Home > 2. politics > An alternative to health care “townhall” meetings

An alternative to health care “townhall” meetings

August 18th, 2009

I worry that the townhall on health care may give many Americans the wrong impression about what is possible for citizen deliberation. So, I was very happy to see Jim Fishkin’s interesting editorial in the NYT explaining how deliberative polling would be a better alternative. Here’s how he frames the issue:

“CONGRESS on Your Corner” has turned into “Your Congressperson Cornered.” Around the country, lawmakers are finding their town hall meetings disrupted by hecklers, many echoing anti-health-care-reform messages from talk radio and cable television. Supporters of reform will surely countermobilize, leading to more outbursts and demonstrations. Forget, for a moment, that these impassioned voters have turned these meetings into political sideshows. Are town halls actually the best way for lawmakers to connect with their constituents?

The two key insights from Fishkin’s deliberative polling design: (1) you can use random sampling to ensure that every citizen is equally likely to be invited to participate and (2) deliberations require structure (e.g., information packets and moderated small group discussions).

Although there are some quibbles with his methods (a la the snarky title “Towhnalls by Invitation” given by the NYT editorial board), I think that deliberative polls are exactly the right form of public consultation for this kind of issue. And Jim and his colleagues have had demonstrated success in contexts even more contentious than the current health care debate in the US:

At the center, we have collaborated on more than 50 deliberative polls around the world. The process has certainly been shown to help overcome sharp divisions. In a 2007 deliberative poll in Northern Ireland on education reform, the percentage willing to agree that “most Catholics” or “most Protestants” were “open to reason” rose 16 points. Those agreeing that most Protestants or Catholics were “trustworthy” also increased considerably.

One we held in Bulgaria, about policies toward the Roma, or Gypsies, produced strongly reconciliatory policies at a time when loud fringe groups wanted to build walls around the Roma communities. And in a deliberative poll in Brussels just before the recent European Union elections, people from 27 countries, partaking in discussions in 21 languages, moved to support more tolerant policies toward immigrants.

Jim concludes by asks us to imagine with these deliberative polls could work for improving the health care debate. I think the answer to that is “yes.” But even more broadly, I think the question is: how improve the design of our democracy to facilitate “more civil and constructive” as these contentious issues continue to be raised? Hopefully we can improve the current dialogue on health care, but also make progress on improving the environment for politics and issues for future issues as well.

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