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CEP/STICERD Applications Seminars

Interest groups, ideology, and indirect lobbying: The rise of private health insurance in the United States

Marcella Alsan (Harvard Kennedy School), joint with Yousra Neberai and Xingyou Ye


Monday 19 February 2024 12:00 - 13:30

SAL 1.04, 1st Floor Conference Room, Sir Arthur Lewis Building, LSE, 32 Lincoln's Inn Fields, London WC2A 3PH

About this event

This study examines the rise of private health insurance (PHI) in the United States in the post-World War II era (1946-1954). We examine the role of the American Medical Association (AMA) which financed a campaign against national health insurance (NHI) directed by the country's first political public relations firm, Whitaker and Baxter (WB). The AMA-WB Campaign had two key components: (1) physicians who would endorse private health insurance (PHI) to patients; and (2) newspaper advertising that described PHI as “freedom” and “the American way." We bring together archival data from several novel sources to assess whether the Campaign was effective. we find that areas more exposed to the Campaign experienced sharp declines in support for NHI and increased enrollment in PHI. A one standard deviation increase in AMA-WB Campaign exposure is associated with a 2.3 percentage point increase in PHI enrollment on average, per year, or 2\% of the increase in the post-Campaign period. We also find effects on physician financial contributions to the Republican presidential candidate in 1952 as well as on policy debates from the Congressional Record. These findings suggest the rise of PHI in the U.S. was not solely due to price controls, collective bargaining, or favorable tax treatment. Rather, it was enabled by an interest group financed Campaign that used ideology to indirectly lobby policymakers by persuading ordinary citizens.


Participants are expected to adhere to the CEP Events Code of Conduct.


Directions

This event will take place in SAL 1.04, 1st Floor Conference Room, Sir Arthur Lewis Building, LSE, 32 Lincoln's Inn Fields, London WC2A 3PH.

The building is labelled SAL on the LSE campus map. You can also find us on Google Maps. For further information, go to contact us.

This series is part of the CEP's Labour Markets programme.