Public Support for National Health Insurance: The Roles of Attitudes and Beliefs

The U.S. is the only developed country without some form of national health insurance. Yet, public opinion polls have consistently reported solid majorities in favor of such a system. In this paper, we examine whether attitudes toward different roles of government and beliefs that may be related to those attitudes are consistent with widespread support for national health insurance. Our analysis is based on the premise that a system of national health insurance would require government redistribution and government intervention in health care markets. We find that people who have favorable attitudes toward government economic intervention are 27 percentage points more likely and those with favorable attitudes toward government economic intervention are 18 percentage points more likely to favor national health insurance than those with unfavorable attitudes. The most intense support for national health insurance, strongly favoring as opposed favoring it, is among people with favorable attitudes toward both roles of government. Consistent with research from other social programs, we find that the beliefs regarding racial minorities, as well as beliefs regarding individual control over life, limit support for national health insurance in the U.S. On the other hand, negative beliefs regarding businesses are an important source of support for national health insurance. We conclude that significant changes in either attitudes and beliefs or their relationship with support for national health insurance are probably necessary to create a strong majority in support of such legislation.

Duke Scholars

Author M. Kate Bundorf Sanford School of Public Policy