Americans engaged in an experiment to see what the public thinks about education and health care—once informed about the issues and discussing them together. Their views changed significantly about policy options, about public officials and about each other.
Problems and Purpose
In September and October 2005, more than 1,000 adult Americans engaged in a national scientific experiment to see what the public would think about education and health care--if people became more informed about the issues and talked about them together. For five weeks, participants engaged online in weekly small group dialogues with trained moderators, discussed balanced briefing materials and posed questions to experts from different points of view. Citizens also participated in 15 face-to-face deliberations, hosted by PBS stations and civic partners that mirrored the online process.
Organizing, Supporting, and Funding Entities
The online experiment, part of Deliberation Week organized by By the People, was conducted by Stanford University's Center for Deliberative Democracy in conjunction with the public opinion research firm Polimetrix of Palo Alto, CA. Polling of participants at the face-to-face deliberations was handled by local conveners with assistance from Yale University’s Institution for Social and Policy Studies and the Guild Group Inc.
Participant Recruitment and Selection
In these sites – Rochester, New Haven, Albuquerque, St. Louis, and Kearney, NE, on education, and Kansas City, Pittsburgh, Charlottesville, Baton Rouge, and Seattle on health – participants in Deliberation Week were drawn wholly or in part from among citizens who had been invited to previous By the People events and had expressed interest or actually attended. Some partners recruited additional participants through local organizations or randomly, to reflect the diversity of their area. Kearney's sample included a randomly invited group of local educators. Bowling Green and Muncie consisted of new randomly invited samples. Some sites convened close to 150 participants. Others intentionally gathered smaller groups. In Bowling Green, Deliberation Week included four community dialogues in different locations that led up to a summit. Local coalitions are engaging legislators in ongoing discussions with citizens and planning follow-up activities. More information about sample selection, methodology, and significant results can be found at www.pbs.org/newshour/btp.
Methods and Tools Used
981 adult Americans completed pre and post-experiment questionnaires. 360 participated in three or more one-hour discussions and the remaining 621 were part of a control group that did not deliberate. There were 150 discussion group meetings (thirty groups meeting for five weeks). The project was conducted online with a nationally representative sample who discussed the issues using voice rather than text (employing microphones for interaction), and software designed to facilitate group discussion. All of the changes are statistically significant comparing participant views at the beginning of the experiment with those at the end. Nearly all are statistically significant when deliberators are contrasted with those of the control group who did not deliberate. The Center for Deliberative Democracy at Stanford University employs Deliberative Polling® to study informed public opinion. Polimetrix is a public opinion research firm in Palo Alto, CA. that employs Web surveys, large-scale databases, and cutting edge statistical techniques.
Influence, Outcomes, and Effects
Participants in By the People’s online Deliberative Poll® moved toward local control and parental involvement as key factors in improving the nation's schools. However, they also lessened their support for vouchers, preferring to put more money into improving the public schools to lower class sizes and increase teacher pay. They also became less supportive of “No Child Left Behind” and statewide reliance on standardized tests.
Respondents also thought that the number of Americans without health insurance was the single most important problem facing the system and they were willing to support policies that would require at least some sacrifices on their part to deal with it. They were also very concerned with the cost of health insurance and prescription drugs. However, they were less concerned with issues such as medical malpractice, quality of health care for those with insurance and medical errors and mistakes.
Analysis and Lessons Learned
When the online participants were asked which of several measures would be the single most important factor for improving the nation’s schools, the top three answers--quality of teachers, academic standards, and parental involvement-- were the same before and after deliberation. However, there were large changes in the percentage naming each of these three. Before deliberation, teacher quality was the most popular response, named by 34% of participants. But after deliberation, it became the third most frequent response, chosen by only 18% of participants. There was a big increase (14% to 25%), on the other hand, in the number of participants naming "parental involvement" as the single most important factor. The proportion naming academic standards did not change significantly, moving from 33% before to 28% afterward. In addition, participants came to see class size as a more important issue. It was named as the single most important factor by only 3% before, but by 12% afterwards.
A follow-up question asked which factor was second most important. When these are combined, participants who mentioned "parental involvement" as either the single most important or the second most important factor in improving the nation's schools rose from 27% before deliberation to 45% after.
There was also increased support for local control of education, with the percentage saying that tests for student achievement should be set at the state level decreasing from 62% to 56%, and the percentage saying such decisions should be made by local school boards in each community increasing from 31% to 38%.
Participants became more supportive of increasing funding to public schools, at least for certain purposes-- even if that meant raising taxes. Before deliberation, 58% of participants supported, and 32% opposed, increasing funding for public schools to reduce class sizes, even if that meant increasing taxes. After deliberation, the percent supporting such a measure increased to 63%, while the percentage opposing decreased to 23%. Similarly, the percentage of participants who supported boosting funding for teacher pay increased from 59% to 66%.
Participants became less enthusiastic about standardized testing in their community’s public schools, with the percentage saying there was too much emphasis on standardized testing increasing from 58% to 65%, and the percentage saying there was not enough emphasis decreasing from 14% to 9%. Support for "No Child Left Behind" dropped from 39% to 31% and disapproval increased from 53% to 59%. Opposition to vouchers to pay for private schools with public money increased from 56% to 61%.
The top priority for health policy, both before and after deliberation, was dealing with the number of Americans without health insurance (45% before, 49% after, selected it as the most important problem). The other most important problem, both before and after, was "the cost of health insurance" (29% before and 30% after, selecting it as the most important). When the top two priorities are considered, the cost of prescription drugs becomes important, rising from 29% to 38% as either first or second most important.
Participants moved in the direction of supporting major changes in the healthcare system, particularly those that might address the uninsured. When asked "would you be willing to pay more than you do now for healthcare if this meant that many more Americans would have health insurance coverage" the percentage answering yes went up from 52% to 62%. Support also increased for the U.S. adopting a "single payer" system "where a government entity accepts all healthcare fees and pays out all healthcare costs for everyone." The number supporting this option rose from 51% to 57% after deliberation.
Another option which increased in support was the idea of the government requiring all individuals to find at least minimal coverage, perhaps funded by a tax credit. Support rose from 37% to 43% and strong opposition dropped from 37% to 25%. Deliberators also liked the idea of offering uninsured Americans on a voluntary basis “income tax deductions, tax credits or other financial assistance to help them purchase private health insurance on their own." Support for this proposal rose from 57% to 66%.
However, support for other options went down or remained stagnant. For example, support for the notion that the government should require employers to provide coverage for their workers declined with deliberation, from 51% to 44%. And support for the notion that the U.S. must increase funding for Medicare and Medicaid, even if this meant increased taxes, was high but unchanged (58% before deliberation and 59% after).
Participants were asked information questions about the two issues and they became more informed overall, as judged by an index for all information items. Some questions showed a dramatic increase. For example, the percentage able to identify the number of Americans who are uninsured-- 45 million-- rose from 30% to 50%. Deliberators became more tolerant of those with different points of view. Those agreeing that "people with views very different from mine often have good reasons for their opinions" went up from 67% before to 75% after deliberation, and the percentage disagreeing decreased from 21.2% before to 8.5% afterwards. Those who agreed with the statement that "People like me don't have any say about what the government does" went down, from 52% to 38% with deliberation.
Taken Directly From https://cdd.stanford.edu/2005/results-of-a-national-deliberation-on-healthcare-and-education/