Attitudinal Feedback towards Sub-national Social Policy: A Comparison of Popular Support for Social Health Insurance in Urban China

Abstract

Policy feedback theory posits that pre-existing policies shape citizens’ policy preferences and attitudes. This attitudinal feedback effect may, in turn, either reinforce or undermine current policies. This study seeks to examine whether attitudinal feedback explains why urban Chinese are motivated to contribute to social health insurance, a highly tangible issue for ordinary Chinese. Empirical data were collected in an original survey of urban inhabitants in three provinces between late 2017 and early 2018. Quantitative results reveal clear attitudinal feedback. Resource effects, interpretive effects, and individual learning effects all appear to shape motivations for contributing to social health insurance.

Keywords:

• welfare attitudes
• social health insurance
• policy feedback
• social security
• comparative analysis
• China

Acknowledgements

This project was generously supported by the General Research Fund of the Research Grants Council, Hong Kong SAR Government (Ref. 18615816), the Chiang Ching-kuo Foundation for International Scholarly Exchange (Ref. RG026-A-16), the Faculty Research Award Program of Amherst College and the Foreign Policy Institute of The Johns Hopkins University's Paul H. Nitze School of Advanced International Studies (SAIS). The authors are very grateful to Miss Zilin Li for excellent research assistance. Great support from Prof Xuemei Han, Prof Junqiang Liu and Dr Chunni Zhang is highly appreciated.

Ethical Approval

Ethical approval was obtained from the Human Research Ethics Committee of the Education University of Hong Kong and the Institutional Review Board of Amherst College.

Notes

1. For a comprehensive review, please refer to van Oorschot (2000).

2. Two of the cities (Zhangye and Linxia) have only one urban district within their jurisdictions, which is also where the municipal government is located. In Lanzhou, we selected the urban district where the municipal government is located to maintain consistency with the other two cities.

3. We chose to omit a mid-point option, such as “neither agree nor disagree”, because respondents are inclined to choose neutral responses, particularly in China and other Asian countries, thereby introducing potential bias (Wang et al. 2008).