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BY Allison Fine | Wednesday, November 26 2008

The Obama folks have launched a discussion on health care policy on their site reports Nancy Scola. Launched yesterday, the health care area has become a "live" forum of conversation hosted by two members of the transition team, Dr. Dora Hughes and Lauren Aronson. This certainly strikes me as more transparent and constructive than the black hole of resumes with which the site started.

In particular, I like the opening statement on the page, "Our policy teams will be sharing new developments with you, the American people, and asking for feedback. It's up to you to respond." In particular, the "it's up to you to respond" part of putting the onus on us, citizens, to participate is great. Brava!

Here's the part that I don't like, it is so close to being something so much better.

This discussion is in essence a blog post, think Huffington Post not Wikipedia. But is that the best way to jumpstart a national conversation about healthcare?

I had an exchange with Noah Flower from Working Wikily about the site and there seemed to us to be three essential ingrediants for this kind of conversation that are missing now:

1. A Pledge to Listening. In order for any of this to work, the Obama folks need to carefully think through how they will listen. This is not a trivial issue - on the contrary it is the central crux upon which this and many other initiatives that have a social media component to them will succeed or fail.

As Noah wrote, "“Listening” amounts to setting up a public competition for good ideas, and the rules of the game should be clear so that the players know where to channel their effort. The Obama administration has the same challenge, on a larger scale, as that of many organizations whose actions impact the public and other stakeholders: how do you take input, which builds *legitimacy* for your actions, and also maintain a wide enough range of *autonomy* so that you can still carry out your own mission? The natural tendency is to provide a simulation of input by promising to listen but offering zero information about what you intend to consider “worthy” input or what input was considered “worthy” in the end."

If we don't know what the rules and expectations are about what will be listened to and what won't these efforts aren't going to work. We've already seen this in action on the job application area of the site; how will resumes be screened, will applicants be contacted, what are the requirements for making your way through the hiring process. We need these answer up front in order to set expectations and ensure that our input is valued. It doesn't mean that everything we say will become law, but, rather, that our participation is really valuable not just window dressing.

This is one area, in particular, that it is such a shame that the new administration won't have a proper interregnum to consider just these kinds of issues.

2. We need on land discussions and facilitation built into every process to go in concert with these kinds of online discussions. The administration should engaging groups like Public Agenda and Everyday Democracy to facilitate local discussions and develop real proposals and solutions.

3. The third issue is more of an opportunity. And that is for each one of these efforts we have the chance to develop better protocols for what tools work best under what circumstances. One could imagine a great health care wiki, similar in structure to the one we used for Twitter Vote Report,, whereby the facilitators, whether they are people from the administration or from communities can pose questions (aside: hopefully these questions will be more pointed and interesting than the one posted on the site right now, "What Worries You Most About the Health Care System?" Really, you can't guess that it's too expensive and leaves too many people out?) or when do we need to chat or call or meet or blog or wiki or tweet. The most exciting part of the new administration is the chance to see all of these tools in action and begin to really figure out what works best when.

The one thing we’re need the most over the next few months is resilience and forgiveness as this process unfolds unevenly and imperfectly.