Confronting value strain: Press coverage of health care reform in Sweden and the United States.

摘要

This comparative content analysis study examines the health care reform debates that took place in the early 1990's in Sweden and the United States in an effort to understand the role that cultural values might play in shaping news narratives about policy reform. In both countries, proposals for health care reform seem to manifest core value strain (seen here in terms of an individualist-collectivist spectrum) in the sense that calls for change both question prevailing institutional arrangements and challenge prevailing notions about how health care should be organized. Thus, in the US, Clinton's proposal for universal coverage challenged predominant values associated with individual freedom and choice, while in Sweden, proposals for increased privatization challenged the predominance of more collectivist values associated with health care security and collective responsibility.;The study asks whether individualist values appear to be privileged in the US news narrative and whether collectivist values appear to be privileged in the Swedish news narrative. It offers the hypothesis of a cultural filter through which values may pass into the news. Accepting the possibility that among western liberal democracies, certain values are held more deeply by the general public and legitimized through institutional configurations more than others, it is proposed that value differences are likely to be observable at the national level which override differences at the institutional, organizational and individual levels.;The overview of media and policy environments confirms cultural filter expectations, as both the media and health care norms and institutions appear to manifest clearly distinctive patterns reflecting the prominence of collective values in Sweden and individual values in the US. The content analysis of the news narrative presented in The New York Times, USA Today, Dagens Nyheter and Expressen further confirms the hypothesis, as the narrative profiles and patterns of value expression at the country level far outweigh distinctions at the organizational (elite/mass paper) or individual (journalist/actor "voice") levels.