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

Award Year:
Mark Schlesinger
Public Values and Attitudes
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.