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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.
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