 2004

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Table of contents


1. Health Policy Change


Why Has Health Care Dominated the Policy Agenda?
Explanations from Social Science


2. Exploring the Foundations of Dynamic Policy Change


Path Dependence
The Importance of Public Opinion in Shaping Health Care Policy
American Health Care Policy
The Dynamic Nature of Health Care Reform?
Incrementalism versus Dynamism in Health Care


3. Path Dependence and Policy Change


Social Constructions and Medicare
How the Elderly Lost and Regained Their Health Insurance
Analyzing Change
Does the Mood Really Matter?


4. Presidents as Advocates, Entrepreneurs, and Agenda Setters


Presidents as Advocates and Entrepreneurs
Policy Change Research
The Presidents and Their Policies
Data and Methods


5. Healthy,Wealthy, and Wise?


Theories of Information
The Failure of the Health Security Act
Information and Policy Support
Measuring and Testing Knowledge
A Model of Reciprocal Causation


6. Examining the Impact of Countervalent Messages on Policy Support


Media Effects: Negative Advertsing and "Harry and Louise"
The Media and the Health Security Act
Study One: Testing the Strength of the Countervalent Information Message
Study Two: Understanding the Effects of Political Sophistication


7. Media Effects and Policy Opinions


Media Priming
Media Coverage and Information about the Health Security Act
Study One: Data and Methods
Study One: A Model of Priming Effects on 1996 Presidential Vote Intentions
Study One: Results and Discussion
Study Two: An Experimental Test of Media Priming of Health Care in the 2000 Presidential Race
Study Two: Data and Methods
A Model of Priming Effects on Candidate Evaluations
Study Two: Results and Discussion


8. Dynamic Health Policy Change


The Public Mood and National Health Care Spending
Health Policy History and Presidential Activity
The Rise and the Demise of the Health Security Act


Methodological Appendix




Examines how public opinion has influenced health care policy.


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.

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