Gusmano Michael K, Schlesinger Mark, Thomas Tracey
International Longevity Center, USA.
J Health Polit Policy Law. 2002 Oct;27(5):731-72. doi: 10.1215/03616878-27-5-731.
This study extends the literature on policy feedback and explores the extent to which public attitudes reflect learning from past government initiatives. We analyze the ways in which feedback mechanisms affecting public attitudes may differ from those earlier identified in the literature. We apply this general analytic framework to help explain variation in public attitudes toward private employer involvement in health care, explore possible causal pathways, and offer some preliminary empirical tests of these hypotheses. There are different levels of public support for the notion of employer obligation involving medical care, long-term care, and the treatment of substance abuse. Our evidence suggests that lessons about the performance of institutions in each of these policy domains represent the most important effect of existing policy on public attitudes. Furthermore, these differences correspond to what one would expect based on our model of policy feedback and cannot be explained by other plausible sources of policy legitimacy.
本研究拓展了关于政策反馈的文献,并探讨了公众态度在多大程度上反映了从过去政府举措中吸取的经验教训。我们分析了影响公众态度的反馈机制可能与文献中先前确定的机制有所不同的方式。我们应用这一通用分析框架来帮助解释公众对私人雇主参与医疗保健态度的差异,探索可能的因果路径,并对这些假设进行一些初步的实证检验。对于雇主在医疗保健、长期护理和药物滥用治疗方面承担义务这一概念,公众支持程度存在差异。我们的证据表明,关于这些政策领域中各机构表现的经验教训是现有政策对公众态度最重要的影响。此外,这些差异与基于我们的政策反馈模型所预期的情况相符,并且无法用其他合理的政策合法性来源来解释。