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Welfare State Reforms Seen from Below pp 245–271Cite as

Palgrave Macmillan

Increasing Conflict in Times of Retrenchment? Attitudes Towards Healthcare Provision in Europe Between 1996 and 2002

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Abstract

Public opinion is considered a major obstacle to changing the status quo of welfare state policies. Yet some far-reaching reforms and gradual changes of European welfare states prompt the reverse question: Have increased reform pressures and restructuring efforts led to changes in individual attitudes? This chapter investigates individual attitudes towards public provision of healthcare in 14 European countries between 1996 and 2002. It shows a strong and stable support for a public provision of healthcare. Testing core assumptions of the new politics theory and power resources theory, the chapter also looks at conflict lines within society. Observing stability, not change, the study does not find evidence that the relevance of old cleavages is in decline. Both old and new cleavages shape individual attitudes.

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Notes

  1. 1.

    In the countries I examined, the total expenditure on healthcare was on average 8.6% of the total GDP in 2001.

  2. 2.

    For example, social class has definitely been a self-interest variable, as people in the same social and economic situation were assumed to share the same interests. But over time, class has possibly developed a formative character as well, socialising its members to hold class-specific values, even if these attitudes might no longer be in the individual interest. See Albrekt Larsen’s (2008) model in which he explains the formation of individual attitudes delineating self-interest, values, and class.

  3. 3.

    A pareto optimum is defined as a situation where at least one member of the group/society is benefitting from a reform and no one is worse off. It is claimed that there will always be a majority who are in favour of this reform.

  4. 4.

    Although acknowledging that more age categories might better represent different stages in the life course, I decided to use this very rough categorisation in order to keep results and models as simple and parsimonious as possible. The results did not significantly change if four or five age groups were used.

  5. 5.

    The differences between countries but also the differences over time are not the result of a changing composition of the interviewed respondents within each country (e.g. due to population ageing) since the inclusion of individual level covariates into the multilevel model controls for such compositional effects.

  6. 6.

    The results are presented in Table 10.2 in the Appendix.

  7. 7.

    When more than two groups are distinguished for one category, the net difference was calculated for the two subgroups which held the most opposed attitudes.

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Author information

Authors and Affiliations

  1. SFB 884 “Political Economy of Reforms”, University of Mannheim, Mannheim, Germany

    Elias Naumann

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  1. Elias Naumann
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Editors and Affiliations

  1. Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom

    Bernhard Ebbinghaus

  2. SFB 884 “Political Economy of Reforms”, University of Mannheim, Mannheim, Germany

    Elias Naumann

Appendix

Appendix

Table 10.2 Determinants of the preference for an extensive responsibility of the state for providing healthcare—Results from multilevel linear regression models
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Naumann, E. (2018). Increasing Conflict in Times of Retrenchment? Attitudes Towards Healthcare Provision in Europe Between 1996 and 2002. In: Ebbinghaus, B., Naumann, E. (eds) Welfare State Reforms Seen from Below. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-63652-8_10

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  • DOI: https://doi.org/10.1007/978-3-319-63652-8_10

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