The “Problem of Preferences”: Medicare and Business Support for the Welfare State

Abstract

Few political observers would readily assume that a present-day politician's or interest group's claims about their preferences accurately reflect their genuine views. However, scholars often unwittingly make this very assumption when inferring the preferences of historical political actors. In this article I explore the influence of business groups on Medicare's passage to illustrate how inattention to political actors’ strategic misrepresentations can bias qualitative and quantitative research. An ongoing debate wrestles with the pattern that businesses often grant support to welfare-state expansions just before they occur, a regularity some take as evidence that business interests dictate these expansions. I use Medicare as a case study and document that key business groups and their allies did not truly favor the program. However, I also show that these actors strategically misrepresented their preferences as Medicare's passage became likely in order to advance more limited alternatives. The strategic nature of this position is exceptionally easy to miss; yet inattention to it produces the opposite, erroneous conclusion about these actors’ historical role. Medicare's legislative history thus illustrates the methodological necessity of documenting whether political actors are misrepresenting their preferences. I discuss how scholars can do so by tracing actors’ stated preferences across strategic circumstances, including audiences and time.