Policy Discourse and Policy Identification: Interests, Values, and Self-concepts in China's Outpatient Mutual-aid Health Insurance Reform

The impact of policy discourse on shaping policy identification depends on the extent to which diverse individual interests and values align with the policy information. However, the psychological mechanisms may be more complex. This study offers a real policy context, the Outpatient Mutual-aid Reform of Public Health Insurance (OM Reform). Its contributions are twofold: (1) it investigates the full interactive process between policy and the public by employing both quantitative and qualitative analyses of Sina Weibo data; and (2) it examines individuals' diverse self-concepts, interests, and values, as well as the complex effects of policy discourse on policy identification. The findings address existing theoretical disputes. (1) Previous research has found that two motivations—abstract values and concrete interests—often lead to conflicting understandings of policy information. Using a grounded theory method, this paper finds that individuals' notions of self—both the value self and the concrete self—play a key role; their varied configurations determine five different identification approaches, contingent on the clarity of the value self and the sensitivity of the concrete self. (2) Previous findings have shown that people's notions of self and their motivations may be either stable or fluid in response to shifts in policy discourse. Using quantitative analysis, this paper explores the significant differences in policy identification before and after the central government changed its policy discourse strategies. However, the attitudinal differences between the two strategies are not statistically significant when assessed independently before and after policy discourse shift. This means that while public opinion may respond to changes in discourse, the notions of self, the self-interpretation of values and interests, are more stable. (3) Qualitative analysis reveals that this complexity is derived largely from the disparity between current policy interpretations and memories of earlier policy discourses and practices as well as from the individuals' already shaped self-concepts, which have been formed consistently through the cyclical construction process of “discourse-context-self”. This paper also provides an example of policy identification research from a self-concept-based perspective. It reveals a deeper understanding of individuals' diverse self-interpretations in the process of policy identification, and sheds light not only on how interests and values are perceived but also on why they are perceived in paticular ways. This helps to form a complete picture of how real people react to policy discourse strategies. Nevertheless, this research has several limitations. The OM Reform involves complex interests and value conflicts, thus requiring validation in other policy domains. The Weibo data are mainly derived from younger users, which may result in an amplification of the conflicting attitudes. Nevertheless, the data still provide meaningful insights into the construction of policy identification among the younger generations. Due to the limitations of unstructured data, the quantitative findings require further testing to establish causal relationships.