Jacobs L R
University of Minnesota.
J Health Polit Policy Law. 1993 Fall;18(3 Pt 2):629-55. doi: 10.1215/03616878-18-3-629.
This paper presents two interrelated arguments: it rethinks conventional understanding of the policy-making process and analyzes an important substantive issue regarding public opinion. The substantive issue involves the public's deep ambivalence toward government reforms: Americans are simultaneously supportive of significant reform and uneasy about expanding government involvement. The critical question is what, if any, impact this public ambivalence will have on policy deliberations. Answering this question requires an analysis of the role of public opinion in policy-making. Investigation of historic as well as contemporary health reform suggests that the impact of public opinion varies, depending on the character of both public opinion and the policy issue. The public's preferences are not especially influential when they are characterized by uncertainty or when an issue is not salient, but strong and sustained sentiment can affect agenda setting, interest group leverage over government officials, and policymakers' formulation of detailed administrative arrangements.
它重新思考了对决策过程的传统理解，并分析了一个关于公众舆论的重要实质性问题。这个实质性问题涉及公众对政府改革的深刻矛盾心理：美国人既支持重大改革，又对政府干预的扩大感到不安。关键问题是，这种公众矛盾心理将对政策审议产生何种影响（如果有影响的话）。回答这个问题需要分析公众舆论在决策中的作用。对历史和当代医疗改革的调查表明，公众舆论的影响各不相同，这取决于公众舆论和政策问题的性质。当公众的偏好具有不确定性或某个问题不突出时，其影响力并不特别显著，但强烈而持续的情绪会影响议程设定、利益集团对政府官员的影响力以及政策制定者对详细行政安排的制定。
