Who Cares About Health Care? Sociodemographics and Attitudes Toward Government’s Role in Health Care Across Germany, Great Britain, and the United States

Abstract

This paper investigates comparative public attitudes as a mechanism to explain American welfare state “exceptionalism” in health care. The countries of Germany, Great Britain, and the United States were chosen as three distinct cases that exemplify different health care models. Using data collected from the 2006 International Social Survey Program (ISSP), this study 1) analyzed the influence of individual-level indicators on public attitudes toward government’s role in health care in the three countries and 2) looked at how these relationships differed cross nationally. Based upon past research regarding path-dependency research and demographics, 11 individual-level indicators were chosen. Findings revealed that although significant differences exist across the nations, majority of participants from Germany, Great Britain, and the United States felt that their governments have a responsibility to provide health care and that the government should be spending more on health care. This goes against conventional wisdom regarding public opinion and health care reform. Overall, Americans wanted to see more government responsibility and spending in health care, but did not feel that the government was successful in delivering health care. Political affiliation in the United States was the only individual-level indicator to predict greater odds of attitudes in government spending, responsibility, and success; the same effects were not found in Germany and Great Britain. Further policy research should look into how trust in government efficacy can be developed. Framing health care as an urgent matter that emphasizes equal opportunity may also help to overcome political bipolarization in America. Additionally enfranchising different interest groups and taking a top-down approach to political reform could additionally move reform forward in the United States.