Measuring attitude toward social health insurance.

In order to understand the health care system a country chooses to adopt or the health care reform a country decides to undertake, one must first be able to measure a country's attitude toward social health insurance. Our primary goal was to develop a construct that allows us to measure this "attitude toward social health insurance". Using a sample of 724 students from the People's Republic of China, Germany, and the United States and an initial set of sixteen items, we extract a scale that measures the basic attitude toward social health insurance in the three countries. The scale is internally consistent in each of the three countries. A secondary factor labeled "government responsibility" is marginally consistent for the total sample and for the German sample. German respondents have the most favorable attitude toward social health insurance, followed by China, and then the United States. Chinese respondents have the most favorable attitude toward government responsibility in health insurance. The scale developed here can be used to further investigate and understand which health care system will succeed and which will fail in a given country, which is important from both a political and an economic perspective.