Mark J. Schlesinger Ph.D.

Fellow, Institution for Social and Policy Studies
Professor of Health Policy
Yale University School of Public Health
Email: Discipline: Economics Expertise: Competition / Markets, Politics and Policymaking, Public Opinion

Investigator Award
Metaphors and Health Policy: The Influence of Public Values and Perception on Policymaking
Award 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.


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.