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Robert J. Blendon, ScD; Drew E. Altman, PhD; John Benson, MA; Mollyann Brodie, PhD; Matt James; Gerry Chervinsky

Arch Pediatr Adolesc Med. 1995;149(10):1065-1069.

Abstract
Objective
To identify the core beliefs and policy preferences of the American public toward changing the welfare system and providing support for low-income families.

Design
Results are presented from 19 telephone and in-person surveys of adults nationwide between 1937 and February 1995.

Setting
At-home interviews with adults.

Participants
Seventeen surveys; each survey involved 1000 to 2000 adults nationwide.

Interventions
None.

Measurements and Main Results
The results showed that the public supports strong welfare reform measures (eg, time limits and work requirements), but it is reluctant simply to cut off welfare benefits to people and leave them without some means of basic support. The surveys identified five underlying beliefs that shape the public's policy preferences: (1) welfare causes more harm than good because it discourages work and causes families to break up; (2) welfare should be a temporary transition to work, not a long-term subsidy for low-income families; (3) the country spends too much on welfare programs; (4) lack of economic opportunity as well as personal responsibility is the reason people need welfare; and (5) both government and people themselves have a shared responsibility for ensuring that people have a minimum standard of living.

Conclusions
The outcome of the welfare reform debate will have a substantial impact on the 21% of the nation's children who now live in poverty. The jury is still out on what the public will support in the welfare reform debate. The Medicaid program is caught in the middle of the welfare reform debate, and its ultimate fate may rely on state rather than federal decision making.

(Arch Pediatr Adolesc Med. 1995;149:1065-1069)

Author Affiliations
From the Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass (Dr Blendon and Mr Benson); the Henry J. Kaiser Family Foundation, Menlo Park, Calif (Drs Altman and Brodie and Mr James); and KRC Communications Research, Newton, Mass (Mr Chervinsky).

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