Health Policy Manag.  2017 Dec;27(4):324-334. 10.4332/KJHPA.2017.27.4.324.

Determinants of Welfare Attitudes towards Healthcare Services: Focusing on Self-Interest, Symbolic Attitude, and Sociotropic Perceptions

  • 1Korea Disabled Peoples' Development Institute, Seoul, Korea.
  • 2Korea University, Seoul, Korea.


The aim of this study is to analyze determinants of welfare attitudes toward healthcare services in South Korea, using three main theories: self-interest (positive welfare attitudes if the policy fulfills people's personal interests), symbolic attitudes (positive welfare attitudes if the person is politically progressive or egalitarian), and sociotropic perception (positive welfare attitudes if the person experienced positive aggregated collective experiences of societal events and trends regarding the policy). Although the definition of the welfare attitude is rather ambiguous in literatures, in this investigation, we operationalize the concept as the "˜willingness to pay higher taxes to improve the level of health care services for all people in Korea' which shows individuals' actional propensity.
We used the health module from the International Social Survey Program 2011 for the analysis (N=1,391). Five logistic regression models were built successively using two variables for each theory to measure key concepts of self-interest, symbolic attitudes, and sociotropic perceptions as independent variables.
The result showed self-interest and symbolic attitudes factors to be strong determinants of welfare attitudes towards healthcare services in South Korea, whereas sociotropic perception factors have inconsistent effects.
For a more politically elaborated healthcare reform in South Korea and elsewhere, there needs to be further research on various dimensions and determinants of welfare attitudes to understand popular basis of welfare expansion, especially in the era of inequality.


Welfare attitude; Healthcare services; Self-interest; Symbolic attitude; Sociotropic perceptions
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