Health Care 2020: Observations from NIF Deliberative Forums


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The cost, fairness, and effectiveness of the US health-care system has been a pressing public concern for decades. In the first half of 2020, Americans participated in forums to deliberate on the problem and possible solutions. The forums were convened by the nonpartisan network of the National Issues Forums (NIF). This report summarizes what we heard.

Between January and June 2020, the NIF network convened more than a dozen nonpartisan forums inviting everyday citizens to deliberate on the future of the health-care system in the United States. These forums took place in three ways:

  • In early 2020, local convenors organized forums in a variety of community settings in cities and towns nationwide.
  • As the COVID-19 pandemic took hold, convenors pivoted to holding forums via Zoom or other videoconferencing technology.
  • Throughout the period, some convenors used the Common Ground for Action platform for online deliberation, which brings participants from different regions together to exchange views.

What unifies all these health-care forums—and NIF forums in general—is the emphasis on “choicework.” Participants weigh the advantages and disadvantages of three broad approaches to an issue and look at specific proposals with risks and trade-offs spelled out. They use nonpartisan issue guides prepared by the Kettering Foundation specifically for nonexperts. Forums typically last about two hours.

Although forum participants are by no means random and representative samples of the general public, the discussions still provide useful insights for understanding how people wrestle with the trade-offs raised by suggested solutions to the most challenging public issues in extremely difficult times. As one might expect, the spring 2020 forums were shaped by the greatest health crisis the country had experienced in a century. Yet, at a deeper level, in forums both before and after the pandemic began, many underlying concerns and priorities remain unchanged.

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Reports on NIF forums