Talking about Health Care in a Divided Nation
The current health-care emergency will extend over the next weeks and months with unforeseeable repercussions. But when the immediate crisis is past, policymakers will turn their attention, once more, to reshaping our complex, costly, and now battered health-care system. They will begin rethinking how to convey the information the public needs. They will want and need constructive input from all Americans.
Most of our nation’s leaders seek to convey information and improve the system in ways that garner broad public attention and support. While information is crucial to sound decision-making, the problem we face is not a lack of knowledge or good ideas. But the methods officials typically use to gauge public thinking are often unhelpful. Polls and focus groups show skepticism about important messages but offer little guidance on how to combat it. They may suggest broad support for a course of action that evaporates over time. Elected officials hold town hall meetings that attract participants with strong feelings about the issues at hand. These sometimes vociferous events often generate fear, concern, and complaints but rarely result in a realistic direction for action.
How can our leaders develop more productive two-way communication with the public?
For forty years, the Kettering Foundation has collaborated with the network of the National Issues Forums (NIF), a group of locally based organizations that convene public forums, to learn what Americans say about urgent issues when they weigh options and deliberate about them together. Since 1984, the NIF network has convened nationwide forums on health care seven times. We have observed how people talk about health care, what they understand, what confuses them, what worries them, and what generates trust versus what breeds skepticism. We’ve heard typical Americans weigh the costs and benefits of many ideas and proposals. This report shares what we’ve learned about what derails useful communication between leaders and the public and what promotes it.