Digital Media and US Health Care Reform

By DJ Edgerton

Diagnosis: deja vu.

Fourteen years ago, there was another health care debate going on. But 14 years ago, there were no social networks, no blogs, no microblogging, no HD video, no Java widgets, no electronic health records – email and the web barely existed, at least in a general public-knowledge sense. But, people were less accustomed to HMOs and all that went with them. A simpler time? Perhaps. But it doesn’t seem to matter: this recent paper by Shapiro and Arrow compares the 1994 and 2009 reform efforts and concludes that the public’s opinions, are comparable. So it’s interesting to wonder whether all of these new digital tools come into play. Are they changing things this time around?

(To digress for a moment: it’s hard to separate the question from the broader question of how much digital tools have shaped the Obama administration overall. That’s hard to overestimate. It’s worth asking whether the Obama administration would be there at all without digital tools. That might be a conversation for another post, though.)

Compared with 1994, individual engagement is much easier and, more importantly, much more visible. It’s not new – Speakers’ Corner has been around for 150 years – but it’s exponential, how much faster we can learn and how much louder we can talk. Two dads have been good examples: Shawn Burns’ posts are often about the latest adventures of his toddler – but he broke that up recently with piece on health care reform. Mr. Dooce, Jon Anderson, has been writing about it frequently.

Second, public statements on both sides, are less pristine than they once were. Internal memos are leaking. This isn’t new either, but the extent is – and therefore, the ramifications.

So people are talking to each other. And they can see that the emperors don’t always have any clothes. So what? The size and breadth and speed and level of the discussion is going to speed the argument up. Simultaneously, neither side can win with a “Harry and Louise” ad campaign. Fittingly enough, there is no panacea, no miracle cure.

The Democrats appear to recognize that the process needs to provide information and feel participatory, and barackobama.com and healthreform.gov reflect that. (The GOP site is a pretty pale imitation, but they offer their weekly address online as well.)

But even best case – will online conversation, involving the proletariat, with respectful participation by the administration and the opposition – will that be enough?

The politics, not to mention the actual plans, are, like the story of the election, their own topics. If you’re interested, Slate has a good clearinghouse that should get you up to speed, and the New York Times has some interesting timelines. With the caveat that both outlets are liberal. But perhaps that’s a relevant point – that the left seems to be making a wealth of information available for interested voters and health care consumers.

But how will health care itself go digital? In what ways will tools like electronic health records be brought to the fore in the efforts to make health care more cost-effective?

Are there new digital tools on the horizon that could be game-changing? Why aren’t we hearing about each party’s bringing in chief digital wizards to help them find new efficiencies in technology?

Are digital media why he’s President Obama, or is that hyperbole? Are you seeing ways that they’re setting this reform apart from 1994? Do you know a way that one – or both – sides should be using them?

Lots of questions. Two camps who say they have answers. But here, as in the national debate, what matters most is the voice of the people. What do you think?