Lau Et Al-2005-Political Psychology

Political Psychology, Vol. 26, No.
1, 2005
Policy Frames, Metaphorical Reasoning, and Support

for Public Policies
Richard R. Lau
Rutgers University
Mark Schlesinger
Yale University and Rutgers University
This article evaluates the predictive value of a new theory for understanding public support
for alternative solutions to policy problems, which we call policy metaphors. A policy
metaphor represents a particular form of cognitive framing that makes use of commonly
understood social institutions and judgments about their effectiveness to form “arche-
types” against which proposed solutions to new policy problems are compared. We test the
extent to which both understanding of and preference for particular policy frames predicts
the nature and strength of policy choices by a representative sample of the American public.
After controlling for factors that past research has shown to be important in understand-
ing public opinion, including general partisan and ideological attitudes, self-interest, polit-
ical values, and emotions, the cognitive frames specified by the general theory of policy
metaphors are shown to strongly predict public support for hypothetical solutions to three
different policy problems. These frames also predict support for President Clinton’s
1993–94 health care reforms after controlling for those same conventional predictors. Most
importantly, we demonstrate that these cognitive frames help constrain the beliefs of even
the least politically aware members of the general public. Discussion centers on the impli-
cations of this new approach for understanding public opinion.
KEY WORDS: Policy Metaphors, public opinion, cognitive frames, health care reform
One of the primary tasks of political science research over the past few
decades has been to learn how people make sense of public affairs. In a repre-
sentative democracy the most direct way a citizenry can influence public policy
is by voting for political leaders who support their own policy goals. Except in
rare circumstances, however, the general public is gloriously ignorant of all but
the broadest outlines of how any politician proposes to solve different political
77
0162-895X © 2005 International Society of Political Psychology
Published by Blackwell Publishing. Inc., 350 Main Street, Malden, MA 02148, USA, 9600 Garsington Road, Oxford, OX4 2DQ
78 Lau and Schlesinger
problems, and oftentimes even ignorant of the broad outlines (Kinder, 1998;
Kinder & Sears, 1985). Few people are aware of what the government is actually
doing about most social problems, much less what politicians are suggesting as
alternative solutions to those problems, nor what anyone is proposing to do in the
future (Delli Carpini & Keeter, 1996; Neuman, 1986). And while most elites seem
to have reasonably coherent political ideologies, the general public is largely
“innocent” of similar ideological understandings of public policy (e.g., Converse,
1964; Jennings, 1992). This makes the task of understanding public opinion no
easier for politicians than it is for political scientists.
This evidence raises an important dilemma for students of public opinion and
democratic theorists alike: must we conclude that public opinion does not in any
real sense constrain public policy? Recent evidence suggests not. Public opinion
at the aggregate level seems to track—and sometimes even lead—policy change
by those in government (Page & Shapiro, 1992). But this evidence changes the
dilemma into a paradox. How can aggregate public opinion “constrain” public
policy if individual public opinions are so unconstrained themselves? As Converse
(1996) points out, the simplest way to reconcile microlevel and macrolevel find-
ings is to assume that on any given issue the majority of people offering an opinion
on a survey are in fact expressing a random “nonattitude,” so long as at least some
of the public has formed thoughtful, reasonably stable opinions about that public
policy issue, opinions which can be revised in response to changing world
conditions. And more sophisticated members of the public are more likely to base
their policy assessments on ideological considerations (Jennings, 1992).
But such a reconciliation of micro- and macrolevel data is inconsistent with
several types of evidence on attitude formation among the American public. First,
a substantial body of research suggests that the public’s attitudes towards policy
are widely held and constrained through systematic reasoning, albeit using a logic
little related to conventional measures of ideology (Feldman & Zaller, 1992;
Gamson, 1992; Graber, 1984; Iyengar, 1991; Mondak, 1994; Nelson & Kinder,
1996; Stafford & Warr, 1985). Second, less informed segments of the public do
not simply make decisions randomly (Bartels, 1996). This suggests that it is also
important to understand the factors influencing attitudes among less politically
sophisticated citizens. We are then left with seeking a nonideological explanation
for how people make sense of public policy issues.
Over the years political scientists have explored many alternative explana-
tions to ideology. Among others, the field has considered cognitive schemata (Lau,
Smith, & Fiske, 1991; Lodge & Hamill, 1986) and other information processing
heuristics (Mondak, 1993; Lau & Redlawsk, 2001; Sniderman, Brody, & Tetlock,
1991), cultural values (Feldman, 1988; McClosky & Zaller, 1984), emotions
(Conover & Feldman, 1986; Marcus, 1988; Marcus & MacKuen, 1993), frames
(Gamson, 1992; Gamson & Modigliani, 1989; Nelson & Kinder, 1996), political
symbols (Edelman, 1971; Kinder & Sears, 1981; Sears, Lau, Tyler, & Allen,
1980), and self-interest (Sears et al., 1980; Sears & Funk, 1991). Each of these
Policy Metaphors 79
different perspectives has something to contribute to our understanding of public

opinion, although each of them offers only a partial explanation, focusing on a
particular set of criteria or influences that affect the public’s assessment of polit-
ical problems and proposed solutions. What seems to be missing is a theory of
how the public can integrate these various factors into a coherent judgment about
policy, a perspective that public opinion researchers have not yet captured.
Policy Metaphors
We are attempting to develop such a broadly integrative theory by turning to

cognitive linguistics and studies of common patterns of speech. It is our contention
that important insights into the public’s understanding of policy can be gained by
thinking about how people communicate about social issues, how they pool their
collective perceptions (Gamson, 1992). In particular, we have begun to develop
a model of public opinion relying on the use of metaphorical reasoning for under-
standing policy alternatives (Lakoff & Johnson, 1980, 1999). Borrowing a term
used occasionally in the literature on policy analysis (Schön & Rein, 1994; Stone,
1988), we refer to this as a model of “policy metaphors” (Schlesinger & Lau,
2000).
In a nutshell, our model takes the following form. Every society has a set of
commonly understood ways of arranging social institutions and judging the effec-
tiveness of their performance. By “social institutions” we refer to a set of social
norms and practices that represent commonly understood ways of allocating
responsibility and distributing scarce collective resources—such as “rights,”
“markets,” “communities,” or “families.” Each person’s understanding of these
institutions is based on a combination of personal experience (with one’s own
family, say) and culturally transmitted “stories” or images or frames (Gamson,
1992; Lakoff, 1996; Nimmo & Coombs, 1980). Each of these arrangements is a
sort of “archetype,” an ideal from which people infer the consequences of actual
policies or project the expected outcomes of proposed policy reforms. It is the
process of cross-domain inference which makes these archetypes function as
metaphors. Thus when new social problems arise, our model holds, extant insti-
tutional arrangements provide “templates” for understanding and judging differ-
ent proposed solutions. By relying on shared social institutions as the basis for
comparative judgments, policy metaphors become accessible to a public that has
little knowledge of or interest in the political process.1
1
This hypothesized reasoning process can perhaps best be explained by illustration. Consider the claim
that a socially valued good or service (safe housing, a decent income in retirement, adequate medical
coverage) ought to be considered a “societal right” (Glendon, 1991; Scheingold, 1974). Advocates
of this position are not in fact claiming that these things are literally rights, in the sense that they
are enumerated in federal or state constitutions as necessary conditions of citizenship. But they are
arguing that these goods or services ought to be treated as if they were a right, that is, should have
the same moral salience as those things which are in fact rights (e.g., freedom of speech, counsel
Our earlier work (Schlesinger & Lau, 2000) focused on establishing the
“coherence” of policy metaphors, demonstrating that coherence is distinct from
support for a particular institutional arrangement or template, and determined the
compatibility among five policy metaphors applied to health care. To do this, we
conducted a series of intense interviews (including elaborate sorting activities)
with a convenience sample of 169 elites and members of the general public. One
of the most striking findings from our earlier research was that policy metaphors
constrained the beliefs of even the least sophisticated members of the general
public. Of course the generality of this finding is limited by the relatively small
and nonrepresentative sample upon which it is based.
In this article, we extend our analysis to explore the usefulness of this
approach for understanding the American public’s choices among policy alterna-
tives, using data from a representative 1995 survey of public opinion toward
reform of the U.S. health care system. By turning to survey data, however, we
lose the ability to distinguish between metaphorical reasoning and other familiar
approaches to studying public opinion, particularly the notion of “frames” as the
term is commonly employed in political science. Unfortunately there appear to
be almost as many definitions of “frames” and beliefs about how they influence
public opinion as there are researchers using the term (Nelson, Oxley, & Clawson,
1997), but they all agree that frames give meaning to key features of some topic
or problem, which is one of the primary roles played by policy metaphors.
Thus it is nearly impossible to distinguish between the different conceptions
of policy metaphors and frames using cross-sectional survey data. We will there-
fore limit our empirical concerns to asking what frames are available for under-
standing a particular policy domain, and whether those policy metaphors/message
frames can help explain policy preferences, beyond the standard set of predictors
usually invoked to explain public opinion: social location, partisanship and ide-
ology, self-interest, and political values. We will employ the term “cognitive
frame” as a reasonable compromise between our theory and the more typical
meaning of “frame” in the political science and communications literatures.
Cognitive Frames Applicable to Understanding Health Care in the United States
To examine the extent to which cognitive frames help people understand and
form opinions about different policy alternatives, we need to determine the
for criminal proceedings; see Dougherty, 1989). More concretely, claiming a particular good or
service as a societal right suggests that the claims are universal, and that it is the obligation of gov-
ernment to ensure that the good or service is universally available to all citizens (Stone, 1988).
Reasoning of this sort is metaphorical in two senses. First, it compares policies in the problem area
to a set of ideals, in this instance, to the image of what rights stand for in the American ethos. Second,
it compares the problem area to other domains in which policies exist which try to operationalize
rights. Thus, when Harris Wofford successfully campaigned for a Senate seat in Pennsylvania in
1991, he powerfully appealed for a right to health care by claiming that a country that could guar-
antee criminals a lawyer for their day in court ought to be able to guarantee its citizens that they had
access to adequate health services (Hacker, 1997).
Policy Metaphors 81
relevant set of cognitive frames which the public was likely to draw upon to help
them decipher the complexities of alternative solutions. This is no small task, and
we do not claim that the same set of frames/metaphors are relevant to all policy
domains. How people understand most foreign policy issues, for example, is likely
to be very different from how they understand most domestic policy issues. When
we began working on this project a decade ago (in the early years of the Clinton
administration), the most important policy problem facing the national govern-
ment was health care reform. There was widespread acceptance that some gov-
ernment intervention into health care is warranted, but much debate over the
appropriate form of that action (Yankelovich, 1995). Because both authors have
long-standing interests in health policy, we decided to focus this research on health
care reform.
In order to determine the relevant set of frames employed to understand health
care reform, we turned to the historical record. We drew primarily on material
that documents the perspectives of policy elites,2 including numerous histories of
the evolution of the American health care system (Garland, 1961; Grob, 1994;
Katz, 1986; Kramer, 1981; Meckel, 1991; Raffel & Raffel, 1984; Rosen, 1983;
Rosenberg, 1987; Rosner, 1982; Rothman, 1978, 1980; Starr, 1982; Stevens, 1971,
1982; Weisman, 1998), supplemented for the twentieth century with a content
analysis of 54 Congressional hearings on health care reform, drawn from between
1921 and 1994. This review of documented positions of political elites on the
appropriate role of government in American medicine identified five dominant
cognitive frames:
1. Health care as a societal right, available (at least to some extent) for all
citizens of the country, with the terms of availability determined collectively
for the nation as a whole;
2. Health care as a community obligation—a collective responsibility only for
those sick and infirm who live in one’s community, with the standards of
appropriate treatment determined independently by each locality;
3. Health care as an employer responsibility, a variant of the community frame
where the collective responsibility is defined by one’s employment arrange-
ments rather than by the locality in which one lives;
4. Health care as a marketable commodity, distributed according to a person’s
ability to pay for medical services, with the standards of care determined by
individual choice and market forces; and
5. Health care as a professional service, allocated according to scientifically
determined standards of need, with the nature of appropriate treatment
determined by individual clinicians based on the norms of their professional
training.
2
Arguably, these elite conceptions will be reflected in subsequent public opinion, either because the
elite views diffuse to the general public (Zaller, 1992), or because elite and public perspectives are
mutually influential (Page & Shapiro, 1992).
Each of these cognitive frames can be traced to different eras in which they
were discussed and communicated by policy makers.3 These periods of dominance
should not be taken as evidence that one frame ever completely displaces the
others, however. Even in eras in which one frame was most influential among
policy makers, strains of the other frames persisted, often in parts of health care
that were less in the mainstream.4 Evidence suggests that all five perspectives play
some role in contemporary health policy, at least as it is discussed by policy
experts. But does the general public use these same cognitive frames in their inter-
pretation of health policy issues?
How Prior Understanding Can Affect Policy Assessment
When people are confronted by a collective concern, a social problem that

must be solved, we believe that they both assess the problem and evaluate possi-
ble solutions by selecting from the portfolio of possible cognitive frames one (or
more) that they consider most relevant. Thus the contents of each cognitive frame,
plus the combination of frames that people deem feasible, create the parameters
for judging the acceptability of proposed solutions. We expect that the array of
frames deemed relevant or applicable to a given policy domain will depend largely
on widely (but not universally) held social norms about appropriate institutional
arrangements. Consequently, there ought to be broad agreement about the frames
relevant to a particular policy debate.5 However, the perceived desirability of (and
hence preference for) any particular frame will depend much more on the per-
sonal experiences that an individual has had with the institutions relevant to that
perspective. Thus, members of the public who have been exposed to the institu-
tions relevant to the “societal right” approach (e.g., receiving benefits under the
Social Security program) will draw on this experience in assessing the frame.
3
Notions of health care as a community obligation are rooted in colonial applications of the British
poor laws (Grob, 1994), though they have more recent application in federal programs supporting
community health and mental health centers (Sardell, 1988; Schlesinger, 1997). Policies encourag-
ing the role of markets in medical care can be traced to the early nineteenth century, though they
have had the largest influence on public policy over the past fifteen years (Luft, 1996; Schlesinger,
2002b). Policies supporting the professionalization of medical care appeared at the beginning of the
twentieth century (Larson, 1977; Schlesinger, 2002a; Starr, 1982). Support for a societal right to
health care was first enunciated by Franklin Roosevelt in the 1940s, but flowered in the 1960s and
retains strong support today (Gabel, Cohen, & Fink, 1989). Notions of employer responsibility
emerged most recently, playing an important role in federal policy debates only in the late 1980s
and early 1990s (Pepper Commission, 1990).
4
For example, during the 1960s when the societal rights perspective dominated thinking about medical
care, some aspects of health care (e.g., mental health care) were seen as most appropriately admin-
istered at the local community level, and market forces were seen as appropriate for other forms of
treatment (e.g., pharmaceuticals).
5
The claim that the public shares a common interpretation of multiple frames or policy metaphors is
one important distinction of our theory from past applications of metaphors to political reasoning
(e.g., Lakoff, 1996; Schön & Rein, 1994), which generally presume that each metaphor represents
an all-encompassing paradigm which inhibits understanding (and thus meaningful dialog with) other
points of view.
Policy Metaphors 83
Because experiences (and interpretations of experience) vary, we expect that there

will be much less congruence in the preference for cognitive frames than in judg-
ments about their applicability to a policy problem.
If this description is accurate, it suggests that there are two distinguishable
stages in making policy assessments. The first involves the understanding or in-
terpretation of proposed policies, their “meaning” in terms of the institutional
arrangements, assignments of responsibility, and ethical norms that each evokes
in a particular policy context. Such interpretations, we would hypothesize, are
widely shared by the public in any given society, although they might vary some-
what across different political subcultures. Thus in the first stage of reasoning,
people determine which cognitive frame(s), as they understand them, are relevant
to solving a given social problem (as they understand it). While many policy
domains will involve several relevant frames, some cognitive frames may simply
not be coherent in a given policy domain. For example, many Americans may be
unable to think sensibly about prisons in terms of “markets” because the freedom
of choice that is inherent in markets does not apply well to prisoners (Lau et al.,
1991).
The second stage of reasoning involves the preference for cognitive frames,
determining which of the relevant or applicable perspectives offers the most
appropriate guidance for developing future policies. Although preferences for a
given frame may in practice be related to the extent to which that frame is under-
stood by an individual, the two stages are conceptually distinct. The better a cog-
nitive frame is understood, the more accurately an individual should be able to
predict the consequences of applying that frame to a particular policy domain, but
those anticipated consequences will be independently judged as either desirable
or undesirable.
We believe this approach is a natural building block for the understanding of
public preferences toward policy issues. We do not contend that it is relevant to
all aspects of public opinion—it says nothing about attitudes toward political
leaders, for example. But when debate centers on alternative means for achieving
an agreed-upon goal, our approach has a lot to offer. Because the underlying
archetypes involve social institutions with which all members of society are rea-
sonably familiar, they allow people to reach “reasoned” (or at least reasonable)
conclusions about public policies even when they are largely ignorant about polit-
ical matters. For the same reason, while the comprehension (and thus utility) of
conventional political ideology might be restricted to a relatively small political
elite, we expect cognitive frames to be utilized by a much broader segment of the
mass public. This is an important claim, one which we will test empirically below.
Method
In July of 1995 a nationally representative sample of 2232 English-speaking

adults were contacted for a telephone interview. Of those contacted, 783 refused
Table 1. Demographic Characteristics of Survey Sample
Age: Under 25 11% Household Under $15,000 12%

25–34 21% Income: $15,000–24,999 15%
35–44 25% $25,000–34,999 16%
45–54 18% $35,000–49,999 25%
55–64 13% $50,000–74,999 19%
65 and Older 13% $75,000+ 13%
Education: Elementary 2% Race: African American 9%

Some High School 6% Asian American 2%
High School Grad 29% Hispanic 7%
Some College 29% Native American 2%
College Grad 18% Non-Hispanic White 79%
Post-Graduate 17% Other 1%
Employment Employed Full-Time 58% Gender: Female 50%

Status: Employed Part-Time 9% Male 50%
Unemployed/Laid-Off 4%
Homemaker 7%
Student 5%
Retired 14%
Unable to Work 3%
to be interviewed, and 27 broke off the interview (which on average lasted over
35 minutes) before completion. This resulted in 1522 successful interviews, with
an overall completion rate of 69%. 259 willing respondents were eliminated
because a 50% male quota was established, and people contacted in the home are
disproportionately female. Some basic characteristics of this sample are listed in
Table 1.6
Determining Policy Preferences
Our basic strategy during the interview was to present respondents with alter-
native solutions to a number of public policy problems that each embodied what
we believed to be the crucial aspects of one of the five cognitive frames identi-
fied above. For example, near the beginning of the survey all respondents were
told “People talk about a number of ways of changing how we pay for and deliver
6
Interviews were conducted by the firm of Schulman, Ronca, and Bucuvalas, Inc. The overall sam-
pling frame involved 4184 apparently valid phone numbers, of which 1593 (38%) were numbers
where the appropriate individual could never be contacted during the time the interview was in the
field. Of these noncontacts, the large majority (946) were numbers where there was no answer after
six call-back attempts, and it is not known how many of these numbers were for a residence where
no one happened to be home when the interviewer called, and how many were nonresidence or effec-
tively nonworking numbers.
Policy Metaphors 85
physician and hospital care.” Five different policy options were described, one
that was directly relevant to each of the five cognitive frames. Initially these policy
alternatives were described in general terms with an effort to mask any labels or
symbols or “codewords” that could be associated with a frame, nor was any actual
concrete policy offered for comparison. For example, the employer mandate
option read
“Each employer would be required to offer health care to their employ-
ees, with government helping to cover the costs for small businesses and
providing insurance for the unemployed. Decisions about what types of
health care and health insurance would be made jointly by employers
and workers at each firm.”7
(Exact wording of the other items is provided in the Methodological Appendix.)
After each option was described, respondents were asked how strongly they
support or oppose that approach to health reform.
Respondents were next asked to consider alternative solutions to one of two
narrower health policy problems assigned randomly to respondents—treating sub-
stance abuse, or providing long-term care to the disabled and elderly. Once again
five alternative solutions to each particular policy problem were described (one
representing each of the different cognitive frames) without specifically men-
tioning the labels or codewords associated with the approach. Respondents offered
their level of support for each different solution. Then respondents were asked to
consider alternative solutions to one of two social problems from policy domains
other than health—providing affordable housing or providing public education.
Within each policy domain, the order of presentation of the five alternative solu-
tions was randomized. These 25 questions (15 answered by any single respon-
dent, 10 of which referred to two different health policy issues) are the primary
dependent variables in the analyses to follow.
Interpreting Proposed Policy Solutions
We have argued that cognitive frames serve two primary functions: helping
people interpret or understand proposed policy solutions and helping people form
preferences among alternative solutions. At least conceptually, these two func-
tions are independent of each other. Both of them must be measured, and the
biggest challenge is devising adequate measures of understanding a frame. After
support for each of the different proposed solutions for providing basic physician
and hospital care was determined, respondents were asked additional questions
7
These policy descriptions are much more complex than those with which survey respondents are
typically confronted. The descriptions were designed to help respondents understand how each alter-
native would actually work. To ensure that choices were not biased by an implicit avoidance of tax
increases, every option had an explicit role for government funding.
about the consequences of each approach for them personally, for poor Ameri-
cans, for wealthy people, and for the country as a whole. Thus four additional
questions relevant to each of the five cognitive frames were asked about differ-
ent alternatives for delivering basic physician and hospital care. In this domain
we therefore have sufficient numbers of questions to construct several indicators
of how well the different frames help people interpret policy solutions that are
consistent with that framework.
First, if respondents are familiar with a particular cognitive frame, they ought
to more easily perceive the consequences of a policy that is consistent with or
“fits” that framework. Thus our first measure of the capacity to interpret a cogni-
tive frame is simply a count of the number of questions about the consequences
of each policy that respondents could answer (or in survey research terms, the
number of “nonmissing” responses to these questions). Although ability (or will-
ingness) to answer a series of questions captures only some aspects of interpre-
tation, inability to answer some of those questions is a very basic measure of
incapacity to make sense of the cognitive frames. On average about 92% of our
respondents could answer all four of the initial questions that were relevant to
each frame—but about 8% could not answer one or more of them.
A second indicator of interpretation is based on Judd and Krosnick’s research
on attitude strength (e.g., Judd & Krosnick, 1982; Krosnick, 1989). According to
Judd and Krosnick, “extreme” attitudes are more central and are more difficult
to change, than are less extreme attitude responses. Thus we constructed a second
indicator of understanding a cognitive frame by “folding” each of the policy
support questions relevant to each frame at their midpoint and then averaging
together the four folded responses. The higher the average, the more extreme are
responses to these items.
The more nuanced a respondent’s interpretation of a policy proposal, the more
readily they ought to be able to discriminate between who will be helped and who
will be hurt by the policy. We created a measure of “discriminate understanding”
by taking the absolute value of the difference between the perceived consequences
of the policy for poor people and for the wealthy. The larger the absolute value of
this difference, the more clearly respondents can predict the full consequences of
a policy proposal. This discriminate understanding variable is a third indicator
of the capacity for policy interpretation. We then constructed summary measures
of interpretive capacity for each of the five cognitive frames by standardizing and
averaging these three indicators together. They were then recoded to have a 1-point
range.8
8
The internal consistency (coefficient alpha) of these three-item summary measures ranges between
a high of .55 for the professional service frame to a low of .47 for the marketable commodity frame,
with a mean of .52 across all five. These reliabilities are not unreasonably low for three-item scales,
although we would like them to be higher. We feel that each of these three indicators of interpreta-
tion is capturing a somewhat different aspect of the broader meaning of this concept even though
they are only moderately intercorrelated.
Policy Metaphors 87
Measuring Preference for Cognitive Frames across Policy Domains
The second major function of cognitive frames is helping people form pref-
erences for different policy alternatives. Near the middle of the interview, after
the questions about alternative solutions to specific policy problems, respondents
were asked how much they supported each of five “different ways to help
Americans meet their basic needs for food, housing, education, and health care.”
(Exact wording is given in the appendix.) Each item, in addition to explicitly
mentioning a specific label or symbol associated with the cognitive frame,
describes in very simple terms who would be responsible for running this type of
program (e.g., the national government; community organizations; individuals),
the reason or logic for placing the responsibility in those hands (e.g., to ensure
that the needs of all people are met; because people are most comfortable getting
help from those who live in the same area they do; because most people don’t
want others to make decisions about their family’s needs), and each item provides
a concrete example of a specific type of program that is most frequently handled
in this manner in American society (e.g., Social Security; public school boards;
Food Stamps). Our previous analysis of metaphorical reasoning (Schlesinger &
Lau, 2000) has identified these three aspects of cognition as the primary ways
through which metaphorical reasoning is applied to complex social issues. These
items, rescaled to vary between -.5 and +.5, constitute our basic measure of pref-
erence for the different cognitive frames. Whereas we expect most people to
understand all five frames, there should be much more variance in the number of
people preferring each of them in particular policy domains. Notice also that while
our measures of understanding a particular cognitive frame come entirely from
the health domain, our measures of preference for a frame are phrased much more
broadly, which give us some basis for attempting to generalize our approach to
policy domains other than health.
Other Scales Used in Analyses
A primary purpose of this article is to demonstrate the power of cognitive

frames to help understand public opinion toward policy alternatives, and to do
that we tried to measure all of the concepts typically employed in studies of public
opinion. Our survey included standard questions about respondents’ background
characteristics, their party identification, and general liberalism-conservatism. We
also asked simply objective questions that would indicate self-interest in the dif-
ferent policy domains addressed in the survey (e.g., “Over the past year, have you
or a member of your family: Been without health insurance for any length of time?
Needed care in a nursing home? Had a substance abuse problem?”). Several addi-
tional control variables deserve slightly more discussion, however.
As mentioned above, one of our indicators of understanding cognitive frames
is the extremity of responses to items related to it. Extremity of response is subject
to misinterpretation under several different circumstances, however. Some respon-

dents may as a matter of personality (Greenleaf, 1992) or cultural background
(Chen, Lee, & Stevenson, 1995) favor more extreme responses. Alternatively,
respondents may fall into response patterns in which they consistently select the
first, or last, or one of the middle alternatives offered in response to any question.
Either of these patterns would produce an artifactual positive correlation between
our measures of understanding a cognitive frame and the dependent variables in
subsequent analyses. To control for this possible confound we constructed an
“extremity of response” scale by simply counting the number of times either the
first or last alternative was chosen in response to 16 questions asked on our survey
that have nothing to do with cognitive frames and which are not otherwise
employed in this study. We included this count as a control in the analyses. To
the extent the measures of understanding a cognitive frame prove to be signifi-
cant, they are explaining variance that is independent of any artifactual response
factor.
At the very beginning of the survey respondents were asked what they think
are “the most important problems facing this country today.” Up to six responses
were recorded, with the answers coded into broad policy domains, including the
five addressed subsequently in the survey. We then computed simple dummy vari-
ables indicating whether each of these five broad policy domains was mentioned
by a respondent, which was taken as an indication that the respondent believed
this to be an important national problem.
Respondents were asked for their emotional reactions when hearing about
different social problems with the following questions:
“Hearing about problems that are being faced by other people or the
country as a whole can sometimes evoke different feelings or emotions
in people. Let me ask you about some of these.
“When you hear about people who do not have health insurance—
because they have lost their job, have some pre-existing health problem,
or find it is too expensive—does it often make you feel: angry? afraid?
sad? or helpless?”
“When you hear about people who have lost their jobs, homes, and fam-
ilies because of a problem with substance abuse, does this make you feel:
angry? afraid? sad? or helpless?”
Similar questions were asked about other policy domains. The order of presenta-
tion of the four emotions was randomized. Within each domain, scales of “emo-
tionality” were computed by simply counting the number of emotions respondents
reported experiencing.
Finally, we also measured beliefs in two broad cultural values. Agreement
with the following three items were combined to form a measure of beliefs in
equality of outcomes—our shorthand for attitudes toward redistribution.
Policy Metaphors 89
“Now I’d like to read you some statements about opportunity and fairness in
American life. How strongly do you agree or disagree that:
• Income should not be determined solely by one’s work. Rather,
everybody should get what he/she needs to provide a decent life for
his/her family.
• We have an obligation to take care of people in our local commu-
nity who are in need, but not all the needy in the entire country.
• We have an obligation to help those in need, whatever their circum-
stances or wherever they live.”
This summary scale had a reliability (coefficient alpha) of .59.
A measure of beliefs in individualism (Feldman, 1988) was constructed from
responses to three items about the role of government in American society.
“Some people think it is the responsibility of the government in Wash-
ington to help people pay for doctor and hospital bills; others think that
this is not the responsibility of the federal government and that people
should take care of these things themselves.”
Respondents were asked two additional questions with this same format, ques-
tions that matched the policy problems they had been asked about in the survey.
Responses to these questions were averaged together to form a scale of “Individ-
ualism.” This scale had a reliability (coefficient alpha) of .62.
Results
Two Stages of Cognitive Reasoning
The two stages of reasoning proposed by our theory involve interpretation

(or understanding) and preference formation. Although the two are intimately
linked, for analytic purposes we will separate them. The more effectively a cog-
nitive frame can be interpreted, the more accurately an individual should be able
to predict the consequences of applying that frame to a particular policy domain,
and thus the stronger should be preferences to support or oppose it. To test this
effect, in a first set of regressions we recode our 4-point policy support measures
to distinguish strong attitudes (support or opposition) from weak attitudes (support
or opposition). When strength of opposition/support for each policy alternative is
regressed on our measures of interpretive capacity and preference for each cog-
nitive frame, the interpretation measure should be strongly predictive while the
preference measure should not predict responses.
We begin by focusing on the three health policy issues addressed by our
survey, because we are most confident that we have identified the major cogni-
tive frames in this policy domain. We will see how well our results generalize to
two additional policy domains at the end of the results section.
Table 2 highlights the results of 15 logistic regressions, where the

dichotomized measure of strength of support for each of five alternative solutions
to three health-related problems are regressed on a fairly complete series of pre-
dictors (see Table 4 below), including our separate measures of preference for the
appropriate cognitive frame and our measure of interpretive capacity for that
frame. Following our theory, the more respondents comprehend a cognitive frame,
the stronger should be their support or opposition toward frame-consistent policy
solutions. The coefficients for measures of comprehension should therefore be
positive and significant. If interpretive capacity and preference formation are
Table 2. Strength of Opposition/Support and Reasoning by Cognitive Frame
Alternative Policy Solutions for Providing:

Basic Physician Long-Term Treating
& Hospital Care Care Substance Abuse
Societal Right
Preference -.01 .70** -.34
Interpretation 2.22*** 1.01* -.04
Extreme Resp. 2.31*** 1.80*** 2.18***
Community Obligation
Preference -.29 .14 .46
Interpretation 1.46** .26 .95*
Extreme Resp. 2.55*** 2.78*** 1.44**
Employer Responsibility
Preference .72*** 1.04*** .01
Interpretation 1.94*** .93* .82*
Extreme Resp. 2.82*** 2.06*** 1.81***
Marketable Commodity
Preference -.19 .22 .00
Interpretation 1.24*** .47 .79*
Extreme Resp. 3.00*** 1.68*** 1.91***
Professional Service
Preference -.31 .25 -.04
Interpretation 1.84*** .77* .61
Extreme Resp. 2.65*** 2.45*** 2.46***
*p < .05 **p < .01 ***p < .001
Note. Strength of preference for each proposed policy solution was dichotomized between
“Moderately” and “Strongly.” Table entries are logistic regression coefficients. All regressions
included controls for gender, race, age, education, family income, the salience of health reform as
an important national problem, one or two objective measures of relevant self-interest in the policy
area, emotions associated with the policy problem, party identification, liberal-conservative
identification, beliefs in individualism, and support for equality. Sample size for alternative
solutions for providing basic physician and hospital care varied between 1292 and 1321; for
providing long-term care, the sample sizes varied between 620 and 634; and for treating substance
abuse, the sample sizes varied between 667 and 674.
Policy Metaphors 91
independent, however, there is no reason for the general measures of preference

for a cognitive frame to be significant predictors in these regressions.
Three coefficients from these regressions—the measures of interpretive
capacity, frame preference, and as a further control, an extreme response scale
(see footnote 5 above)—are reported in Table 2. As expected, a tendency to use
extreme response categories in answering survey questions in general is related
to making extreme responses on these particular questions: the extreme response
scale is always positive and significant in these analyses. (It will therefore be
included as a control in all further analyses.) Controlling for this general response
tendency, however, the measures of comprehending the cognitive frames are
almost always positive and add significantly to the equations 11 of 15 times. On
the other hand, the measures of frame preference are only significant three of 15
times. The overall pattern of results across the 15 regressions is very supportive
of the hypothesis that interpretation and preferences are distinct aspects of rea-
soning in terms of cognitive frames.
Cognitive frame preferences, on the other hand, should be reflected prima-
rily in terms of willingness to support particular policies. To test this, for a second
set of regressions we dichotomize the 4-point dependent variables into “support”
and “oppose” (rather than strong and weak) to isolate the “preference formation”
function of cognitive frames. If people reason in terms of frames in the way that
we have hypothesized, the general measures of preference for each cognitive
frame should be positively related to support for each alternative policy solution.
Because interpretation and preference formation are distinguishable processes,
however, there is no reason that understanding a frame should be associated with
either support or rejection of its application to a particular policy domain.
Table 3 only reports the crucial coefficients (the measures of frame prefer-
ence and the measures of frame understanding, along with the extremity of
response control) from these 15 regressions. Ten of the 15 measures of preference
for a cognitive frame were significant predictors in these regressions, and all 10
of these (and 14 out of 15 overall) had the expected positive sign. Although our
hypothesis is not supported in all 15 tests, once again the overall pattern of results
is clearly positive. On the other hand, the measure of interpretive capacity for a
cognitive frame was a significant predictor only once out of 15 times, a pattern
which clearly does not differ from chance.
Explaining Support for Hypothetical Policy Alternatives
The results in Tables 2 and 3 provide solid support for the two hypothesized
functions of cognitive frames. But the two dichotomizations used in these analy-
ses are artificial and make it difficult to directly illustrate how cognitive frames
help predict support for alternative solutions to various social problems. In choos-
ing among policy alternatives, interpretation (or understanding) and preferences
are not considered serially, or independently, but instead are intimately linked and
Table 3. Preference Formation and Reasoning by Cognitive Frame
Alternative Policy Solutions for Providing:

Basic Physician Long-Term Treating
& Hospital Care Care Substance Abuse
Societal Right
Preference 1.14*** .79** .80***
Interpretation .13 .35 -.27
Extreme Resp. -1.06 -1.45** -.51
Community Obligation
Preference 1.33*** 1.34*** 1.32***
Interpretation .23 -.55 -.66
Extreme Resp. -.04 -.17 -.17
Employer Responsibility
Preference 1.66*** 1.60*** .28
Interpretation .26 -.27 -.12
Extreme Resp. -.57 1.31* .15
Marketable Commodity
Preference .01 -.18 .05
Interpretation .16 .66 .28
Extreme Resp. -.58 -.75 -.06
Preference 1.02*** .81*** .21
Interpretation -.69* .39 -.40
Extreme Resp. -.69* -.28 -.32
*p < .05 **p < .01 ***p < .001
Note. Preference for each proposed policy solution was dichotomized between “support” and
“oppose.” Table entries are logistic regression coefficients. All regressions included controls for
gender, race, age, education, family income, the salience of health reform as an important national
problem, one or two objective measures of relevant self-interest in the policy area, emotions
associated with the policy problem, party identification, liberal-conservative identification, beliefs in
individualism, and support for equality. Sample size for alternative solutions for providing basic
physician and hospital care varied between 1292 and 1321; for providing long-term care, the
sample sizes varied between 620 and 634; and for treating substance abuse, the sample sizes varied
between 667 and 674.
simultaneously applied. Consequently, to examine reasoning by cognitive frame,

we must combine both interpretation and preference. We do this by creating a new
independent variable which is the multiplicative product of our (artificially sepa-
rated) measures of interpretation and preference for each frame. If frames operate
cognitively in the manner we have described above, and moreover help explain
choice among policy alternatives, this combined measure of reasoning by cogni-
tive frame should predict positively in each analysis.9 Please note that our model
9
Because the measures of preference ranged between -.5 and +.5 (opposition is negative, support
positive), while understanding ranged between 0 and 1, the product of these two variables ranges
Policy Metaphors 93
does not hold that preference and understanding “interact” with each other (in a
classic experimental sense) to produce support for policy alternatives. If that were
the case, we would want to include the “main effects” of both preference and
understanding, along with their multiplicative “interaction,” in all analyses. While
preference and interpretation are in theory independent cognitive mechanisms, in
practice they are not independent, and it makes little sense to us to apply a sta-
tistical model that assumes they are. Nonetheless we respecified every analysis
presented to Table 4 below to include three variables representing cognitive
frames, the two “main effects” of preference and understanding, and their multi-
plicative interaction. We conducted these analyses in two stages, where the first
stage included all predictors except the cognitive frame measures, and the second
stage adds in the three indicators of our cognitive frames. In every case in Table
4 where the single (combination) cognitive frame variable is statistically signifi-
cant, the three separate frame variables also added significantly to the equations.
(And in the one case in Table 4 where the single cognitive frame variable did not
predict significantly, the three separate measures did no better.) In two of the four
positive cases (societal right and employer responsibility), the “interaction” term
was also statistically significant, above and beyond the simple “main effect” vari-
ables with which it correlates. In the other two cases it had the expected sign but
did not prove to be statistically significant. These alternative specification results
are available from the authors upon request.
We regressed the full 4-point measure of support for each of the five alter-
native solutions to the different policy problems on 15 control variables and the
new variable which combines support and interpretation. The control variables
include a variety of factors that have proven to be important predictors of public
opinion, including a number of demographic background characteristics, party
identification and ideology, the political values of equality (of outcomes) and indi-
vidualism, measures of relevant self-interest, the salience of health care as an
important national problem, and emotions associated with the policy problem.
Thus we are examining our theory of reasoning by cognitive frame in the context
of a very completely specified model of policy preference. If our measures of cog-
nitive frames prove to be significant predictors, they will be so only after all of
the standard predictors or public opinion have already been entered into our
models.
The results of these ordered logistic regressions are presented in Table 4 for
the first policy area, providing basic physician and hospital care; the results are
much the same for policies to provide long-term care and treating substance
between -.5 and +.5. The extreme values represent those respondents who understood the frame very
well and who strongly supported (or strongly opposed) its application to providing basic social needs.
Respondents coded “0” on this combination variable would therefore have no understanding of the
underlying cognitive frame and/or no particular preference concerning its general approach to solving
social problems.
94
Table 4. Support for Alternative Solutions for Providing Basic Physician and Hospital Care
Societal Community Employer Marketable Professional

Right Obligation Responsibility Commodity Service
Coef. S.E. Coef. S.E. Coef. S.E. Coef. S.E. Coef. S.E.
Female .03 .11 -.16 .10 .29** .11 .20* .10 -.11 .11
Black -.39* .20 .45* .19 -.26 .20 .18 .19 .45* .19
Hispanic -.05 .21 .54** .21 -.15 .22 .18 .20 .20 .21
Age .36* .18 -.72*** .17 .18 .18 -.48** .17 -.36* .18
Education -.64 .45 -1.02* .44 -.30 .45 -.17 .44 -1.09** .45
Income .37 .20 -.33 .19 -.01 .20 .09 .19 .09 .20
Disabled .56 .35 .61 .33 .52 .38 .20 .34 -.30 .37
No Health Ins. -.02 .12 .20 .12 .15 .12 -.02 .12 .12 .12
Imp. Natl. Prob. .31 .19 .00 .19 .15 .19 .01 .19 -.26 .19
Emotionality .26 .20 -.07 .20 .23 .21 .31 .20 -.11 .20
Rep. Party ID -.55** .17 -.05 .17 -.24 .18 -.23 .17 -.12 .17
Conservatism -.20 .17 -.13 .17 .02 .17 .07 .17 .25 .17
Individualism -1.18*** .24 -.52* .23 -1.47*** .24 -1.08*** .23 -.28 .24
Equality .54* .23 .89*** .22 .93*** .24 .90*** .22 .79*** .22
Extreme Resp. -.45 .29 -.46 .29 .45 .30 -.49 .29 -1.36*** .30
Cognitive Frame 1.94*** .27 2.11*** .29 3.19*** .29 .29 .25 1.82*** .26
Cut 1 -1.56*** .47 -2.42*** .47 -2.08*** .50 -1.78*** .46 -1.63*** .48
Cut 2 -.97* .47 -1.42** .46 -1.20* .50 -.94* .46 -.69 .48
Cut 3 .69 .47 .03 .46 .52 .50 .64 .46 .94* .48
Lau and Schlesinger

Chi-Square (16) 194.11*** 174.19*** 304.94*** 112.35*** 138.23***
Nagelkerke Pseudo R2 0.15 0.13 0.22 0.09 0.11
N 1,298 1,317 1,323 1,292 1,300
*p < .05 **p < .01 ***p < .001
Note. Table entries come from an ordered logistic regression.
Policy Metaphors 95
abuse.10 All predictors in the regressions have a 1-point range to make interpre-
tations easier. Although we are most interested in the effects of reasoning by cog-
nitive frame, we will comment first on the 15 “control” variables in the analyses.
We attempted to include in our survey examples of every major type of explana-
tory variable that have been offered to help understand political attitudes. Thus
among our 15 control variables were three measures of self-interest in the policy
area (two objective, having a family member who is disabled and currently having
no form of health insurance; and one subjective, perceiving this policy area as
among the most important problems facing the country; see Sears et al., 1980, or
Sears & Funk, 1991); a measure of emotionality toward the policy problem
(Conover & Feldman, 1986; Marcus & MacKuen, 1993); two standard symbolic
attitudes (party and ideological identifications); two political values (support for
individualism and equality; see Feldman, 1988); and six common measures of
demographic background information. There is undoubtedly a good deal of shared
variance among these 15 predictors, and we would not make much of the statis-
tical significance (or lack there of) of the individual control variables in any of
these equations. Our purpose was only to provide as complete an explanation as
possible for preferences among public policy alternatives before we examined the
importance of reasoning by cognitive frame.
The most important variable is the last in the table, the measure of reasoning
by cognitive frame. This measure is significantly greater than zero in four of the
five equations (all but the marketable commodity equation) and is clearly the most
important predictor in the four cases where it is significant. Because these logis-
tic regressions involve nonlinear estimators, it is difficult to assess the substan-
tive importance of the coefficients of the frame variables from Table 4. The
substantive effects (with the exception of the market proposal) are in fact quite
large, as can be illustrated by calculating the changing probabilities of strong
support or opposition to each policy alternative. Figure 1 depicts the effect of rea-
soning by cognitive frame on the probability of strongly opposing, and strongly
supporting, the policy alternative which had the greatest overall level of public
support, the employer responsibility plan, and the alternative which had the lowest
level of overall public support, the professional service plan. In calculating these
probabilities, all other variables in the equation are held at their median or mode.
Respondents with little understanding of the Employer Responsibility frame
were more likely (p = .39) to support strongly this approach to providing basic
physician and hospital care than to oppose strongly the plan ( p = .11). But respon-
dents who clearly understood the frame and strongly supported its use in general
were very likely (p = .74) to support strongly its application to this policy
10
These results are available from the authors upon request. Each equation also included the extreme
response scale described above. Conceptually the same control variables were used in every policy
domains, although the specific measures on self-interest and emotionality were unique to each policy
domain.
Employer responsibility
Figure 1. Effect of Cognitive Frames on Probability of Support for Two Alternative Solutions for
Providing Basic Physician and Hospital Care.
problem, and very unlikely ( p = .03) to oppose strongly its application. Similarly,
respondents who understood the frame but generally opposed its use as a model
for solving the country’s social problems were much more likely to oppose
strongly its application in this policy area ( p = .41) than they were to favor
strongly its application ( p = .10).
Turning to the professional service alternative to providing basic physician and
hospital care, respondents with little understanding of the Professional Service
frame were much more likely (p = .58) to oppose strongly this approach to pro-
viding basic physician and hospital care than to support strongly the plan ( p = .10).
But respondents who understood the frame and strongly opposed its use in general
were even more likely (p = .63) to oppose strongly its application to this policy
Policy Metaphors 97
problem, and very unlikely ( p = .04) to support strongly its application. Conversely,
respondents who understood the frame and generally supported its direction for
solving the country’s social problems were about equally likely to support strongly
(p = .22) or oppose strongly ( p = .21) its application in this policy area.
The same general pattern of results holds for alternative solutions to provid-
ing long-term care and treating substance abuse. Although space precludes our
presenting the full analyses, we can characterize them briefly. For both policy
areas, reasoning by cognitive frame is statistically significant in every case except
the marketable commodity solution. It is clearly the most important predictor
of support for the other four alternative solutions to providing long-term care,
although it is generally not as important as with support for alternative solutions
to providing basic physician and hospital care. Reasoning by cognitive frame is
somewhat less important, although still statistically significant, in the substance
abuse policy area.
This cross-domain difference merits some further discussion. Recall that the
five cognitive frames were identified by reviewing elite discourse on medical care
policy. But substance abuse policies have historically been shaped by the inter-
action of the medical model and paradigms derived from the field of criminal
justice (Gerstein & Harwood, 1990). Because recent portrayals of the substance
abuse problem have been cast in more legalistic and moral terms, it is not sur-
prising that cognitive frames relevant to the medical model have less salience
(Reeves & Campbell, 1993; Reuter & Caulkins, 1995). Long-term care policies
appear to occupy a more intermediate category, with medical frames playing a
more consistent role in shaping public attitudes. This also fits the pattern of elite
discourse in this policy domain (Caplan, 1988).
In interpreting these results, it is helpful to compare the power of cognitive
frames in explaining support for policy alternatives to that of other important pre-
dictors that are typically found in studies of public opinion. Consistent with the
symbolic politics literature (see for example Sears et al., 1980), across the three
policy domains only one of 25 measures of tangible self-interest were ever sta-
tistically significant in these equations, while at least one (and usually more than
one) of the more symbolic political beliefs and values were significant in all equa-
tions but one. Of these, the values of individualism and equality seemed espe-
cially important (Feldman, 1988). On the other hand, measures of emotionality,
which seem particularly important in explaining attitudes towards political figures
(Marcus, 1988; Marcus & MacKuen, 1993), were significant only once in the 15
equations and thus seem to add little to attitudes toward alternative policies.11
11
One reader of an earlier version of this article suggested that we may have misspecified our model
by modeling only the direct effect of emotions on policy preferences. Why should respondents with
very different policy preferences and evaluations respond with the same emotion directed at dif-
ferent targets? Damasio’s theory of emotions (1994; see also Marcus, Neuman, & MacKuen, 2000),
for example, would predict that the cognitive systems of respondents experiencing certain emotions
(anxiety or fear) would become more strongly engaged as people expended more energy making
Effects of Political Sophistication
Another important claim of our theory is that people at all levels of sophis-
tication employ these common cognitive frames as a heuristic to help them form
impressions of competing policy solutions. Near the end of our survey respon-
dents were asked five factual questions about American politics, modeled after
those included in the ANES surveys. We divided respondents into three categories
of political knowledge according to their answers to these questions and ran the
15 regressions discussed above again within each level of sophistication.12 The
results are summarized in Table 5, which for comparison also lists the “full
sample” regression coefficients. Concerning the policy problem of providing basic
physician and hospital care (shown in the top panel of Table 5), it is clear that
cognitive frames are important for respondents at all levels of sophistication. Only
in the case of the Societal Right policy solution does the importance of reason-
ing by cognitive frame seem noticeably weaker for the least knowledgeable
portion of the public, and even here it still has a significant impact.
The pattern of results for alternative plans for providing long-term care and
treating substance abuse is not as consistent. In the former case, reasoning by cog-
nitive frame seems widespread and important for those with high and moderate
knowledge, but noticeably weaker, and restricted to a single policy alternative,
for the least knowledgeable respondents. In the latter case just the opposite pattern
of results appears, however, with reasoning by cognitive frame most prominent
among those with low and moderate knowledge. This inconsistency in the impor-
tance of cognitive frames across levels of sophistication can be explained by the
relevance of alternative frames (e.g., those involving the family, or crime) in these
two additional policy domains that were not measured by our survey. In summary,
then, we conclude that most of the general public can and very often do employ
cognitive frames to help them choose among policy alternatives. There is no con-
sistent evidence to suggest that such reasoning is limited to any particular subset
of the population, defined by sophistication or any other variable that we have
been able to examine.
sure they were making the right choice. We conducted a brief test of this idea by removing our
measure of emotionality from the basic equations reported in Table 4 and running the analyses sep-
arately for respondents high and low in emotionality. We saw no obvious evidence that emotions
were playing such a role in our equations. The models seem to fit equally well in the high and low
emotionality groups, and the same patterns of significance of individual variables in the models held
across subgroups.
12
We have a similar measure of domain-specific knowledge about health care issues, which correlates
.48 with general political knowledge. Because we are trying to illustrate the generality of metaphor-
ical reasoning as a framework for making sense of complex policy alternatives, however, we feel
it is preferable at this stage in the analysis to use a more general measure of knowledge or sophis-
tication. It makes little practical difference which measure we use, however, as the pattern of results
looks much the same whether we subdivide respondents by their level of general political knowl-
edge or domain-specific knowledge.
Policy Metaphors 99
Table 5. Effect of Political Knowledge on Reasoning by Cognitive Frame

Providing Full Sample 1.94*** 2.11*** 3.19*** .29 1.82***
Basic Physician (.27) (.30) (.29) (.25) (.26)
and Hospital High 2.21*** 2.00*** 3.10*** .47 2.10***
Care Knowledge (.57) (.54) (.52) (.49) (.55)
Moderate 2.59*** 2.52*** 3.01*** .73* 1.40***
Knowledge (.42) (.47) (.44) (.39) (.40)
Low .81* 1.67*** 3.12*** -.33 1.75***
Knowledge (.49) (.55) (.61) (.45) (.47)
Providing Full Sample 1.44*** 1.77*** 2.80*** -.04 1.44***
Long-Term (.38) (.41) (.41) (.35) (.37)
Care High 1.43* 2.19** 3.70*** -.90 2.68***
Knowledge (.76) (.79) (.80) (.73) (.84)
Moderate 1.97** 2.24*** 2.00*** .40 .98*
Knowledge (.60) (.65) (.64) (.56) (.58)
Low .50 .66 3.32*** .51 .77
Knowledge (.69) (.80) (.85) (.67) (.69)
Treating Full Sample 1.26*** 2.20*** .95** -.36 .72*
Substance (.38) (.40) (.38) (.35) (.35)
Abuse High 1.05 2.50*** .12 .15 .26
Knowledge (.88) (.73) (.70) (.70) (.72)
Moderate 2.23*** 2.23*** 1.25* -.52 .96*
Knowledge (.59) (.63) (.61) (.56) (.54)
Low .79 1.65* 1.44* -.07 1.03
Knowledge (.69) (.84) (.81) (.66) (.64)
*p < .05 **p < .01 ***p < .001
Note. Table entries are ordered logistic regression coefficients, with standard errors in parentheses.
Probability levels are one-tailed. The median full sample N for Basic Physician and Hospital Care
is 1300; Low Knowledge N = 334, Moderate Knowledge N = 570, High Knowledge N = 405. The
median full sample N for Providing Long Term Care is 627; Low Knowledge N = 163, Moderate
Knowledge N = 265, High Knowledge N = 201. The median full sample N for Treating Substance
Abuse is 671; Low Knowledge N = 168, Moderate Knowledge N = 300 High Knowledge N = 203.
Cognitive Frames Applied to Other Policy Domains
One might reasonably ask, do policy metaphors, and/or the cognitive frames
we are considering in this article, apply to policy problems outside of the health
domain. The simple answer is that they should—there is nothing in our theory
which would lead us to expect that there is anything unique about the health policy
domain that would make these particular cognitive frames irrelevant for other
policy domains. That being said, we have not done the research to know the prin-
cipal ways in which problems in other policy domains have historically been
framed. Consequently, we make no claims that the five frames we have identified
Table 6. Effect of Political Knowledge on Reasoning by Cognitive Frame in Two Non-Health

Policy Domains

Providing Full Sample 3.17*** 2.23*** 2.37*** 1.49*** 1.51***
Public Housing (.40) (.41) (.41) (.37) (.34)
High 2.73*** 2.30** 3.75*** 2.43*** 1.45*
Knowledge (.89) (.79) (.86) (.78) (.79)
Moderate 3.00*** 2.32*** 2.76*** .89 1.73***
Knowledge (.59) (.63) (.65) (.56) (.52)
Low 3.86*** 2.25** .49 1.93** .97
Knowledge (.80) (.85) (.74) (.72) (.63)
Providing Full Sample 1.67*** 1.52*** 1.58*** .93** 1.70***
Public (.38) (.41) (.38) (.35) (.39)
Education High .76 1.23* 1.17* 1.97** 2.66***
Knowledge (.77) (.71) (.68) (.74) (.76)
Moderate 1.97*** 1.14* .86 1.39** .64
Knowledge (.62) (.67) (.58) (.59) (.62)
Low 1.20 2.90*** 2.81*** .17 1.39*
Knowledge (.74) (.83) (.91) (.66) (.78)
*p < .05 **p < .01 ***p < .001
Note. Table entries are ordered logistic regression coefficients, with standard errors in parentheses.
Probability levels are one-tailed. The median full sample N for Providing Public Housing is 671;
Low Knowledge N = 175, Moderate Knowledge N = 298, High Knowledge N = 199. The median
full sample N for Providing Public Education is 639; Low Knowledge N = 158, Moderate
Knowledge N = 273 High Knowledge N = 209.
as crucial in the health domain are equally important in other policy domains, or
that other cognitive frames are not applicable to these other domains.
Nonetheless we can explore with our survey the extent to which the cogni-
tive frames identified in health policy “cross over” to two policy domains outside
of health: providing public housing to the poor and providing public education.13
We replicated all of the analyses presented above in these two new policy
domains. Again space precludes the presentation of the complete regression
models. Table 6 presents the results for the predictions of reasoning by cognitive
frame. The findings in these two new policy domains are consistent with the evi-
dence presented for health policy options. Indeed in some ways the evidence is
even stronger, in that for these non-health domains we see that respondents utilize
the marketable commodity frame in forming preferences toward different pro-
posed solutions. In the full sample results for both of these new policy domains,
all five of the cognitive frames prove to have very significant effects on forming
13
A random half of our sample was asked about each of these two policy problems.
Policy Metaphors 101
policy preferences. And even among the least sophisticated third of the sample,
at least three of the five frames provide some guidance to forming policy
preferences.
This evidence demonstrates that the cognitive frames are quite generalizable.
We will not argue that we have identified all of the most prominent frames in the
housing or public education domains, as we do believe to be the case with health
policy. But we can clearly document that the five frames we have identified here
do seem to be applicable in a broad array of policy areas.
Cognitive Frames and Support for President Clinton’s Health Care Reforms
Cognitive frames would thus appear to play a major role in shaping public
opinion about different policies offered as solutions to major social problems.
While the general area of health care reform was very much on the public agenda
at the time our data were collected, the specific solutions tested in all of our three
policy domains did not precisely match any real world proposals. One would
therefore expect that public opinion had not “crystallized” around these concerns.
It is important to determine whether cognitive frames can also help explain public
opinion in a context where much of the public has already formed reasonably
stable opinions.
In the second half of our survey, respondents were asked if they remembered
enough about the health care reform plan developed by the Clinton Administra-
tion to answer some questions about it. The 658 respondents (46%) who said they
did were first asked how much they supported this plan for changing the health
care system and then how much the Clinton plan included each of the
“approaches” (i.e., cognitive frames) that had just been described. By July of 1995
that part of the public who had followed the health care debate had formed opin-
ions of Clinton’s reform proposal, and those opinions were closely tied to broader
partisan positions (Jacobs & Shapiro, 1994). Can cognitive frames help explicate
public opinion even in such a well-understood context? This is our final test of
the utility of cognitive frames.
Table 7 shows the extent to which the public perceived that the Clinton plan
embodied each of the different cognitive frames. Although almost half of the
knowledgeable public (i.e., those who remembered something about the Clinton
plan) thought the Clinton plan included each of the different cognitive frames at
least “a fair amount,” the societal right frame and the employer responsibility
frame clearly were seen as most salient. The Clinton Administration, however,
had gone to considerable effort to emphasize not only these two aspects of the
proposal, but also its consistency with market mechanisms and consumer choice
(Zelman, 1994).
The data presented in Table 7 allow us to apply a variant of our basic model
of how cognitive frames explain policy support. Because these questions about
the Clinton plan could logically only be asked after the cognitive frames had been
Table 7. Perception of Cognitive Frames in Health Security Act, by Level of Political Knowledge
Metaphors Percent of Respondents Seeing Each Metaphor in Acta

All Political Knowledge
Respondents
High Medium Low
Societal Right 86.5% 89.7% 88.0% 80.4%
Community Obligation 49.2% 48.3% 45.1% 54.4%
Employer Responsibility 79.4% 86.6% 74.8% 72.2%
Marketable Commodity 50.2% 42.3% 52.2% 58.8%
Professional Service 58.8% 55.9% 54.3% 67.4%
Number of Observations 582–645 265–290 149–166 165–189

a
Reporting that approach was in Clinton proposal “a great deal” or a “fair amount.”
described in some detail, our previous measures of “understanding” are no longer

very discriminating. Almost everyone can “understand” a cognitive frame imme-
diately after it is described to them. Instead, we substitute the measures of the
extent to which the Clinton plan was judged by the respondents to have embod-
ied each cognitive frame. The ability of respondents to identify these frames
amidst the complexity of the Health Security Act and the partisan climate sur-
rounding it seems to be a plausible indirect measure for their understanding of the
frames.
We conducted an analysis where support for the Clinton plan was regressed
on the same “control” predictors used in the earlier models, the measures of basic
preference for the three cognitive frames that were most central to the Clinton
plan (Societal Right, Employer Responsibility, Marketable Commodity), percep-
tions of how much the Clinton plan included each of these three frames, and the
multiplicative interaction between preference and perceptions.14 If cognitive
frames help explain support for President Clinton’s health care reforms, the inter-
action terms should be positive and significantly greater than zero.
The results are shown in Table 8. Because this reform plan was so closely
identified with President Clinton himself, support for it should be strongly
14
Because the crucial questions were only asked of respondents who claimed they could remember
something about the Clinton plan, the regressions reported here might suffer from the several prob-
lems associated with sample selection effects. To control for this possibility, we estimated a two-
stage regression model, based on the Heckman selection procedure (Greene, 1995). The first-stage
estimates the probability that a respondent will remember the Clinton plan sufficiently well to answer
questions about it. Independent variables in this first-stage model included sociodemographic char-
acteristics (including education), an index of political sophistication, and a separate index of sub-
stantive knowledge about health policy. The predicted values from this first-stage regression (which
effectively convert the dichotomous “willingness to answer” variable into a continuous variable cap-
turing awareness about the Clinton plan) have been shown by Heckman (1979) to control for unmea-
sured selection effects in the second-stage model predicting support for the Clinton proposal. This
selection effects variable was not related in a statistically significant manner to respondent’s atti-
tudes toward the Health Security Act, except among the least sophisticated respondents.
Table 8. Support for President Clinton’s Health Security Act
Political Knowledge
Full Sample Low Moderate High
Coef. S.E. Coef. S.E. Coef. S.E. Coef. S.E.
Female .08 .18 -.17 .33 .79* .35 -.37 .33
Black -.52 .36 -.43 .51 -.65 .67 -.76 1.29
Hispanic -.23 .39 -.74 .62 .02 .78 .52 .74
Age .21 .31 -.85 .62 .63 .60 .40 .54
Education -.69 .79 1.08 1.42 -1.10 1.60 -2.87* 1.44
Income -.48 .32 -2.01** .68 -.86 .64 -.14 .52
Disabled 1.12* .57 -.14 .96 -.64 1.08 2.73** 1.01
No Health Ins. .02 .20 -.23 .36 .04 .40 -.05 .36
Nursing Home -.34 .20 -.12 .39 -.56 .45 -.74* .34
Import. Natl. Prob. .45 .30 .80 .64 .65 .55 .28 .52
Emotionality .15 .35 -.22 .70 .60 .67 .21 .61
Extreme Resp. -1.12* .48 -.06 .91 -1.76 1.02 -1.10 .92
Rep. Party ID -2.51*** .30 -1.81*** .57 -2.95*** .60 -3.80*** .61
Conservatism .06 .27 .23 .49 -.03 .53 -.08 .49
Individualism -1.96*** .59 -1.30 .72 -1.64 .86 -2.96*** .72
Equality .74* .38 .08 .63 .58 .76 1.50 .78
Sample Selection -.41 .33 1.18 .67 -.71 .76 -2.73*** .74
Support Cognitive Frame:

Societal Right -.23 .73 .02 1.22 1.00 1.35 -3.74* 1.84
Employer Respons. -1.31* .59 -2.15* 1.08 -3.15** 1.18 .30 1.04
Marketable Commod. -.47 .41 -.86 .74 -.02 .98 -.52 .71
See Frame in Clinton Plan

Societal Right 2.02*** .37 2.51*** .64 2.36*** .73 2.32** .86
Employer Respons. -.13 .30 -.46 .60 .71 .57 -.71 .54
Marketable Commod. .73* .31 .54 .55 .72 .64 1.21* .56
Interaction Terms (Support ¥ See Frame)

Societal Right 1.22 .87 .23 1.48 .18 1.62 4.26* 2.06
Employer Respons. 2.22** .77 4.62** 1.55 3.51* 1.51 .67 1.34
Marketable Commod. 1.19 .73 2.99* 1.29 .08 1.66 .01 1.36
Cut 1 .15 .93 1.43 1.56 2.29 1.97 .65 2.08

Cut 2 1.24 .93 2.34 1.57 3.59 1.99 2.09 2.08
Cut 3 3.90*** .95 4.93** 1.61 6.43** 2.04 5.55** 2.12
Chi-Square (26) 338.24*** 81.92*** 124.50*** 207.96***

Pseudo R2 .48 .41 .55 .63
N 582 169 173 240
*p < .05 **p < .01 ***p < .001
Note. Table entries come from an ordered logistic regression. Pseudo R2 measure is Nagelkerke.
associated with party identification—and party ID is in fact the strongest predic-

tor in the equation. Democrats tended to support the plan, while Republicans
tended to oppose it. Similarly, respondents who highly valued individualism
tended to oppose Clinton’s reforms.
But after controlling for all of this variance, cognitive frames are also impor-
tant, at least among respondents who perceived that the Clinton plan included one
or more of the frames. All three of the interaction terms are positive (as predicted),
much larger than their standard errors, and two are statistically significant with
one-tailed hypothesis tests. Interestingly, simply believing that the Clinton plan
embodied a concern for societal rights or marketable commodity increased
support for the plan, whether or not the respondent endorsed those frames. Con-
versely, respondents who did not see in the Clinton plan frames that they gener-
ally endorse were less likely to support the proposal, though this effect was
statistically significant only for the employer responsibility frame.
As with our previous analysis of hypothetical policies, it is important to also
test our claim that cognitive frames can be used by less sophisticated members of
the public. Fortunately, even in our self-selected subsample who answered ques-
tions about the Clinton plan, there were a substantial number of respondents who
had modest scores on the index of political knowledge.15 For cognitive frames to
be equally useful to citizens whatever their stock of political knowledge, less
sophisticated respondents must be able to (a) interpret real-world proposals in
terms of frames in a manner similar to that of more politically aware citizens, and
(b) also be able to use cognitive frames to assess the desirability of those poli-
cies. In the context of our model of support for the Health Security Act, less
sophisticated respondents ought to favor the Clinton plan if it is thought to embody
cognitive frames that they support and to oppose the proposal if it slights their
preferred frames.
As can be seen in the right-hand columns of Table 8, citizens who score low
on the index of political knowledge nonetheless see the same cognitive frames in
the Health Security Act as do their more politically knowledgeable counterparts.
For each subgroup, the Societal Right and Employer Responsibility frame
dominate public perceptions. The responses of the least sophisticated respondents
rank the representation of the frames in exactly the same order as the most
sophisticated.
Limited political sophistication thus does not appear to hinder the interpre-
tation of real-world policies in terms of cognitive frames. Are such frames equally
useful for constraining policy attitudes among the politically ignorant? The find-
ings in the right-hand columns of Table 8 suggest that they are. Indeed, believing
15
There was, not surprisingly, some skewing of the distribution toward more sophisticated respon-
dents. “High knowledge” individuals represented 31% of the complete sample and 41% of the
selected sample. But more important for testing our claims, more than a quarter of both groups fell
into the “low knowledge” category.
that the Health Security Act contained one’s preferred cognitive frames appears
to most strongly predict attitudes among the least politically sophisticated. And at
all levels of sophistication, observing the Societal Rights frame in the proposal
produced a more favorable assessment of the plan, while not seeing favored
frames was associated with a lower level of support. In short, the American public,
no matter what their general level of political knowledge, appear equally able and
willing to make use of cognitive frames. In contrast, both partisanship and core
values exert more constraint on the attitudes of the most sophisticated respondents
than was true for those who were less politically aware.
Discussion
This article focuses on the extent to which cognitive frames help determine
public acceptance of different policy proposals. Whether expressed in terms of
policy metaphors or cognitive frames, we would argue quite strongly for the wide-
spread understanding of these heuristics among the general public.16 Cognitive
frames are beliefs about general types of solutions to social problems. People use
them to help interpret and evaluate more specific proposals. If a new proposal can
be described as “like” some more familiar (and presumably already existing)
policy or institutional arrangement, then it has a major advantage for being
understood.
Our analysis suggests that the cognitive frames most relevant to particular
domains powerfully shape public support. This was equally true for real and hypo-
thetical policies, for problems both in and clearly outside of the health domain,
and for populations with high and low levels of political knowledge. These find-
ings hold even after controlling for various demographic indicators, symbolic
beliefs, political values, self-interest, and emotions. The casual reader may wonder
what we have shown beyond general attitudes predicting more specific attitudes,
but this criticism ignores the distinction between interpretation and preference for-
mation. The importance of both functions illustrates the heuristic role of cogni-
tive frames and serves to distinguish them from more conventional measures
of public opinion (Kuklinski, Luskin, & Bolland, 1991). Cognitive frames—or
policy metaphors—are something new in the study of political attitudes, and their
distinctive contributions ought to interest all students of public opinion.
The findings presented here increase our understanding of the role and impor-
tance of metaphorical reasoning in the assessment of public policy. But each new
insight creates another set of questions to be answered. Consider three examples.
First, our analyses suggest that citizens’ comprehension of metaphors influences
16
At least if by “existence” we mean that the public responds to policies described in terms of cog-
nitive frames. The current data do not demonstrate that people spontaneously organize their think-
ing about policy alternatives in terms of cognitive frames or that the underlying reasoning involves
all the characteristics we have said it does. Support for those claims is provided in Schlesinger and
Lau (2000).
their attitudes towards policy, apart from their support of or opposition to those
metaphors. But we still know little about how people understand policy metaphors
and how particular aspects of understanding translate into particular insights in
policy assessments. Most crucially, the analyses presented here do not demon-
strate that it is the distinctively metaphorical aspects of understanding that shape
policy attitudes, as opposed to more general framing effects. Indeed, one of our
frustrations with the current data is our inability to distinguish between the broader
and more familiar concept of a “frame,” and our conception of a policy metaphor.
Frames help us understand what people are thinking about when they form policy
preferences. Our theory attempts to also help us understand how people are think-
ing when they form those preferences.
One way to disentangle the different conceptualizations would be to expose
respondents to increasingly more of the aspects that we believe characterize policy
metaphors—labels, problem definition, norms of fairness, familiarity or comfort
levels, attributions of responsibility, and concrete comparisons. Some of these
aspects fit comfortably under typical conceptions of frames (problem definition,
comfort level, attributions of responsibility), while others (labels, concrete com-
parisons, norms of fairness) are more clearly metaphorical in their orientation.
Another useful technique would be to present subjects with a set of competing
solutions to some social problem and ask them to think aloud (à la Ericsson &
Simon, 1980) as they consider the strengths and weaknesses of the different pro-
posed solutions and try to decide among them. Transcripts of these “think aloud”
transcripts could be coded for evidence of different aspects of our model. Alter-
natively, internal decision memos and other “private” documents could be exam-
ined to identify how metaphorical arguments are employed by elites in the process
of making policy decisions (e.g., Khong, 1992). These are issues that can and
should be explored in future research.
Second, we demonstrate here that the policy metaphors derived from health
care also have some explanatory power in other policy domains: housing and
public education. There certainly may be other metaphorical templates that are
unique to housing or education issues, which we have not identified. Conse-
quently, our assessment of the impact of metaphorical reasoning in these other
policy domains should be viewed as a lower-bound estimate, since there may well
be other powerful metaphors which were not even presented to our respondents.
Third, our current study demonstrates that preferences for metaphors are
related to attitudes towards concrete policies (real and hypothetical). But they do
not demonstrate that metaphorical reasoning helps citizens make better choices.
Certainly one could create criteria for these better decisions, such as choices that
more accurately reflect their preferences if they were more fully informed, or
choices that the citizens in question feel are more soundly reasoned or fully com-
prehended. Ultimately, it would be useful to consider whether metaphorical
framing enhances the quality of deliberation about complex policies—the ability
of citizens to hear and be heard on matters of public interest. This more active
version of democratic participation may not often be feasible or even desirable

for the average American. Nonetheless, it would be useful to explore whether
metaphorical framing creates the potential for deliberative democracy, should
citizens be so motivated by particular social issues.
One final point is worth making with these data. We opened this article with
a brief review of the public opinion literature. The conventional view within the
discipline—and among politicians, political consultants, and the media who cover
public affairs—is that the general public cares little and knows less about the
details of policy issues. Politicians speak of policy goals, but no one except “policy
wonks” cares about the details of specific proposals. Our findings are somewhat
at odds with this conventional wisdom. Although we would never argue that the
public cares about the details of proposed policy solutions, our data suggests that
people do care about the broad outlines of proposed solutions, at least if they can
be described by metaphor, as like some other more familiar policy solution. When
President Clinton, in presenting his proposed health reforms to the nation, showed
everyone a health insurance card all Americans would receive just like all older
Americans now have a Social Security card, he was very successful in conveying
at least certain aspects of what his proposed reforms would be like. Fully nine
months after Clinton’s plan died in Congress, almost half of the general public
could remember enough about it to correctly identify (in terms of cognitive frames)
crucial aspects of his proposal. Unfortunately for President Clinton, the societal
right frame that his proposal leaned most heavily upon was the least popular of
the five cognitive frames we have identified as relevant to health policy.
For people who care about the workings of democracy, however, our data
should prove more comforting. Given the right circumstances, a large proportion
of the public will listen to proposed solutions for social problems and can form
and express reasonable (by which we mean “consistent with prior beliefs or
values”) opinions toward those proposals. It only remains for survey researchers
to become more sensitive to the “metaphorical” content of different policy pro-
posals. Were questions designed to more effectively tap into such content, poll-
sters could more reliably measure support for such proposals. By the same token,
political leaders who present their proposals with careful attention to how their
proposals will be cognitively framed or understood could more effectively com-
municate their ideas and more consistently shape coalitions of support among a
reasonably informed and engaged public.
ACKNOWLEDGMENTS
This research was funded by a grant from the Robert Wood Johnson foun-
dation to the second author, and by general research funds provided by Rutgers
and Yale Universities to both authors. The manuscript was largely completed
while the first author was a fellow at the Center for the Study of Democratic
Politics at Princeton University. We would like to thank Jane Junn and Gerry
Pomper for commenting on earlier versions of this manuscript. Correspondence

concerning this article should be addressed to Richard R. Lau, Professor of
Political Science, Institute of Health, Health Care Policy, and Aging Research, 30
College Avenue, Rutgers University, New Brunswick, NJ 08903. E-mail:
ricklau@rci.rutgers.edu
METHODOLOGICAL APPENDIX
Alternative Solutions for Providing Physician and Hospital Care
Near the beginning of the survey respondents were told:

“People talk about a number of ways of changing how we pay for and
deliver physician and hospital care. Let me describe five different
options.” (The order of presentation of the following options was
randomized.)
• Single-payer plan, most relevant to societal right frame
“The federal government provides a single health insurance plan to every Amer-
ican. A federal agency would decide what benefits to cover, but people would
choose their own doctors and would be financially responsible for any services
not covered by the plan.”
• Community-based plan, relevant to community obligation frame
“People would get their health insurance from the town or city where they live.
Each community would be given money by the federal government to pay for the
program, and the community would decide how best to spend it.”
• Employer mandate, relevant to employer responsibility frame
“Each employer would be required to offer health care to their employees, with
government helping to cover the costs for small businesses and providing insur-
ance for the unemployed. Decisions about what types of health care and health
insurance would be made jointly by employers and workers at each firm.”
• Voucher plan, most relevant to marketable commodity frame
“Each family would get a voucher from the federal government that would allow
them to purchase the health insurance plan of their choice. Insurers would be
required to accept any person who applied and to cover all pre-existing condi-
tions. Families would pay out-of-pocket for any services not covered by the insur-
ance or for insurance plans that cost more than the voucher.”
• Physician-controlled plan, relevant to professional service frame
“People would sign up with groups of physicians, who would be paid a fixed
amount for each enrollee by the federal government. The physicians in each group
would decide what was covered and how best to spend the money available for
health care.”
These five alternatives were presented to respondents in random order. After

each option was described, respondents were asked (using a 4-point scale) how
strongly they support or oppose that approach to health care reform.
Preference for Cognitive Frames
The following items, asked near the middle of the survey, serve as the basic
measure of preference for each cognitive frame.
“People in Washington talk about different ways to help Americans meet
their basic needs for food, housing, education, and health care. I’m going
to describe different approaches and ask you whether or not you think
that they make sense and should be supported by policy makers.”
• Societal Right Frame
“Some people talk about meeting basic needs as a societal right. You need national
solutions to adequately address the full range of people’s basic needs and ensure
that the needs of all people are met. You can rely on the federal government to
be fair and responsive in administering these programs. One way to better meet
basic needs would be to design more federal programs to be like Social Security.”
• Community Obligation Frame
“Basic needs can be defined as a community responsibility. Community organi-
zations are best able to understand and provide for the basic needs of people who
live in their city or town. People feel most comfortable getting help from those
who live in the same area they do. For these reasons, programs to help meet
people’s basic needs are best run at the local level, like public schools are run
now.”
• Employer Responsibility Frame
“Basic needs can be made the responsibility of employers. A good way to help
people meet their basic needs is to let workers and managers freely bargain with
each other to decide upon benefit packages that cover services like day care,
health, or school scholarships in addition to wages. Companies can be relied upon
to help their workers deal with these problems, although they may need some
government subsidies to help pay the costs of these benefits.”
• Marketable Commodity Frame
“Market forces can determine how best to meet basic needs. Individuals are best
able to decide for themselves which of their needs are most vital and how they
should be met. Most people don’t want others to make decisions about their
family’s needs. The best solution is a program like Food Stamps, giving people
coupons of a certain value for housing, food, or education and allowing each
family to determine what they will buy and from whom they will buy it.”
• Professional Service Frame
“We can let professionals decide how best to meet basic needs. To really under-
stand people’s needs, you must have advice from experts who study education,
housing, and nutrition. The only people who we can trust to make these decisions
are people who can find scientifically correct answers. We should develop a
program like the space program that would give specialists money to develop and
administer new programs to improve housing, education, and health care.”
These five alternatives were presented in random order. Four-point “Strongly

Agree” to “Strongly Disagree” scales were used to measure preference.
Support for President Clinton’s Health Care Reform
“Last year, Congress extensively debated a health care reform plan devel-
oped by the Clinton Administration. Do you remember this plan well
enough to answer some questions about it?” (Only respondents who
answered “Yes” [48%] were asked the following questions.)
• “How much did you support this plan for changing the health care system?
Did you support it a Great Deal, a Fair Amount, Not Very Much, or Not at
All?”
• “To what extent did the Clinton plan include each of the approaches to
health care reform that we described earlier? How much did it include:
• a societal right to health care for all Americans? [Same four response
options.]
• a community-based system of medical care?
• health care as an employer responsibility?
• a market-based health care system?
• preserving the role of doctors in determining the care their patents
receive?”
Again, these options were presented in random order.
REFERENCES
Bartels, Larry M. (1996). Uninformed votes: Information effects in presidential elections. American
Journal of Political Science, 40(February), 194–231.
Caplan, Arthur. (1988). Is medical care the right prescription for chronic illness? In Sean Sullivan and
Marion Ein Lewin (Eds.), Economics and ethics of long-term care and disability (pp. 73–89).
Washington: American Enterprise Institute.
Chen, Chuansheng, Shin-ying Lee, & Harold Stevenson (1995). Response style and cross-cultural
comparisons of rating scales among East Asian and North American students. Psychological
Science, 6(May), 170–175.
Conover, Pamela J., & Stanley Feldman. (1986). Emotional reactions to the economy. American
Journal of Political Science, 30(February), 50–78.
Converse, Philip E. (1964). The nature of belief systems in mass publics. In David E. Apter (Ed.),
Ideology and discontent (pp. 206–261). New York: Free Press.
Converse, Philip E. (1996). The advent of polling and political representation. PS: Political Science
and Politics, 29(December), 649–657.
Damasio, Antonio R. (1994). Descartes’ error: Emotion, reason, and the human brain. New York:
Putnam.
Delli Carpini, Michael X., & Scott Keeter. (1996). What Americans know about politics and why it
matters. New Haven: Yale University Press.
Dougherty, Charles. (1989). American health care: Realities, rights, and reforms. New York: Oxford
University Press.
Edelman, Murray. (1971). Politics and symbolic action. New York: Academic Press.
Ericsson, K. Anders, & Herbert A. Simon. (1980). Protocol analysis: Verbal reports as data. Cam-
bridge: MIT Press.
Feldman, Stanley. (1988). Structure and consistency in public opinion: The role of core beliefs and
values. American Journal of Political Science, 32(May), 416–440.
Feldman, Stanley, & John Zaller. (1992). The political culture of ambivalence: Ideological responses
to the welfare state. American Journal of Political Science, 36(February), 268–307.
Gabel, John, Howard Cohen, & Steven Fink. (1989). American’s view on health care: Foolish incon-
sistencies? Health Affairs, 8(January), 104–118.
Gamson, William. (1992). Talking politics. New York: Cambridge University Press.
Gamson, William, & Andre Modigliani. (1987). The changing culture of affirmative action. In R. A.
Braumgart (Ed.), Research in political sociology (Vol. 3). Greenwich: JAI Press.
Gamson, William, & Andre Modigliani. (1989). Media discourse and public opinion on nuclear power:
A constructionist approach. American Journal of Sociology, 95(July), 1–37.
Garland, Joseph. (1961). Every man our neighbor: A brief history of the Massachusetts General Hos-
pital: 1811–1961. Boston: Little, Brown.
Gerstein, Dean, & Henrick Harwood. (1990). Treating drug problems. Washington: National Academy
Press.
Glendon, Mary Ann. (1991). Rights talk: The impoverishment of political discourse. New York: Free
Press.
Graber, Doris A. (1984). Processing the news: How people tame the information tide. New York:
Longman.
Greene, William. (1995). Econometric analysis. New York: MacMillan.
Greenleaf, Eric A. (1992). Measuring extreme response style. Public Opinion Quarterly, 56(Fall),
328–351.
Grob, Gerald. (1994). The mad among us: A history of the care of America’s mentally ill. New York:
Free Press.
Hacker, Jacob S. (1997). The road to nowhere: The genesis of President Clinton’s plan for health
security. Princeton: Princeton University Press.
Heckman, James J. (1979). Sample selection bias as a specification error. Econometrica, 47(January),
153–161.
Iyengar, Shanto. (1991). Is anyone responsible? How television frames political issues. Chicago, Il:
University of Chicago Press.
Jacobs, Lawrence R., & Robert Y. Shapiro. (1994). Questioning the conventional wisdom on public
opinion toward health reform. PS: Political Science and Politics, 27, 208–213.
Jennings, M. Kent. (1992). Ideology among mass publics and political elites. Public Opinion Quar-
terly, 56(Winter), 419–441.
Judd, Charles M., & Jon A. Krosnick. (1982). Attitude centrality, organization, and measurement.
Journal of Personality and Social Psychology, 42(March), 436–447.
Katz, Michael. (1986). In the shadow of the poorhouse: A social history of welfare in America. New
York: Basic Books.
Khong, Yuen F. (1992). Analogies at war: Korea, Munich, Dien Bien Phu, and the Vietnam decisions
of (1965). Princeton: Princeton University Press.
Kinder, Donald R. (1998). Opinion and action in the realm of politics. In Daniel Gilbert, Susan T.
Fiske, and Gardner Lindzey (Eds.), The handbook of social psychology (Vol. 2, 4th ed.,
pp. 778–867). Boston: McGraw Hill.
Kinder, Donald R., & David O. Sears. (1981). Prejudice and politics: Symbolic racism versus racial
threats to the good life. Journal of Personality and Social Psychology, 40(March), 414–431.
Kinder, Donald R., & David O. Sears. (1985). Public opinion and political action. In G. Lindzey and
E. Aronson (Eds.), Handbook of social psychology (Vol. 2, 3rd ed., pp. 659–741). New York:
Random House.
Kramer, Ralph. (1981). Voluntary associations in the welfare state. Berkeley: University of Califor-
nia Press.
Krosnick, Jon A. (1989). Attitude importance and attitude accessibility. Personality and Social Psy-
chology Bulletin, 15(September), 297–308.
Kuklinski, James H., Robert C. Luskin, & James Bolland. (1991). Where is the schema? Going beyond
the “S” word in political psychology. American Political Science Review, 85(December),
1341–1356.
Lakoff, George. (1996). Moral politics: What conservatives know that liberals don’t. Chicago: Uni-
versity of Chicago Press.
Lakoff, George, & Mark Johnson. (1980). Metaphors we live by. Chicago: University of Chicago Press.
Lakoff, George, & Mark Johnson. (1999). Philosophy in the flesh. New York: Basic Books.
Landau, Martin. (1961). On the use of metaphor in political analysis. Social Research, 28(Fall),
331–353.
Larson, Martin. (1977). The rise of professionalism. Berkeley: University of California Press.
Lau, Richard R., & David P. Redlawsk. (2001). Advantages and disadvantages of cognitive heuristics
in political decision making. American Journal of Political Science, 45(October), 951–971.
Lau, Richard R., Richard A. Smith, & Susan T. Fiske. (1991). Political beliefs, policy interpretations,
and political persuasion. Journal of Politics, 53(August), 644–675.
Lodge, Milton, & Ruth Hamill. (1986). A partisan schema for political information processing. Amer-
ican Political Science Review, 80(June), 505–519.
Luft, Harold. (1996). Modifying managed competition to address cost and quality. Health Affairs,
15(Jan/Feb), 23–38.
Marcus, George E. (1988). The structure of emotional response: 1984 presidential candidates. Amer-
ican Political Science Review, 82(September), 737–761.
Marcus, George E., & Michael B. MacKuen. (1993). Anxiety, enthusiasm, and the vote: The emo-
tional underpinnings of learning and involvement during presidential campaigns. American
Political Science Review, 87(September), 672–685.
Marcus, George E., Neuman W. Russell, & Michael MacKuen. (2000). Affective intelligence and polit-
ical judgment. Chicago: University of Chicago Press.
McClosky, Herbert, & John Zaller. (1984). The American ethos: Public attitudes toward capitalism
and democracy. Cambridge: Harvard University Press.
Meckel, Richard. (1991). Save the babies: American public health reform and the prevention of infant
mortality: 1850–1929. Baltimore: Hopkins University Press.
Mondak, Jeff. (1993). Public opinion and heuristic processing of source cues. Political Behavior,
15(June), 167–192.
Mondak, Jeff. (1994). Cognitive heuristics, heuristic processing, and efficiency in political decision
making. In Michael X. Delli Carpini, Leonie Huddy, and Robert Shapiro (Eds.), Research in
micropolitics: New directions in political psychology (pp. 117–142). Greenwich: JAI Press.
Nelson, Thomas E., & Donald R. Kinder. (1996). Issue frames and group-centrism in American public
opinion. Journal of Politics, 58(November), 1055–1078.
Nelson, Thomas E., Zoe M. Oxley, & Rosalee A. Clawson. (1997). Toward a psychology of framing
effects. Political Behavior, 19(September), 221–246.
Neuman, W. Russell. (1986). The paradox of mass politics: Knowledge and opinion in the American
electorate. Cambridge: Harvard University Press.
Nimmo, Dan, & James Combs. (1980). Subliminal politics: Myths and mythmakers in America.
Englewood Cliffs: Prentice-Hall.
Page, Benjamin I., & Robert Y. Shapiro. (1992). The rational public: Fifty years of trends in Ameri-
cans’ policy preferences. Chicago: University of Chicago Press.
Pepper Commission (U.S. Bipartisan Commission on Comprehensive Health Care). (1990). A call of
action. Washington: U.S. Government Printing Office.
Raffel, Marshall, & Norma Raffel. (1984). The U.S. health care system: Origins and functions. Albany:
Delmar Publications.
Reeves, Jimmie L., & Richard Campbell. (1994). Cracked coverage: Television news, the anti-cocaine
crusade, and the Reagan legacy. Durham: Duke University Press.
Reuter, Peter, & Jonathan P. Caulkins. (1995). Redefining the goals of national drug policy: Recom-
mendations from a working group. American Journal of Public Health, 85(1), 1059–1063.
Rosen, George. (1983). The structure of American medical practice: 1875–1941. Philadelphia: Uni-
versity of Pennsylvania Press.
Rosenberg, Charles. (1987). The care of strangers: The rise of America’s hospital system. New York:
Basic Books.
Rosner, David. (1982). Health care for the ‘truly needy’: Nineteenth-century origins of the concept.
Milbank Memorial Fund Quarterly, 60(3), 355–385.
Rothman, David. (1978). The state as parent: Social policy in the progressive era. In Willard Gaylin,
Ira Glasser, Steven Marcus, and David Rothman, (Eds.), Doing good: The limits of benevolence
(pp. 67–96). New York: Pantheon Books.
Rothman, David. (1980). Conscience and convenience: The asylum and its alternatives in progres-
sive America. Boston: Little, Brown.
Sardell, Alice. (1988). The U.S. experiment in social medicine: The community health center program,
1956–1986. Pittsburgh: University of Pittsburgh Press.
Scheingold, Stuart. (1974). The politics of rights: Lawyers, public policy, and political change. New
Haven: Yale University Press.
Schlesinger, Mark. (1997). Paradigm lost: The persisting search for community in American health
policy. Journal of Health Politics, Policy and Law, 22(4), 937–992.
Schlesinger, Mark. (2002a). A loss of faith: The origins of declining political legitimacy for the
American medical profession. Milbank Quarterly, 80(2), 1–45.
Schlesinger, Mark. (2002b). On values and democratic policymaking: The deceptively fragile
consensus around market-oriented medical care. Journal of Health Politics, Policy and Law,
27(6), 889–926.
Schlesinger, Mark, & Richard R. Lau. (2000). The meaning and measure of policy metaphors. Amer-
ican Political Science Review, 94(September), 611–626.
Schön, Donald, & Martin Rein. (1994). Frame reflection: Toward the resolution of intractable policy
controversies. New York: Basic Books.
Sears, David O., & Carolyn Funk. (1991). The role of self-interest in social and political attitudes. In
Leonard Berkowitz (Ed.), Advances in experimental social psychology (Vol. 24, pp. 1–91). New
York: Academic Press.
Sears, David O., Richard R. Lau, Tom R. Tyler, & Harris M. Allen, Jr. (1980). Self-interest versus
symbolic politics in policy attitudes and presidential voting. American Political Science Review,
74(September), 670–684.
Sniderman, Paul M., Richard A. Brody, & Philip E. Tetlock. (1991). Reasoning and choice: Explo-
rations in political psychology. New York: Cambridge University Press.
Stafford, Mark, & Mark Warr. (1985). Public perceptions of social problems: Some propositions and
a test. Journal of Applied Behavioral Science, 21(September), 307–316.
Starr, Paul. (1982). The social transformation of American medicine. New York: Basic Books.
Stevens, Rosemary. (1971). American Medicare and the public interest. New Haven: Yale University
Press.
Stevens, Rosemary. (1982). A poor sort of memory: Voluntary hospitals and the government before
the depression. Milbank Memorial Fund Quarterly, 60(December), 551–584.
Stone, Debra. (1988). Policy paradox and political reason. Glenview: Scott, Foresman.
Weisman, Carol. (1998). Women’s health care: Activist traditions and institutional change. Baltimore:
Johns Hopkins University Press.
Yankelovich, Daniel. (1995). The debate that wasn’t: The public and the Clinton plan. Health Affairs,
14(1), 7–23.
Zaller, John. (1992). The nature and origins of mass opinion. New York: Cambridge University Press.
Zelman, Walter A. (1994). The rationale behind the Clinton health reform plan. Health Affairs, 13(1),
9–29.

Lau Et Al-2005-Political Psychology

Transféré par

Informations du document

Copyright

Formats disponibles

Partager ce document

Partager ou intégrer le document

Options de partage

Avez-vous trouvé ce document utile ?

Ce contenu est-il inapproprié ?

Droits d'auteur :

Formats disponibles

Lau Et Al-2005-Political Psychology

Transféré par

Droits d'auteur :

Formats disponibles

Political Psychology, Vol. 26, No.

Policy Frames, Metaphorical Reasoning, and Support

different perspectives has something to contribute to our understanding of public

We are attempting to develop such a broadly integrative theory by turning to

Cognitive Frames Applicable to Understanding Health Care in the United States

How Prior Understanding Can Affect Policy Assessment

When people are confronted by a collective concern, a social problem that

Because experiences (and interpretations of experience) vary, we expect that there

In July of 1995 a nationally representative sample of 2232 English-speaking

Table 1. Demographic Characteristics of Survey Sample

Age: Under 25 11% Household Under $15,000 12%

Education: Elementary 2% Race: African American 9%

Employment Employed Full-Time 58% Gender: Female 50%

Determining Policy Preferences

Interpreting Proposed Policy Solutions

Measuring Preference for Cognitive Frames across Policy Domains

Other Scales Used in Analyses

A primary purpose of this article is to demonstrate the power of cognitive

to misinterpretation under several different circumstances, however. Some respon-

Two Stages of Cognitive Reasoning

The two stages of reasoning proposed by our theory involve interpretation

Table 2 highlights the results of 15 logistic regressions, where the

Table 2. Strength of Opposition/Support and Reasoning by Cognitive Frame

Alternative Policy Solutions for Providing:

independent, however, there is no reason for the general measures of preference

Explaining Support for Hypothetical Policy Alternatives

Table 3. Preference Formation and Reasoning by Cognitive Frame

Alternative Policy Solutions for Providing:

simultaneously applied. Consequently, to examine reasoning by cognitive frame,

Societal Community Employer Marketable Professional

Lau and Schlesinger

Effects of Political Sophistication

Table 5. Effect of Political Knowledge on Reasoning by Cognitive Frame

Societal Community Employer Marketable Professional

Cognitive Frames Applied to Other Policy Domains

Table 6. Effect of Political Knowledge on Reasoning by Cognitive Frame in Two Non-Health

Societal Community Employer Marketable Professional

Metaphors Percent of Respondents Seeing Each Metaphor in Acta

Number of Observations 582–645 265–290 149–166 165–189

described in some detail, our previous measures of “understanding” are no longer

Table 8. Support for President Clinton’s Health Security Act

Support Cognitive Frame:

See Frame in Clinton Plan

Interaction Terms (Support ¥ See Frame)

Cut 1 .15 .93 1.43 1.56 2.29 1.97 .65 2.08

Chi-Square (26) 338.24*** 81.92*** 124.50*** 207.96***

associated with party identification—and party ID is in fact the strongest predic-

version of democratic participation may not often be feasible or even desirable

Pomper for commenting on earlier versions of this manuscript. Correspondence

Alternative Solutions for Providing Physician and Hospital Care

Near the beginning of the survey respondents were told:

These five alternatives were presented to respondents in random order. After

Preference for Cognitive Frames

These five alternatives were presented in random order. Four-point “Strongly

Support for President Clinton’s Health Care Reform

Vous aimerez peut-être aussi

Chi-Square (26) 338.24* 81.92* 124.50* 207.96*