Health Care: How Can We Bring Costs Down While Getting the Care We Need? — New Conversation Materials Released

I am pleased to announce publication today of the most recent National Issues Forums issue guide, Health Care: How Can We Bring Costs Down While Getting the Care We Need?

From the guide:

Americans, individually and as a nation, are worried about high health-care costs. Many of us fear that skyrocketing drug prices and surprise medical bills could keep us from getting the care we need or ruin us financially whether we have insurance or not. Businesses and governments also face increasing costs. Health-care costs continue to grow faster than inflation.

How can we bring costs down while getting the care we need? This issue advisory looks at three ways of making our health-care system sustainable and fair. Each option offers advantages as well as downsides.

    • If we create a single government program to pay for everyone’s health care, would taxes rise and quality suffer?
    • Can gradual reforms hold costs down and still get everybody covered?
    • Should we take responsibility for our own choices in a more transparent and competitive marketplace even if that means those who make poor decisions will suffer the consequences?

NIFI is offering a full set of materials on this issue:

    • The issue guide in a printed, 28-page format and as a downloadable PDF
    • A briefer 6-page issue advisory that presents the same three options for deliberation (printed and PDF)
    • A 4-minute overview video
    • Post-forum questionnaire
    • Spanish versions of the issue advisory and questionnaire as downloadable PDF, and a subtitled overview video
This issue is part of the Hidden Common Ground initiative, a joint project that brings together nationwide survey research by Public Agenda, reporting and editorial coverage from USA TODAY, issue guides developed by the Kettering Foundation, and the network of National Issues Forums. The forums are meant to foster deliberation where people make decisions together on what actions we should take on pressing issues, and where we are divided and still have work to do.

Leadership Paradox

I recently began formally mentoring someone, and so I have been thinking about the nature of leadership. There’s a bind that “leaders” face. It has to do with the expectations of those who are led, and of the person who is trying to be a helpful leader.

Consider the teacher of yoga class. They “lead” the class.

On the one hand, as a member of the class, I want someone to inspire me and instruct me, to push me to do “better” and to “improve.”

But on the other hand, in reality the effort I make is personal. My yoga teacher does not actually make me perform “better,” but instead sets me up to unlock the capabilities I already have. True, she or he may invite me to try to work beyond my limitations. And true, I may practice with others, and the feeling of being in community may lift me. But it is always me, on my mat, alone, making the effort.

The abilities I have are all already locked within me.

And so here is the leadership paradox: If I am a leader, I have knowledge to pass on and I know that I might be able to spur others to self-surpass. But would it not be a shame if what others take away from me was that I “made them do well?” For then, what they learned was that they need someone else in order to perform.

As a leader, I want to awaken people to what they already have the capacity to do. I want to cultivate the sense that a leader is unnecessary — if not now, then soon.

As a student, what I may then learn is that self-surpassing is always fundamentally available to me, solely through my own efforts.

Friday Morning Street Banjo Music

When I am in DC, on weekdays I go to my office near the US Capitol. It is on the Senate side, so for those who know the city I take the train to Union Station and walk a few blocks. Like many train stations, Union Station attracts street musicians.

While we all have heard the stories of undiscovered diamonds busking in the streets, the truth is many of the musicians are just okay. A lot of it is singing performed over karaoke loops. But it’s all great — as someone who has tried it himself, I admire anyone who has the courage to get up in front of people and perform. And I love music.

The unwritten deal of street music is, if you stop and listen you are honor-bound to drop a dollar (or more) in the hat. Sometimes, to be honest, I just walk on by because even though I want to support, I am in a hurry, feel stressed, the music doesn’t grab me, or I don’t have any cash on me and don’t want to break the deal.

This morning, a clear, crisp, bright Fall day, I was stopped short by this:

 

 

That’s Brian Williams, playing the banjo. I was not only moved to stop and listen, but to talk to him a while. The figure he cut, and his sound, just entered my spirit. I asked if I could video him and he agreed.

Brian is a multi instrumentalist (guitar, cello, bass, banjo) who has been playing since 1968. Recently his guitar was stolen and he was without instrument. He says he met “an Irish man in Georgetown” who was having trouble finishing a song. Brian finished it for him, and in return the man gave him this banjo. He was going to sell it, but the music store told him it was a vintage 1930’s banjo, so he kept it.

I hope you enjoy his music.

A Theory of Community

 

  1. Human beings are innately social. We live together in groups.

  2. Living together brings a number of benefits: we can protect ourselves, we can pool resources, we can find safety when vulnerable due to illness, we can raise children, we can better shelter ourselves from elements. These things motivate our group life. In part, they are why we live in society rather than apart.

  3. Living together also brings with it a set of challenges, related directly to the benefits:
    • Crime. Fellow group members threaten us (either physically, or our property). How do we protect ourselves?
    • Economy. The place in which we live become a locus of exchange. How do we make it one where we can thrive?
    • Poverty. Differences in how exchange takes place creates some who have too few resources. What do we do about people who have trouble surviving (poverty)?
    • Health. Proximity brings with it increased disease. We depend on others to care for us when vulnerable. How do we care for group members?
    • Education. Our young ones must acquire the norms and habits that we require of one another. How do we create citizens of our group?
    • Environment. The byproducts of life become concentrated (waste, extraction of resources). How can we manage this?

  4. These challenges are not problems to be solved, but conditions to be managed. The possible ways to address them are myriad, require collective actions, and there is not an objectively correct outcome.

  5. Any group of people living together in a place will face such challenges. These are the challenges that come with being a “community.”

  6. These problems, in varying degree, face everyone in the group. Everyone is therefore trying, in their own ways to address them. This is happening throughout the group, always.
One definition of community:
  • The places where, and collective means by which, such opportunities and challenges are collectively addressed.

How Should We Prevent Mass Shootings In Our Communities? Announcing New Conversation Materials

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I am pleased to announce publication today of a brand-new update to the National Issues Forums issue advisory, How Should We Prevent Mass Shootings In Our Communities? The materials are meant to support deliberative conversations in community and other settings, and are free to download.

From the guide:

The tragic attacks in El Paso, Texas; Dayton, Ohio; Parkland, Florida; and other places have raised concerns among many people across the nation. Such shootings have become more frequent and more deadly in the last decade. Each mass murder has devastating effects on a whole community.

Overall, the United States has become safer in recent years. Yet mass shooters target innocent people indiscriminately, often in places where people should feel safe—movie theaters, shopping centers, schools. Many believe these attacks are nothing short of terrorism. How can we stop mass shootings and ensure that people feel safe in their homes and communities?

This issue advisory presents three options, along with their drawbacks. These are not the only options, and you may think of others.

Option One: Make Mass Killings More Difficult

According to this option: The problem is that we are too vulnerable to gun violence. Communities and homes should be places where people are safe. The tools for carrying out mass shootings are all around. It is too easy for individuals to obtain weapons that are designed to kill a large number of people in a short time.

We cannot stop all violent impulses, but we can and should make it much more difficult for people to act on them. We should restrict the availability of dangerous weapons, identify potentially dangerous people, and prevent them from carrying out their plans.

Option Two: Equip People to Defend Themselves

According to this option: The problem is that most people are not able to defend themselves from the sudden danger posed by mass shootings. There will always be some who are a threat to those around them. We cannot afford to rely on the presence of police to rescue us. We should be prepared for violence and have the means to defend against it. The Second Amendment to the US Constitution guarantees this right.

Option Three: Root Out Violence and Hate in Society

According to this option: The problem is that we live in a culture that perpetuates violence and numbs people to its effects. The Internet provides a platform and organizing space for hate groups and domestic terrorists. Violence and criminality are pervasive in movies, television, and video games. Mass murderers gain notoriety through nonstop media portrayals.

This results in a culture in which stories of mass murder circulate and gain momentum—so further shootings become a greater possibility. We must root out and stop the glorification of violence and promotion of hate to break this cycle.

Please let me know if you use these materials and, if you do, what happens.

* * * * *

I serve as executive editor of issue guides at the Kettering Foundation. We develop these nonpartisan materials to support deliberation on difficult public issues, and make them available for publication by the National Issues Forums Institute. The NIF network is comprised of all sorts of organizations who use the guides in their own ways, holding conversations in which people deliberate together about what we ought to do.