The Conditioning Effect of Party Linkages on Attitudes on Health Care Provision

This paper examines how characteristics of party organizations, in particular whether the relationship between parties and voters is based on programmatic or clientelistic linkages, affect the extent to which voters think that the provision of health care is the responsibility of the state. We find that the type of party-voter linkage mediates the preferences of voters regarding the provision of health care. Specifically, with programmatic linkages between party and voters, moving from a left-wing to a right-wing voter decreases the support for government sponsored health care. The partisan effect is absent or reversed for cases with mixed or clientelistic linkages, which suggests that in such party systems, the traditional channels for transforming preferences into policy are distorted, therefore also jeopardizing accountability mechanisms. Our results suggests a feedback mechanism whereby the characteristics of political parties shape voters’ preferences, which opens up new questions regarding the role and motives of political parties.

 Our paper thus advances our understanding of how contextual factors shape voters’ policy preferences and attitudes. Furthermore, it contributes to the literature on welfare state changes, where one of the main accepted mechanisms is that political parties channel voters’ preferences and translate them into policy.

 The study uses a mixed effects cross-sectional model, where the first level utilizes individual-level data from the European Social Survey (2008). The second level utilizes country level data from the Varieties of Democracy database, Eurostat and the World Bank.