On Saturday, October 29, a random sampling of 100 Allegheny County residents discussed and deliberated health-care issues along with thousands across the country as part of the first-ever nationwide Deliberation Week. The success of Saturday?s poll opens the doors for a student and community poll on campus November 19.
This Saturday's event was organized by PBS's initiative By The People. It was headed by the Southwestern Program for Deliberative Democracy, a partnership between Carnegie Mellon and the Carnegie Library of Pittsburgh.
The topic at hand was particularly relevant to Pittsburgh, a national leader in health care and a city whose population would be drastically affected by possible state budget cuts and reduction of Medicaid funds. Participants debated care and insurance costs, health care for the elderly, tort reform, Medicare and Medicaid, and the impact of advances in treatment.
"Deliberation" in this sense was a discussion between community members on local and national issues. The goal was to create thoughtful resolutions for difficult community choices. After filling out an initial survey, participants discussed health-care issues in small groups with a moderator. Each group developed two questions to ask an expert panel, and then reconvened to discuss the questions addressed by the panel before taking the concluding survey. The results of both surveys were compared to gauge the effect of deliberation on survey response.
Deliberators emphasized personal responsibility as a factor in keeping insurance costs low, and they cited cost as an issue of greater concern than quality. Participants complained about health care's complexity and lack of centrality. "To get anything done, you have to jump through all these hoops," one deliberator said.
Some thought that insurance holders seek excess care because they believe that insurance will cover the costs, which jacks up insurance prices. "Let's talk about the must-haves and put the want-to-haves away for the moment," said one participant. "Whatever happened to rest and drinking plenty of fluids?" asked another. Participants were frustrated by the medical jargon of medical and drug information and also expressed worries about misunderstanding instructions or being billed incorrectly.
Darlene King of Baldwin, Pa., said she chose to attend the poll because she hoped it would clarify health-care policies to allow her to make informed decisions for her family members. However, she said her favorite part of the poll was watching participants of all walks of life come together during discussion.
Carol Emerson of Squirrel Hill, former president of the League of Women Voters of Greater Pittsburgh (1998-2000) and alternate moderator, was "impressed by the caliber of involvement of participants, the depth of their inquiry, how well prepared they are, and how all participants have been encouraged to speak up." She hoped that the legislature hears the concerns of the public and takes the results of the poll seriously.
Julia Posteraro, a grad student in Pitt?s International Development Program, served as a small-group moderator because she was "hoping to see where people in this region come together to gauge how much people want change." A lifelong resident of the Pittsburgh area, she was interested in seeing where people from her own region stood on the issues.
The technique of deliberative polling was developed by professor James Fishkin, founder of Stanford's Center for Deliberative Democracy. Fishkin partnered with Robert Cavalier, a philosophy professor and director of the Center for the Advancement of Applied Ethics and Political Philosophy. He also focuses on developing online tools for deliberative polling in cooperation with Fishkin's center at Stanford. Cavalier stated that Fishkin was instrumental in "developing a tool that could address various access and scalability issues relating to the potential wide-scale use of deliberative polls as a way of enhancing our democratic institutions."
Hearing Fishkin speak at CMU in 2001 sparked the interest of Liz Style, now the project manager for the poll. "The more locally you hold these kinds of polls, the better it is," she said. Organizing a discussion for community members in which their opinions are respected is a way of saying to the public, "you deserve this kind of information," Style said. Her favorite part of the day was the expert panel. "People don't normally have the chance to talk to experts and have their questions answered," she said.
The next deliberative poll on campus, CMU's Campus Conversation, will be open to college students and community members on November 19. It is the first deliberative poll in the nation designed specifically for use at the campus level. The poll will focus on the issues of campus diversity and moral values, particularly the sharing of copyrighted material.