ON THE AGENDA | APRIL 24TH, 2014 | Megan Rose Donovan

The Need For Public Engagement On Health Care

Providing a time and space for conversation on how to reduce health care costs gives the public an opportunity to help solve the broken and complex health care system.

How much do average Americans care about public issues like health care?

According to the Kaiser Family Foundation’s index, less than half of Americans were closely following news coverage of Affordable Care Act enrollment - a surprising figure given its headline dominance.

That number looks even starker compared to the more than three-quarters of Americans that said they "very" or "fairly closely" followed coverage of the missing Malaysia Airlines flight.

These numbers alone don't reveal why so many of us seem disinterested in following health care policy, though in many ways the disinterest is understandable. At the same time, we believe there is immense potential to ignite meaningful public conversation about solutions on out-of-control health care spending.

One reason for the public's lack of interest may be our lack of agency when it comes to health care policy. As our co-founder Daniel Yankelovich wrote, “From the perspective of experts, the public has nothing to contribute to strategic policy thinking and has been effectively left out of the conversation.”

Health care is also complex, and these complexities may contribute to public ambivalence – and exhaustion. We’ve all struggled with problems pertaining to our own personal health care costs, so it’s easy to understand how thinking about the big policy picture doesn’t come to mind when trying to read an insurance bill or figure out which prescriptions are covered under our plans. Even experts find it difficult to envision a workable solution that the majority of Americans would be willing to accept, so how could the public conceive of one?

...participants' thinking moved away from resigned futility and toward constructive action.

Yet one of our most recent projects suggests that, with the right support, the public can quickly develop a deeper understanding of and interest in big-picture health care policy issues.

After participating in carefully designed, moderated conversations that helped those in the study engage with realistic policy options, participants' thinking moved away from resigned futility and toward constructive action. Following the study, many participants described themselves as angry but eager for more information and more opportunities to engage.

There is a great opportunity for average Americans to contribute to solutions to rising health care costs, but what the public needs is the time and space to deliberate in.


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