Welfare Attitudes in Crisis: The Role of Ideology in Healthcare Satisfaction in Portugal and Ireland

Previous studies have documented that crisis trends are associated with negative changes in healthcare satisfaction. Yet, most research has focused on the role of self-interest and little is known about the ideological dimension of these changes. The article investigates this underexplored topic by examining the ideological divide in satisfaction with healthcare in two countries strongly hit by the recent economic crisis, Portugal and Ireland. The results of the empirical analysis based on the European Social Survey data from 2008 to 2015 show that ideology played a role in shaping healthcare satisfaction in both countries. In Portugal, healthcare satisfaction declined more for the left- than for the right-oriented, while in Ireland the right-oriented demonstrated a stronger decline in satisfaction than the left-oriented. In addition, the results identify an interaction between ideology and self-interest, showing that ideology trumps self-interest among the low income, but the opposite is true among the high income groups. Overall, these findings suggest that there is a substantive ideology-driven dimension in public satisfaction with health systems and point to the need for theoretical integration of different approaches in the analysis of healthcare attitudes in the crisis context.