Medicare is one of the largest social programs in the world. Did organized industry favor Medicare's passage in 1965? If it did, this would represent powerful evidence in favor of the theory that social programs typically require cross-class alliances to pass, such as alliances between business and labor. However, in a previous article in this journal, I argued that answering questions about political actors’ preferences—such as whether organized industry favored Medicare's passage—can be surprisingly difficult due to the “problem of preferences”; that is, political actors might misrepresent their true policy preferences for many reasons. For example, when their ideal proposals are not politically feasible, political actors may wish to bolster support for a more politically viable alternative to a disliked proposal—even if they do not truly support this alternative to the status quo. To better understand political actors’ true policy preferences, I argued, scholars should trace how those actors’ expressed preferences change as a function of their strategic context—just as scholars seeking to understand the impact of any other variable trace the effects of changes in it.
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