Mark J. Schlesinger Ph.D.
Fellow, Institution for Social and Policy Studies
Professor of Health Policy
Yale University School of Public Health
Email: mark.schlesinger@yale.edu
Discipline: Economics
Expertise: Competition / Markets, Politics and Policymaking, Public Opinion
Investigator Award 
Metaphors and Health Policy: The Influence of Public Values and Perception on PolicymakingAward Year: 1993 Dr. Schlesinger examines ways in which perceptions and values in the form of four metaphors for health care affect public attitudes and the policymaking process. The metaphors represent four dominant ways in which people view the health care system: 1) as a societal right; 2) as a community responsibility; 3) as a professional service; and 4) as a marketable commodity. The project operates on and tests the belief that Americans formulate their goals for the health care system in terms of these four metaphors, providing the primary standards against which government health policies are judged. It further explores whether the many failures of contemporary policymaking can be traced to flaws in the ways that particular metaphors are linked to policies or to conflicts among competing metaphors. A conceptual framework for interpreting the role of these four metaphors in popular thinking and policymaking is developed through historical review of their role in shaping federal policy as well as application of the model to current health policy issues.
Background 
Mark J. Schlesinger, Ph.D. is a wayward economist often mistaken for a political scientist or social psychologist. For the past two decades, he has studied patient experience and patients’ responses to problematic medical encounters; over the past five years complementing that work with research into ways of enhancing the scope, clarity, and influence of patient voice. Dr. Schlesinger’s other research interests include the determinants of public opinion about health and social policy, the influence of bounded rationality on medical consumers, the impact of economic insecurity on political attitudes, and the role of nonprofit organizations in health care systems. Dr. Schlesinger is Professor of Health Policy and a Fellow of the Institution for Social and Policy Studies at Yale University and past editor of the Journal of Health Policy, Politics and Law. His favored sports include uncompetitive volleyball and unlighted table tennis.
- Schlesinger, M., Gray, B.H. How Nonprofits Matter in American Medicine, And What to Do about It. Health Affairs, 2006, 25(4): 287-303.
- Schlesinger, M., Gray, B.H., Gusmano, M. A Broader Vision for Managed Care, Part 3: The Scope and Determinants of Community Benefits. Health Affairs, 2004, 23(3): 210-21.
- Wailoo, K., Jost, T.S., Schlesinger, M. Professional Sovereignty in a Changing Health Care System: Reflections on Paul Starr's The Social Transformation of American Medicine. JHPPL, 2004, 29(4-5): 557-68.
- Schlesinger, M., Mitchell, S., Gray, B.H. Public Expectations of Nonprofit and For-Profit Ownership in American Medicine: Clarifications and Implications. Health Affairs, 2004, 23(6): 181-91.
- Schlesinger, M. Reprivatizing the Public Household? Medical Care in the Context of American Public Values. JHPPL, 2004, 29(4-5): 969-1004.
- Schlesinger, M., Mitchell, S., Gray, B. Measuring Community Benefits Provided by Nonprofit and For-Profit HMOs. Inquiry, 2003, 40(2): 114-32.
- Schlesinger, M. A Loss of Faith: The Sources of Reduced Political Legitimacy for the American Medical Profession. Milbank Quarterly, 2002, 80(2): 185-235.
- Schlesinger, M.J. On Values and Democratic Policy Making: The Deceptively Fragile Consensus around Market-Oriented Medical Care. JHPPL, 2002, 27(6): 889-925.
- Schlesinger, M.ÊParadigms Lost: The Persisting Search for Community in U.S. Health Policy.ÊJHPPL, 1997, 22(4): 937-92.
- Mechanic, D., Schlesinger, M.ÊThe Impact of Managed Care on Patients' Trust in Medical Care and their Physicians. JAMA, 1996, 275(21): 1693-7.