Prospects for single payer coverage after Harry and Louise

This paper considers evidence of indirect influences of the Harry and Louise media campaign on public support of single payer health coverage in a conservative state.

Data from a statewide, representative public opinion survey on health reform conducted in Oklahoma over a two-year period, 1992-1994, were combined with data on the Harry and Louise media campaign broadcasts. A two-stage structural-equation model tested the hypothesis that support for single payer varied inversely with support for "mainstream" health reform.

Findings support the hypothesis, providing evidence that a campaign affecting support for mainstream health reform inversely affects support for single payer, despite the tendency for support for health reform to correlate with support for single payer.

Findings suggest that an unintended indirect effect of a campaign against mainstream health reform may have been increased support for single payer. Those proposing future reforms should be aware of available media technologies and how they will be used.