Democrats and Republicans agree: Take politics out of health policymaking

It's no secret that Americans are politically divided, but a new report offers hope that Democrats and Republicans find common ground on at least one issue: the role of "evidence" in developing and shaping health laws. Strong bipartisan support exists for a greater use of "evidence—defined as information based on reliable data and produced by statistical methods—in development of health policy in the United States. The study is published today in Translational Behavioral Medicine from a researcher at Drexel University's Dornsife School of Public Health.

In a 2018 public opinion survey, 532 Americans were asked to what extent six factors "should have" and "currently have" influence on health policy decisions made by members of the United States Congress, including industry interests, evidence, and budget costs. The data was weighted to be representative of the U.S. adult population.

"Evidence" as well as "citizens' desires," were the factors most often identified by both Democrats and Republicans as those that should have the most influence. While members of both parties agreed on the most important factors that should shape policy, they were comparably cynical about whether their voices are being acted upon. Although 59 percent of respondents said that evidence should have "a lot of influence" on policy, only 11 percent said that evidence currently has "a lot of influence" on those decisions.

Additionally, more than half of respondents said that desires of citizens should have "a lot of influence," but only 14 percent reported that citizens actually have "a lot of influence" on policy. This disconnect was also found in the role of pharmaceutical companies' lobbying efforts. Just six percent said the interests of pharmaceutical companies should have a lot of influence, but 44 percent said they felt those companies currently have "a lot of influence."

"There is a wide gap between what Americans think should influence health policymaking in U.S. Congress and what they think actually does influence policy," said author Jonathan Purtle, DrPh, MPH, an assistant professor of Health Management and Policy in the Dornsife School of Public Health. "Across the political spectrum, Americans want evidence to play a much stronger role."

Political division has been well-documented. A 2017 Pew Research Center report of 5,000 surveyed Americans notes record levels of division between Democrats and Republicans on many political values, including race, immigration, the environment and other issues.

As prior studies have shown that public opinion can influence decisions made by policymakers, Purtle suggests that members of the U.S. Congress may be held more accountable by efforts to disclose evidence behind specific policy decisions.

Although the findings show no statistically significant difference across party lines on the role of evidence and citizens' desires in health policy, Purtle notes that "evidence" is a flexible idea that can be altered to support an individual's pre-existing policy preferences. He adds that future research should look at how opinions about the influence that evidence should have on policymaking vary when evidence unequivocally supports legislation decisions that are counter to citizens' preferences.