Health Policy Reforms and the Public Opinion

The relationship between public opinion and welfare state policies lies at the centre of representative democracy. Scholars of policy responsiveness have tested whether support for government spending affects the level of program generosity and vice versa. Similar to preferences for universal or selective policies, public views on policies are expected to pressure governments into reforming the system. Likewise, reforms are expected to reduce individuals’ concerns and thus increase their satisfaction. Employing a newly collected innovative dataset of reforms in the health system for 32 European countries since 1990, bi-annual Eurobarometer data on the saliency of health care, and 7 waves of ESS data on satisfaction with health system, I test empirically using longitudinal methods the causal relationship between health policy reforms and the public opinion. Preliminary analysis indicates a bidirectional relationship between reforms and both satisfaction with and saliency of health system. This study has important implications for the literature on public responsiveness and representative democracy; and makes a substantive empirical contribution to the debate on welfare state reforms under the pressure of population aging, globalization and migration, especially in the area of health care, where market-based services are proposed as a solution to citizens’ rising dissatisfaction.