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

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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.
 

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Contents

Health Policy Change
1
EXPLANATIONS FROM SOCIAL SCIENCE
4
OVERVIEW
7
Exploring the Foundations of Dynamic Policy Change
11
THE IMPORTANCE OF PUBLIC OPINION IN SHAPING HEALTH CARE POLICY
14
AMERICAN HEALTH CARE POLICY
16
THE DYNAMIC NATURE OF HEALTH CARE REFORM?
20
INCREMENTALISM VERSUS DYNAMISM IN HEALTH CARE
26
CONCLUSION
90
Examining the Impact of Countervalent Messages on Policy Support
93
NEGATIVE ADVERTISING AND HARRY AND LOUISE
94
THE MEDIA AND THE HEALTH SECURITY ACT
97
TESTING THE STRENGTH OF THE COUNTERVALENT INFORMATION MESSAGE
99
UNDERSTANDING THE EFFECTS OF POLITICAL SOPHISTICATION
101
DISCUSSION
104
CONCLUSION
107

Path Dependence and Policy Change
29
SOCIAL CONSTRUCTIONS AND MEDICARE
33
ANALYZING CHANGE
35
DOES THE MOOD REALLY MATTER?
44
CONCLUSION
46
Presidents as Advocates Entrepreneurs and Agenda Setters
47
PRESIDENTS AS ADVOCATES AND ENTREPRENEURS
49
POLICY CHANGE RESEARCH
50
THE PRESIDENTS AND THEIR POLICIES
52
DATA AND METHODS
61
RESULTS
66
DISCUSSION
69
CONCLUSION
72
Healthy Wealthy and Wise?
75
THEORIES OF INFORMATION
77
THE FAILURE OF THE HEALTH SECURITY ACT
81
INFORMATION AND POLICY SUPPORT
83
MEASURING AND TESTING KNOWLEDGE
84
A MODEL OF RECIPROCAL CAUSATION
85
RESULTS
89
Media Effects and Policy Opinions
109
MEDIA PRIMING
110
MEDIA COVERAGE AND INFORMATION ABOUT THE HEALTH SECURITY ACT
113
DATA AND METHODS
114
A MODEL OF PRIMING EFFECTS ON 1996 PRESIDENTIAL VOTE INTENTIONS
115
RESULTS AND DISCUSSION
116
AN EXPERIMENTAL TEST OF MEDIA PRIMING OF HEALTH CARE IN THE 2000 PRESIDENTIAL RACE
117
DATA AND METHODS
118
RESULTS AND DISCUSSION
120
CONCLUSION
122
Dynamic Health Policy Change
125
THE PUBLIC MOOD AND NATIONAL HEALTH CARE SPENDING
129
HEALTH POLICY HISTORY AND PRESIDENTIAL ACTIVITY
130
THE RISE AND THE DEMISE OF THE HEALTH SECURITY ACT
131
CONCLUSION
133
Methodological Appendix
135
Notes
155
References
159
Index
175
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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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