The following article is one of a series of articles NCDD created in August 2009 in response to the volatile town hall meetings on healthcare held at the time. NCDD members were encouraged to adapt the articles and submit them as op-eds in their local papers. Go to https://ncdd.org/rc/item/3172 to see the other articles and one-page flyer.
Town hall meetings being held on healthcare legislation across the country are exploding with emotion, frustration, and conflict. Citizens are showing up in throngs to speak out about health care as well as dozens of other topics, but it seems the louder voices get, the less people are actually heard.
The meetings have become a vivid demonstration of what’s missing in American Democracy.
Why is this happening? Members of the National Coalition for Dialogue & Deliberation—a network of people who bring together Americans of all stripes to discuss, decide and act together on today’s toughest issues—have outlined some ideas to help us understand what has evolved.
There is a lack of trust between government and citizens
While Americans’ distrust of government is playing out in obvious ways at town hall meetings across the country, another level of distrust is less frequently acknowledged: government officials’ lack of trust in citizens’ ability to grapple with complicated issues and trade-offs. Government officials often don’t see citizens as peers who, when given the opportunity, can talk reasonably together across partisan and other divides and come to agreement even on elements of highly divisive issues like healthcare, gay marriage, and abortion.
The typical “town hall meeting” format isn’t working
Today’s typical “town hall meetings” don’t live up to the traditional New England Town Meetings they’re named after. They don’t allow citizens to feel they’ve been truly heard, or to discuss issues in any depth. The current town hall design sets the stage for activist groups and special interest groups to try to ‘game’ the system and sideline other concerned citizens in the process. As one NCDD member said, “the loudest voices are the ones that get heard.”
The issue is in crisis mode
Another NCDD member observed that when people are only invited in when there is a final battle between proposals, “this fact alone invites polarization.” When an issue is in crisis mode, it is easier to manipulate people; there is less time to get information and issues clarified; there is less patience on all sides to delve into the actual complexities; and nonpartisans get the sense they are being sold false alternatives.
What to do?
So how can officials hold more effective open-to-the-public meetings with their constituents? Dozens of effective public engagement techniques have been developed to enable citizens to have authentic, civil, productive discussions at public meetings—even on highly contentious issues. These techniques have names like National Issues Forums, Study Circles, 21st Century Town Meetings, Open Space Technology, and World Cafe, to name just a few.
When done well, these techniques create the space for real dialogue, so everyone who shows up can tell their story and share their perspective on the topic at hand. Dialogue builds trust and enables people to be open to listening to perspectives that are very different from their own. Deliberation is often key to public engagement work as well, enabling people to discuss the consequences, costs, and trade-offs of various policy options, and to work through the emotions and values inherent in tough public decisions.
Though it may not seem like it when we watch clips from recent healthcare town halls, the truth is that people can come together to have a positive impact on national policy—not only in spite of our differences, but because working through those differences allows us to make better decisions. Citizens have higher expectations than ever for a government that is of, by and for the people, and it’s high time for an upgrade in the way we do politics.
NCDD recommends the following resources to those interested in engaging the public in healthcare in more meaningful and substantive ways:
NCDD Members Directory: www.ncdd.org/members
Find a facilitator or convening organization in your region. Or contact email@example.com for help finding someone.
NCDD’s Engagement Streams Framework: www.ncdd.org/streams
This free resource helps practitioners, community leaders and elected officials decide which public engagement methods are most appropriate for their circumstances and resources.
Core Principles for Public Engagement: www.ncdd.org/pep
These seven principles were developed collaboratively by leaders in citizen engagement, and have been endorsed by over 50 organizations.
Discussion Guides on Healthcare
– Coping with the Cost of Health Care: How Do We Pay for What We Need? (National Issues Forums): www.nifi.org/issue_books/
– Citizens Survival Kit on Health Care (Public Agenda): www.publicagenda.org/citizen/electionguides/healthcare
Millions of Voices: A Blueprint for Engaging the American Public in National Policy-Making: http://americaspeaks.org/democracy-lab/convenings/millions-of-voices/
Offers a plan for National Discussions that will engage more than one million Americans in substantive deliberations about public issues.