The Daschle Guides to Getting the Conclusion the Obama Team Wants on Heathcare
[I'm leaving this sticky because it's important and creative -- a virtual Daschle house party with reality-based material! But I'm also seeing people volunteering for house parties on the ground. Kudos to all on this thread, and let's do it! --lambert]
Edited to add:
RL house party volunteers as of 12/18:
- allys gift in Baltimore
- basement angel in L.A.
- Paul Lukasiak in Philly
- Me and the fab GF in Monroe/Seattle area
Can't host but will help a host:
- ElizabethF in West Palm Beach
We also have document development:
- -6Qs That Should Be Asked
- -Press release and PSA templates
- -Fun Facts factsheet
[I will revise and sharpen if others will draft. Perfection is not necessary! --lambert]
Keep a lookout for dates for virtual house parties here in the Mighty Corrente Building.
Via the PNHP website, I downloaded the Participant Guide PDF and the Moderator Guide PDF to HHS Sec.-designate Daschle's healthcare house parties thing just to take a quick look. My impressions as follows...
The Participant Guide begins with two pages identifying three big healthcare problems:
- First, health care costs are skyrocketing, hurting our families as well as our economy
- Second, over forty-five million Americans have no health insurance
- Third, our nation’s investment in prevention and public health is inadequate, leading to rapid spread of chronic diseases, many of which could be prevented entirely or managed
Each section has key facts about health insurance, healthcare, and other issues footnoted throughout. But these two pages aren't about facts; they're about appearing authoritative. Whether the data expressed in each bullet point is factual or not, combining them the way they have frames the problem about healthcare as lack of access to private health insurance.
The first and third bullet points are all about people being hurt by rising costs and lack of preventive care. The Obama team snuck in health insurance between the two, connecting them with a solution---access to health insurance.
Now to first question for discussion:
1. Briefly, from your own experience, what do you perceive is the biggest problem in the health system?
The construction of "what do you perceive" is a nice way of diminishing a person’s statements as only opinion. You're talking about your perception---not fact. All the relevant facts are footnoted in the preceding pages and connected to a concluding solution to our healthcare problems. (I'd suggest, too, that the most important part of the question is the use of the term "health system." If the question were, "What is the biggest problem with healthcare?" people would give answers the Obama team does not wants to hear.)
This question sets up the rest of the discussion. In fact, it may very well be the only question the group discusses.
The Moderator's Guide suggests the house party should last an hour to an hour and a half, with 15-20 or, it later says, 20-25 people involved.
The number of people is too big. Focus groups tend to be smaller, about 7 to 10 people---small enough so people feel comfortable speaking, but large enough to get an array of experiences. A trained moderator can control dominant and submissive relationships (not the kind you’re thinking, mind out of gutter) as well as chit-chat with a smaller group.
So why so many people? That the Obama team recommends this number suggests to me that the team is seeking, perhaps even relying on, the consensus effect. Some people actively adopt the opinions of the leader. Some people will tacitly accept the opinions of the leader. Some may not accept, but won’t speak up in such a large group. This benefits the Obama team as they can point to consensus, when there may be no such thing, on their stated positions.
The Moderator’s Guide continues, offering an eight-item agenda that doesn't include things like taking your coat off, going to the bathroom, or the group getting its picture taken. So in this hour to an hour and a half,
- The host should welcome everyone to the Health Care Community Discussion, introduce him/herself, and lead introductions.
- The host should give a short description of the purpose of the Health Care Community Discussions (there’s a sample paragraph).
- The host should go over the three goals of the Health Care Community Discussion: 1) To discuss health care reform and draft a submission to the Transition Health Policy Team; 2) To use a process to do this that respects and empowers attendees; and 3) To identify stories that exemplify the need for health care reform. My note: This chunk includes the gratuitous sentence: “Please stress that everyone should conduct the meeting like President-elect Obama would: respecting everyone, listening to everyone’s opinion, and engaging in spirited discussion without being disagreeable.” Would someone please tell Dear Leader I just barfed?
- The moderator (if someone other than the host) should start leading the discussion by explaining his/her role to listen, facilitate discussion, and answer any questions on the process.
- Pass out the Health Care Community Discussion Participant Guide. Attendees should take 5-10 minutes reading the document.
- The group should then select a note taker.
- The group should decide whether they want to address all discussion questions or instead focus on a particular area.
- The group should decide how much time to spend for each topic in the Participant Guide. If the group is discussing all the questions, it should spend 5 to 10 minutes per question.
- Use the discussion questions in the Participant Guide to guide the conversation, and make sure the group follows the agreed timing. Try to make sure that each attendee has a chance to give input and contribute to what will eventually be submitted online to the Transition Health Policy Team. Help the group get past any obstacles. My note: How do you get 15-20 people to participate in a discussion if you only have 5-10 minutes for each question? Easy---you get them to shut up and look like they agree.
- Draft the Submission to the Transition Health Policy Team: The group can have the note taker draft its submission to the Transition Health Policy Team as it goes along or at the end of the discussion. Encourage brevity and plain language. My note: The fastest way to do this is to copy material in the Participant’s Guide.
- Fill Out Participant Surveys: Pass out the Participant Survey (at the end the Participant Guide) and collect completed surveys from everyone.*
- Listen for Compelling Stories: Identify participants with stories that would be good features to highlight the need for health care reform. (The host/moderator should submit names, contact information, and a summary of stories with the group submission.) My note: This really doesn’t need comment, but I will anyway. This is about finding horribly stories to insert into speeches.
- Closing: Thank everyone for their participation.
The questions continue:
2. How do you choose a doctor or hospital? What are your sources of information? How should public policy promote quality health care providers?
3. Have you or your family members ever experienced difficulty paying medical bills? What do you think policy makers can do to address this problem?
4. In addition to employer-based coverage, would you like the option to purchase a private plan through an insurance-exchange or a public plan like Medicare?
5. Do you know how much you or your employer pays for health insurance? What should an employer’s role be in a reformed health care system?
6. Below are examples of the types of preventive services Americans should receive. Have you gotten the prevention you should have? If not, how can public policy help?
The moderator is supposed to guide participants into deciding if they want to discuss all the questions or just those that interest them. Of the questions offered in this document,which ones are the most likely to engender discussion? For example, question 2 is like the peanuts in a can of mixed nuts---would you go to a meeting like this to talk about how you found your healthcare provider? (Note: Interesting it's doctors and hospitals, not healthcare providers. Lots of competent people provide healthcare, ya know, not just people with an MD after their names.)
Question 2 is either a skip or a quick answer: "My HMO gives me a list, I picked someone." No drama, so not worth much in the discussion, unless your doctor or hospital messed up---and that becomes a great story for further propaganda or a way to bond.
Question 3 is all about engendering group identification. This is particularly important if we're talking about a group of people who may not know each other well. Even strangers can bond over stories of an asshole boss or asshole doctor or asshole insurance company.
Questions 4 and 5 are both based on a pre-determined solution. And it ain't healthcare for all.
Question 6 focuses on people talking about their personal health. Some people love to talk about themselves (with all the assorted details), but few want to hear about it. And by the time they get to this one, it's way past an hour and a half and everyone is hungry.
So these questions are designed to set up other groups (doctors, hospitals, people who don't take care of themselves) as enemies standing in our way to affordable health insurance---not about developing healthcare for all. It's someone else's fault and on that, the group can agree.
Now the survey.
1. What do you perceive is the biggest problem in the health system?
a. Cost of health insurance
b. Cost of health care services
c. Difficulty finding health insurance due to a pre-existing condition
d. Lack of emphasis on prevention
e. Quality of health care
What a crock. Whoever wrote this survey can take any response that does not conform and chuck it out of the final result.
2. What do you think is the best way for policy makers to develop a plan to address the health system problems?
a. Community meetings like these
b. Traditional town hall meetings
c. Surveys that solicit ideas on reform
d. A White House Health Care Summit
e. Congressional hearings on C-SPAN
This is about how to make people feel like they’re involved in the process in a meaningful way, when in fact this is a way to get people on board with bad policy. My bet is that they’ve already planned and scheduled to do all, especially the summit thing.
3. After this discussion, what additional input and information would best help you to continue to participate in this great debate?
a. More background information on problems in the health system
b. More information on solutions for health reform
c. More stories on how the system affects real people
d. More opportunities to discuss the issues
You just gave the Obama team permission to get more propaganda and to ask you to fill out more skewed surveys with the answers the Obama team wants.
Your turn. I need coffee and some Cheerios.