T03P06 - Policy, Values and Human Behaviour

Topic : Policy and Politics sponsored by Policy & Politics Journal

Chair : Linda Botterill - linda.botterill@canberra.edu.au

Second Chair : Geoff Cockfield - Geoff.Cockfield@usq.edu.au

Third Chair : Alan Fenna - a.fenna@curtin.edu.au

General Objectives, Research Questions and Scientific Relevance

Call for papers

Session 1 Values and evidence in the policy process

Thursday, June 29th 13:30 to 15:30 (Manasseh Meyer MM 2 - 1)

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Values & Perceptions in Urban Water Supply Reform: Evidence from India

Olivia Jensen - olivia.jensen@nus.edu.sg - National University of Singapore LKY School of Public Policy - Singapore

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Urban water services in many developing countries are characterised by limited coverage, poor service quality, low levels of efficiency and are dependent on subsidies. This poor performance is particularly stark in India where almost half of urban residents have no piped water connection and no city is able to provide a continuous, 24-hour/day supply of water to its residents. At the same time, there are high levels of non-compliance by households who make illegal connections to the network or who refuse to pay their bills. This lack of compliance, in turn, tends to reinforce the poor performance of the utility. Authors have emphasised different reasons for the difficulties in reforming urban water supply, from the economic characteristics of the sector, to its political economy, weak governance and corruption to the role of social movements. Beyond numerous contingent valuation studies, often prepared in the context of an incipient loan from a multilateral development bank, the values and perceptions of households in relation to water services have received less attention.

In this paper, we seek to understand whether these values and perceptions can help to explain why water services are so difficult to reform. We do so through the study of a mid-sized city in central India where water reforms through a public-private partnership (PPP) are ongoing. We analyse data from a survey of 1500 households in the city representing different types of water users – households with a piped connection, households with an illegal connection and households with no piped connection – along with data from in-depth interviews with households, the utility, policy-makers and other stakeholders.

The analysis reveals several trends in values and perceptions that shed light on the difficulty of designing effective policy for water service supply, while also showing some constraints to be less critical than often assumed: the vast majority of households of all income and education levels do not want 24-hour supply; the majority say that 6 hours of supply or less would be adequate for their needs. There is no general preference for government or private provision of water supply – most households are unaware and unconcerned about the PPP contract as well as tariff adjustments; of those that are aware, many view the involvement of the private sector positively. Households who do not pay bills or maintain illegal connections often do not view themselves as non-compliant: the majority of households with illegal connections also approve of the utility cutting off illegal connections.  

These findings may have useful implications for policy design. For example, policies may be needed to generate demand for improved services, through demonstration or pilot projects; public opinion could be mobilised to counteract interest group opposition to PPP-based reforms; efforts need to be made to improve accuracy and reliability of billing in order to clarify which households are non-compliant before non-compliance can be effectively addressed.

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ABORTION POLITICS AND THE ROLE OF LEGAL EXPERTS IN POLICY

jennifer Duxbury - jenny.duxbury@canberra.edu.au - Institute for Governance and Policy Analysis, University of Canberra - Australia

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ABORTION POLITICS AND THE ROLE OF LEGAL EXPERTS IN POLICY

 

Six roles of legal experts in government
“We forthwith acknowledge our awareness of the sensitive and emotional nature of the abortion controversy, of the vigorous opposing views, even among physicians, and of the deep and seemingly absolute convictions that the subject inspires. …….. Our task, of course, is to resolve the issue by constitutional measurement, free of emotion and of predilection.” Per Blackmun J, Roe v Wade, 410 U.S. 113 (1973).

 

 “I am putting pro-life justices on the Court.” Donald Trump, CNN, October 19, 2016

 

There is a strong sub-field of policy scholarship around the appropriate role of technical experts in government policy which has largely focused on experts from research based disciplines such as science and economics. Scholars have long argued whether policy decisions are or should be the result of a rational decision-making process. The term “Abortion Politics” was coined by Roger Pielke to describe a policy environment characterised by a high degree of values conflict and emotion (Pielke, 2007). In volatile, values-driven debates, Pielke argues that experts’ knowledge plays a limited role in resolving the policy problem under review. Decision-makers cannot avoid making values-based judgements about the countervailing interests and social values in the mix.

In one important respect, legal experts are very different to other technical experts advising on policy because of the rule of law. At its most basic, the rule of law requires government as much as citizens to comply with the law. The rule of law drives governments’ need for expert legal advice on policy problems. Although the nature, meaning and purpose of the rule of law are highly contested, in all its incarnations it assumes law, policy and politics are separate spheres. Paradoxically, for law to remain integral to government decision-making the doctrine requires law to remain apart from the political process.

The rule of law assumes that law can fulfil a prudential function in government because it is relatively determinate and legal experts can apply it objectively, without judging the policy outcome. This is a “legalistic” perspective of the law as iterated by Justice Blackmun in Roe v Wade. In contrast, Donald Trump espouses a “realist” or “behaviourist” approach to law. On this view law is relatively indeterminate and resides in the value judgments made by legal experts. Politicians can secure policy outcomes by “shopping around” for legal experts who are policy partisans. A “realist” approach allows legal experts to adopt a more sceptical stance towards legal rules in guiding government decisions and a willingness to incur the risk of them being tested by the electorate.

Drawing from “legalist” and “realist” theories about law in society and Roger Pielke’s model for technical experts in policy and politics, this paper develops a conceptual framework which shows six idealised role choices open to legal experts advising government on policy. These are: the “Adversarial Advocate”, the “Arbiter”, the “Non-Practitioner”, the “Issues Advocate”, the “Pragmatic Lawyer” and “the Engineer”. These role choices are then contextualised within different institutional settings and types of politics with varying degrees of values contest. The framework maps the role choices open to legal experts in different political terrains and shows how those choices affect the rule of law.

 

Jennifer Duxbury, PhD candidate, Institute of Governance and Policy Analysis. University of Canberra, Australia, January 2017 

Reference:

Pielke, Roger A., The Honest Broker. Making Sense of Science in Policy and Politics (Cambridge University Press, 2007)

 

The non-intrinsic motivations for public service: empirical evidence from China

XU CHENGWEI - cxu005@e.ntu.edu.sg - Public Policy & Global Affairs, Nanyang Technological University , Singapore - Singapore

Haque Ariful - arifenglish@yahoo.com - Nanyang Technological University - Singapore

The public administration scholars nowadays have paid much attention to the motivation for public service. And the Public Service Motivation (Buelens & Van den Broeck, 2007) theory has been a leading approach in this trend. The PSM gained so much success in terms of conceptualization, measurement, and casual analysis. However, there is little progress in implementation. Researchers found lacking extrinsic motives made PSM problematic and unrealistic (Bozeman & Su, 2015; Prebble, 2014; Ritz, Brewer, & Neumann, 2016; Xu & Chen, 2016). Several recent studies suggest analysing the motivations for public service through Self-Determination Theory (SDT). By SDT, the motivation for public service (MPS) contains six types of motivations: amotivation, intrinsic motivation, identified motivation, instrumental motivation, introjected motivation, and external motivation. Then we examined individuals’ MPS by 37 interviews and two rounds of questionnaire survey. The factor analysis confirmed that the motivation for public service includes six dimensions by SDT. The results show the public employees are driven by both intrinsic and extrinsic motivations. A measurement scale for frontline employees’ motivation was proposed as well. Lastly, regression results show that the public employees who perceived higher need satisfaction (Wittmer, 1991b) are more likely driven by autonomous motivations and may have a higher level of job satisfaction. The employees with an autonomous motivation for job selection (MJS) more likely show an autonomous motivation for public service.

Session 2 Nudge, behavioural insights, and policy choice

Friday, June 30th 08:15 to 10:15 (Manasseh Meyer MM 2 - 1)

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Are nudges new, or a new label for old tools? The policy makers perspective.

Colette Einfeld - colette.einfeld@unimelb.edu.au - Australia

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Nudges were lauded as having the potential to ‘revolutionise policy and governance’ (Barrett, 2011) and have been eagerly adopted by administrations around the world. There is evidence of nudging in the UK, USA, EU, South America and Australia. Some of these countries have established dedicated Behavioural Insights Teams to advance this ‘new tool’. State government in Australia certainly seems to see nudges as a different approach, describing behavioural insights as a ‘new way of looking at public policy challenges…’ (NSW Behavioural Insights Unit, 2014).

 

Nudging is also described in the academic literature as a ‘new approach’, and the traction the approach has in policy does seem to be new. Nudges have also been contrasted with traditional policy tools reinforcing the notion that nudges are different to established tools. Some aspects of the approach do seem to be new, including the use of the principles of behavioural economics and psychology in choice architecture in public policy.

 

Yet there are debates in the literature about whether nudging is really anything new. In part, the argument of whether nudges are new rests on how nudges are understood. For example, if information provision or persuasion are included as nudging, then nudging may not be seen as new, but simply a new name for traditional approaches.

 

Arguments that nudging is nothing new are not substantiated by empirical research with policymakers. To date, the voices of those involved in developing and designing nudges in public policy have not been included in the debate. This original research seeks to provide an empirically informed understanding of whether policy workers see nudging as new. This paper begins by reviewing the discussion in academic literature on how nudging contrasts or is similar to other policy tools. It then introduces the empirical research, outlining the methodological approach of in-depth interviews with those involved with the design and development of nudge policies, including policy officers, academics and consultants. The paper concludes with a discussion on policy makers’ perspectives of nudges as innovative policy tools or rebranding of previous approaches, and that perceptions of the newness of nudging partly depends on how nudges are understood.

 

This paper provides an empirical contribution to the debates on whether there is something new in nudging, by exploring the views of those who are designing, developing and using the approach.

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The advancement of behavioural insights: Implications for policy design

Colin Kuehnhanss - colin.kuehnhanss@vub.be - Vrije Universiteit Brussel - Belgium

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Behavioural insights are becoming increasingly popular with policy practitioners. Findings and methods originally provided by cognitive psychology and later behavioural economics have found use in the formulation of public policies. Their most popularised application has emerged with Libertarian Paternalism and the related 'nudging'. Its proponents claim to provide a new instrument to facilitate the formulation of effective and evidence-based policy, taking people's actual behaviour into account from the outset, while preserving their liberty to choose. This paper reviews the origins of the behavioural insights and Libertarian Paternalism movements and takes a critical look at the normative foundations nudging relies on as a policy tool. It also discusses the ongoing efforts to build policy capacity to integrate behavioural insights and experimental methods in the creation of public policy. While behavioural insights offer a powerful tool to re-shape and design new evidence-based policy, designers - and the targets of those policies - should be aware of the distinctly normative basis that many of the most celebrated examples of nudging come with despite their empiric appearance.

Micro-foundations of Groupthink

R Sulitzeanu-Kenan - raanan.s-k@mail.huji.ac.il - Hebrew University - Israel

TAHER ABOFOL - taheraf@gmail.com - Technion - Israel

The notion of “groupthink” – coined by Irving Janis – has been identified by both academics and policymakers as a central cause of major institutional and organizational failures. The main behavioral claim underlying groupthink is the tendency of group members to self-censor views that threaten the group’s consensus, leading to sub-optimal performance, and sometime major organizational failures. However, while many case studies identify elements of groupthink as antecedents of poor decisions, and experimental studies provide mixed support for the model’s predictions, no study has so far demonstrated the causal effect of group cohesiveness on group output performance. Moreover, despite the fact that a central feature of the historical cases that provided inspiration for the theory (e.g. The Pearl Harbor attack) is the failure of groups to address changes in their environments, this particular element is absent from previous attempts to test the theory experimentally.

We rely on a two laboratory experiments (N=240). Participants were tasked with an experience-based decision making assignment (Erev & Roth 2014). Such assignments provide environments whose structure is not explicit nor directly observable, thus decision makers can learn about the properties of their options only by experiencing the outcomes of their choices. Participants were assigned to one of three conditions. (1) Individual (N=30); (2) Group (N=90: 30 groups of 3); (3) Cohesive-group (N=90: 30 groups of 3). Participants played a computer game that consists of 100 sequential choices between two alternatives presented as two unlabeled buttons on a computer screen. On each trial, participants clicked on one of the two buttons and either won or lost points. After clicking, participants saw the outcomes of their choices. Their objective was to maximize the number of points obtained over the 100 trials in each game. The game had two stages (unknown by the participants): a stage where one option dominated the other and a stage where the dominant option switched to be the other one. These two stages simulate a stable environment (rounds 1-60), and a dynamic environment (round 61 onward). All the participants performed the experiment on their own computer terminal, without seeing any of the other participants. Participants in the group condition were informed that they are part of a 3-member group, and after they made their individual choice, the actual decision was a group-decision (majority). The cohesive-group condition was the same as group with the addition that participants whose individual choice was different from the subsequent group decision (i.e. dissenters) incurred a small deduction from their payoff.

Our results show that cohesive-groups performed slightly better than individuals and groups in a stable environment, but were markedly slower in recovering from a change in the environment compared to both individuals and groups. These results provide direct support for the effect of group cohesiveness on group performance, and further specifies its detrimental consequences as applying to dynamic environments. The second experiments (N=30) addresses a competing explanation, and the paper further discuss the implications of the findings to public policy.

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“Our Money Or Your Life!” The real architecture of choice in public policy

Duncan Grant - L.G.Duncan@massey.ac.nz - New Zealand

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Concerns about technocratic ‘nudge’ policies focus on values such as individual autonomy, public deliberation and transparency. The present paper’s theme is trust and distrust, as the necessary background for such techniques. To be valid, nudge interventions presuppose both trust (in public authorities) and distrust (in people’s rationality). Dis/trust does not presuppose nudges, however. Transparency and normal safeguards are needed in case citizens (even if a minority) reject some nudge techniques as too manipulative or culturally inappropriate. We are left with the age-old question: Who guards the guardians? Who designs the choice architecture surrounding the choice architects? Do we trust them?

Democratic constitutions entrust office-holders with only limited powers for the very sound reason that no one can be trusted with unlimited, absolute power. Citizens’ trust/distrust in decision-makers is politically and constitutionally vital, but their trust is not normally calculated or chosen. Trust is an inter-subjective quality of relationships and social networks; it is in itself neither a decision nor a value. But trust entails behaviour that people do value. Hence, ‘values’ in public service and democratic politics – such as integrity or fairness – rely upon conditions of trust. Policy studies reduce trust to a one-dimensional, individualized statistical indicator, however, treating it as unequivocally ‘good’ and failing to capture its political complexity and ambiguity. The present paper aims to correct this.

My public policy example is money – legal tender issued by a public authority (central bank) underpinned by systemic or abstract trust. My example of ‘irrational’ behaviour is the finding that people ‘mispredict’ future utility (defined as ‘subjective well-being’) when making decisions about augmenting incomes. Should we be ‘nudged’ away from relentless pursuit of money, and towards intrinsic well-being rewards through less commuting and more time with family? ‘Nudgenomics’ intervenes into the logic of free choices, but it does not address the structure of choice itself, particularly ‘forced choices’ where there is no ‘opt-out.’

The systemic trust that monetary systems and governments rely upon needs re-examination before we consider interventions into ‘choice architectures.’ Recent political events reinforce a belief that political trust is in decline. But it sounds ethically wrong and practically infeasible to propose a behavioral intervention to raise the level of citizens’ trust in governments. On the other hand, politicians and public servants (indeed anyone) can rightly aim to act in ways that are worthy of trust. Should our attention turn to the leaders rather than the led?

Session 3 Values and politics

Friday, June 30th 10:30 to 12:30 (Manasseh Meyer MM 2 - 1)

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Political values, voting intentions and policy attitudes: An exploratory study from Australia

Linda Botterill - linda.botterill@canberra.edu.au - University of Canberra - Australia

Geoff Cockfield - Geoff.Cockfield@usq.edu.au - University of Southern Queensland - Australia

Alan Fenna - a.fenna@curtin.edu.au - Curtin University - Australia

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There is limited but increasing empirical work examining connections between personal values, ideology and support for particular political parties. There is however, very little work that considers the links from these factors to policy preferences. This paper is part of a larger project considering the role and analytical potential of values in politics and policy processes. In order to develop this, we consider if and how, personal values translate through political and policy preferences to actual policy responses.

In this paper we explore the relationships between a set of core political values items, voting intentions and attitudes to three interrelated and highly salient issues. These issues are: coal seam gas extraction, wind farm developments and climate change. We build on the empirical work of Schwartz et al. (2010), in considering whether or not the degree of adherence to particular political values predict voting for particular parties. We then consider whether or not, either or both values and voting intention predict attitudes to particular policy issues. We present the results of the empirical analyses and then consider the implications for theorising the relationships between individual values, parties and their policy and proclaimed values and ideology. 

Politics rules, okay? Rhetorical predictability, blame games and ‘the logic of fateful choices facing commissioners of inquiry’ in metropolitan reforms in New South Wales (NSW) Australia 2011-17.

Bligh Grant - Bligh.Grant@uts.edu.au - University of Technology Sydney - Australia

Joseph Drew - Joseph.Drew@uts.edu.au - uTS - Australia

Against the backdrop of an increase in the application of behavioural approaches to public policy and political science, we present an overview of three analyses of the high-stakes reform processes around ‘Sydney Global City’ from 2011 to the present. The first applies Albert Hirschman’s (1991) ‘rhetoric of reaction’ thesis, which is grounded in the unnerving idea that all public policy debates ‘lumber predictably through set motions and manoeuvres’. The second applies and adapts Christopher Hood’s (2007) ‘blame games’ thesis, where the pursuance of rational, indeed reasonably defensible public policy grounded upon empirical claims is revealed as farcical and sacrificed to political expediency. The third applies Joe Wallis’ (2013) theory of the ‘logic of fateful choices of commissioners of inquiry’ to the same public policy process. Notwithstanding the important caveat that social scientists are prone to reveal what they seek to discover, we argue that all three theories were substantively (rather than casually, or minimally) vindicated by the empirical research undertaken. Reflecting upon the implications of this for the practices of political science and public policy analysis, we locate the work of Hirschman (1999) Hood (2007) and Wallis (2013) along a continuum of behaviourism, nevertheless arguing that all three approaches validate the rhetorical over the empirical in the pursuance of public policy where evidence is a mere element of rhetoric. However, we argue that this particular public policy process was still tacitly structured around the conflict between utilitarian ends-based goals on the one hand and deontological, rights-based claims on the other.Against the backdrop of an increase in the application of behavioural approaches to public policy and political science, we present an overview of three analyses of the high-stakes reform processes around ‘Sydney Global City’ from 2011 to the present. The first applies Albert Hirschman’s (1991) ‘rhetoric of reaction’ thesis, which is grounded in the unnerving idea that all public policy debates ‘lumber predictably through set motions and manoeuvres’. The second applies and adapts Christopher Hood’s (2007) ‘blame games’ thesis, where the pursuance of rational, indeed reasonably defensible public policy grounded upon empirical claims is revealed as farcical and sacrificed to political expediency. The third applies Joe Wallis’ (2013) theory of the ‘logic of fateful choices of commissioners of inquiry’ to the same public policy process. Notwithstanding the important caveat that social scientists are prone to reveal what they seek to discover, we argue that all three theories were substantively (rather than casually, or minimally) vindicated by the empirical research undertaken. Reflecting upon the implications of this for the practices of political science and public policy analysis, we locate the work of Hirschman (1999) Hood (2007) and Wallis (2013) along a continuum of behaviourism, nevertheless arguing that all three approaches validate the rhetorical over the empirical in the pursuance of public policy where evidence is a mere element of rhetoric. However, we argue that this particular public policy process was still tacitly structured around the conflict between utilitarian ends-based goals on the one hand and deontological, rights-based claims on the other.

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Bias, cognition, and post-truth politics: considering the cognitive-political origins of misperceptions to improve evidence use in political arenas

Justin Parkhurst - j.parkhurst@lse.ac.uk - London School of Economics and Political Science - United Kingdom

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While calls for evidence to inform policy have grown over recent years, these appears to stand in stark contrast to recent high level political events demonstrating that large segments of the population can show minimal regard for evidentiary rigour or expertise in regard to politics. Indeed the creation and belief of misinformation, and the apparent public rejection of corrections, during campaigns such as the British EU referendum and the recent US general election, has led to many now describing the political environment as having entered an era of ‘post-truth politics’.

 

The proliferation of politically motivated misinformation, and the failure of evidence and fact-checking to correct it, can be seen to many as providing a fundamental challenge to the democratic ideals of rational decision making by a well-informed populace. The cognitive sciences, however, have provided a wealth of information that can help explain both the origins and the mechanisms by which evidentiary bias arises, and through which misinformation is embraced or persists [1-3].  

 

While recent political events appear to show a lack of relevance of evidence, fact-checking or expertise, the relative importance of these is subject to change and will vary by context. One example is the recognition that highly polarised political contexts can generate or perpetuate biases through processes of motivated reasoning [4]; but levels of societal polarisation will shift over time and place. As such, while cognitive psychology has shown that many sources of bias lie in the natural or intuitive functioning of the human mind, it may ultimately be social, political, and structural contexts that will shape whether or how those biases influence the acceptance and use of policy-relevant evidence.

 

In recent years there have slowly been efforts to link cognitive science with public policy concerns – for example to map out features of policy debates that may facilitate different underlying mechanisms through which bias arises [5]; or to test different de-biasing or myth-correcting strategies in relation to political information [6, 7]. There is clearly significant further work needed, however, to consider how such cognitive insights might inform strategies to avoid, offset, or mitigate bias in political arenas. This paper will review both the conceptual and empirical work on bias, misinformation, and debiasing in relation to policy-relevant information; and discuss whether these insights can help to design institutional arrangements, rules or  processes, that can help to (re)establish the importance and relevance of evidence and expertise, thereby working to address the biases and misinformation of the ‘post-truth’ age.

 

1.            Flynn, D., B. Nyhan, and J. Reifler, The Nature and Origins of Misperceptions: Understanding False and Unsupported Beliefs about Politics. Advances in Pol. Psych, 2016.

2.            Kahan, D.M. What Is Motivated Reasoning and How Does It Work? 2011  06/03/2015]; Available from: http://www.scienceandreligiontoday.com/2011/05/04/what-is-motivated-reasoning-and-how-does-it-work/.

3.            Kahan, D.M., et al., Motivated numeracy and enlightened self-government. Yale Law School, Public Law Working Paper, 2013(307).

4.            Kahan, D.M., Ideology, motivated reasoning, and cognitive reflection. Judgment & Decision Making, 2013. 8: p. 407-424.

5.            Parkhurst, J.O., Appeals to evidence for the resolution of wicked problems: the origins and mechanisms of evidentiary bias. Policy Sciences, 2016. 49(4): p. 373-393.

6.            Nyhan, B. and J. Reifler, Which corrections work? 2013, New America Foundation: Washington D.C.

7.            Lewandowsky, S., et al., Misinformation and its correction continued influence and successful debiasing. Psychological Science in the Public Interest, 2012. 13(3): p. 106-131.

 

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Public attitudes toward government level control over healthcare – self-interest, ideological values or an impact of institutions

Mare Ainsaar - mare.ainsaar@ut.ee - University of Tartu - Estonia

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Public attitudes are important in shaping health-care policies and bringing legitimacy to the policymaking process, especially in times of increasing pressures on health care. The formation of public attitudes toward healthcare has been explained by three broad sets of factors – interests, ideologies and institutions previously, but the relative importance of these factors is poorly understood. The aim of the paper is to investigate the relative importance of self-interest, ideological values and institutional factors associated with public attitudes toward the role of a government in regulating health-care in 29 countries.

 

Methods

We use European Social Survey (ESS) data. ESS round 4 (2008/2009) was one of the richest in terms of number of countries in the survey. Public attitudes toward government responsibility in healthcare provision was measured with a question “People have different views on what the responsibilities of governments should or should not be to ensure adequate health care for the sick. In this paper we are interested in what factors distinguish those people who do not support government actions from those in favor of a government, and what is the importance of self-interest, ideological and institutional factors in this division. We split the variable “Health care for the sick is governments' responsibility” into two groups. The first group (points 0-5) includes those who do not to support government’s role in health care and the second is a group of supporters of government responsibility (6-10). All together the first group represent 6.4% individual in the dataset for 29 countries. However  the distribution is quite unequal in different countries, ranging from 20% to 3%. We run multilevel logistic regression models.

 

Results

Countries differ considerably in their structure of support to government in heath care activities. The most universal is the influence of ideological leaning variables on the attitudes about the role of a government. Also  men, people with less than lower secondary education and people with fair and good health have lower support toward government’s responsibility providing health-care compared to women, more educated people and people with very bad, bad and very good health, respectively. However the U- curve relationship between individual health conditions and public attitudes emerges clearly only in 10 countries out of 29. In these countries interestingly people with the best and worst health support more government actions. Among institutional factors, people in countries with lower expenditures on health care have higher odds for not supporting the role of a government in health-care. In U countries the direction of the relationship is opposite and also people in countries with higher share of public expenditures and higher share of out of pocket payments have higher odds for not supporting the role of the government.

 

Conclusions

Ideological leaning have the most robust influence on the public attitudes toward the role of  a government in provision of health-care. Institutional factors and self-interest variables have more limited influence.

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