04/28/2010 08:42 am ET | Updated May 25, 2011

Framing Risks, Losses, and Costs During the Health Care Reform Debate

Brendan Nyhan posted yesterday about his article in the just-released special issue of The Forum on the politics of health care reform. There are several compelling articles in the issue by notable scholars, including Representative David Price.

My own contribution to the issue (along with co-author David Eckles) is an expansion of an earlier post on this blog. Here is the key take-away from our piece:

While a large majority of Americans did see rising health care costs as a problem, very few of these same people thought that reform would improve this situation, and when it came to whether people supported or opposed the reform plan, it was the anticipated costs of the legislation, not concerns about current rising costs, that appeared most salient to Americans. Ultimately, Democrats passed health care reform legislation in spite of their inability to secure significant public support for the plan. Yet their efforts to mitigate the effects of loss aversion on public support for the proposal may have kept even more Americans from opposing the legislation, and if Republicans mount a serious attempt to repeal the reform law, it will be Democrats who are appealing to the public's
aversion to risk and loss.

For the most part, the public agreed that rising health care costs were a major issue and that something had to be done to curtail those costs. However, they also tended to agree with Republicans that the health care reform legislation was not going to help limit those costs. In fact, a significant proportion thought it was going to make them worse. And, as the figure below indicates, prospective views about how the legislation would influence costs had a much more influential role in structuring opinion on the health care reform legislation than did concerns about current rising costs.


Another major point of our article is the importance of loss aversion; that is, the public's tendency to over-value what they already have and under-value what they do not yet own. This tendency worked against Democratic efforts to win public support for health care reform, but it is also why we argue that now that people have been given health care reform, it will likely be quite difficult for Republicans to attempt to take it away.

Check out our piece here, and all of the other great contributions here. (Free registration is required for access).