Popular Support for Welfare State Reforms: On Welfare State Preferences and Welfare State Reforms in the Netherlands

The aim of this research is to better understand what is meant by general support for the welfare state. At the start of this study, I observed an alleged discrepancy between people’s preferences and welfare state policies. Whereas on the one hand various studies demonstrate that public support for generous welfare state arrangements remained high or in some countries increased across time, actual policy designs changed in the opposite direction and became increasingly sober and conditional. This mismatch between preferences and welfare state transformations has led me to research in detail whether and why the public continues to support welfare state arrangements. In general, this study reveals three conclusions that extend previous research in the field. First, welfare state support and real welfare policies are inextricably intertwined. Individual welfare preferences cannot sufficiently be understood if the reform of various welfare state policies is not considered simultaneously. Second, support for welfare state reforms contains several theoretical and empirical dimensions. When just one general support dimension is considered, inaccurate claims about support can occur. Third, it is not merely economic self-interest that explains individual welfare state support. Moral conceptions also drive support for welfare state reforms

Understanding and using comparative healthcare information; the effect of the amount of information and consumer characteristics and skills

<p>Abstract</p> <p>Background</p> <p>Consumers are increasingly exposed to comparative healthcare information (information about the quality of different healthcare providers). Partly because of its complexity, the use of this information has been limited. The objective of this study was to examine how the amount of presented information influences the comprehension and use of comparative healthcare information when important consumer characteristics and skills are taken into account.</p> <p>Methods</p> <p>In this randomized controlled experiment, comparative information on total hip or knee surgery was used as a test case. An online survey was distributed among 800 members of the NIVEL Insurants Panel and 76 hip- or knee surgery patients. Participants were assigned to one of four subgroups, who were shown 3, 7, 11 or 15 quality aspects of three hospitals. We conducted Kruskall-Wallis tests, Chi-square tests and hierarchical multiple linear regression analyses to examine relationships between the amount of information and consumer characteristics and skills (literacy, numeracy, active choice behaviour) on one hand, and outcome measures related to effectively using information (comprehension, perceived usefulness of information, hospital choice, ease of making a choice) on the other hand.</p> <p>Results</p> <p>414 people (47%) participated. Regression analysis showed that the amount of information slightly influenced the comprehension and the perceived usefulness of comparative healthcare information. It did not affect consumers’ hospital choice and ease of making this choice. Consumer characteristics (especially age) and skills (especially literacy) were the most important factors affecting the comprehension of information and the ease of making a hospital choice. For the perceived usefulness of comparative information, active choice behaviour was the most influencing factor.</p> <p>Conclusion</p> <p>The effects of the amount of information were not unambiguous. It remains unclear what the ideal amount of quality information to be presented would be. Reducing the amount of information will probably not automatically result in more effective use of comparative healthcare information by consumers. More important, consumer characteristics and skills appeared to be more influential factors contributing to information comprehension and use. Consequently, we would suggest that more emphasis on improving consumers’ skills is needed to enhance the use of comparative healthcare information.</p