01/29/2009 05:12 am ET Updated May 25, 2011

Obama's Health Care Reform and Social Networks: An Experiment

Between Christmas and New Year's I decided to try a "noble" experiment. I decided to invite people from my Facebook and Twitter networks to an Obama Health Care Reform party at my home. I want to see if the Obama administration's social networks are real, and if the information flows both ways. You have to understand that my friends are an eclectic group of everything from ordinary senior citizens to A-list bloggers to idealists barely out of their teens, because each person belongs to several categories.

We have the power to help Obama in a big way if he truly wants to produce health care reform, because we understand the virality of social networks.

Example: People who couldn't come for one reason or another wrote on the wall for my event. One man was even going to fly his plane from Arizona to California to attend, although he was ill on the day of the event. (He sent copious background information for us, because he's a retired health care executive.)

And immediately before the event, an edition of NewsgangLive devoted part of its discussion to health care reform. If the show's not posted yet, it will be up by the end of today.

Two of the people on the show shared their personal stories about the need for health care reform. If they want to identify themselves, they will.☺

There's a section in the reporting document that asks the moderator to fill out the answers to questions that the Obama people are thinking about. Below is my summation of what I think the group(s) discussed. I could be wrong, because I was both note taker and hostess. But the great thing about the blogosphere is that if I am wrong, I will be corrected below in the comments!

Caveat: these guests were not really ordinary people. They are Silicon Valleyites. One is a health writer, one an A-list blogger, Scobleizer. I'm trying to get him and Fast Company interested in this issue, which is a big one for Fast Company's viewers and readers since many of them are without insurance. There's a place to ask if the press showed up. What should I say? Half of my friends could be considered "the press."

The major takeaway: we can help, if the government lets us. The social networks would like nothing more than to use their power to good end. MyBarackObama was cited as an example of the use of social networks for social good.

What does the group perceive as the biggest problem in the health system?

Access and expense. Our economy, one person pointed out, it moving from employed to self-employed, and insurance is still mainly provided through employers. As a nation of self-employed, we need to create a large enough risk pool to provide ourselves insurance. Organizations such as the NASE were considered "scams" that provided only minimal insurance and did not cover what people thought should be covered: primary care and prevention. One participant proposed a back door system, in which hospitals and doctors allowed use of equipment and facilities for reduced prices at odd hours in order to better use equipment. And people would pay cash -- an Underground Economy of health care.

How do attendees choose a doctor or hospital?

Informal networks.

Where do attendees get information in making that decision?

From friends and doctors.

How should public policy promote quality providers?

Personally, I think Health 2.0 is moving in that direction, through companies Matthew Holt can talk about. Several start-ups are doing quality ratings on doctors, including Yelp.

People discussed their problems with Stanford as a teaching hospital and other good hospitals in the valley for childbirth (some new parents in the room). Teaching hospitals were said not to provide quality care in most situations. Sequoia Hospital and Mills Peninsula were considered great places to have a baby. People got their information from word of mouth, their doulas, their friends, and their OBGYNs.

Have attendees or their family members experienced difficulty paying medical bills?

Start back further in the process: people are having trouble making their premiums and paying their co-pays. Everyone has had trouble paying their medical bills, or knows someone who has. More important, everyone is terrified of losing their jobs and getting sick. We have all seen how sick people are economically ravaged by health care expenses or forego treatment.

How can policy makers address this problem?

By encouraging different use of the heath care system that lowers costs, such as rationing care at end of life, eliminating unnecessary treatments that have no outcome studies to prove them effective, automating the health care system through things like remote patient monitoring and patient education and electronic health records.

In addition to employer-based coverage, would the group like the option to purchase a
private plan through an insurance-exchange or a public plan like Medicare?

Yes!! The most common suggestion here was to expand the government (Congressional) health care program to people who want to be on a government-sponsored plan. Put the people on a single payer system who believe in it, and let others choose private plans.

Did attendees know how much they or their employer pays for health insurance? What should employer's role be in a reformed health care system?

Everyone would hope the employer would have a role in a reformed plan, but so many of the people were "unemployed" in the sense of lacking employer-provided health insurance that there wasn't much discussion about the employer. There was a real tacit divide in the room between people with conventional jobs and health insurance (who are generally less interested and informed on the issue) and people who are self-employed.

Were attendees familiar with the types of preventive services Americans should receive? Had attendees gotten the recommended prevention? If not, how can public policy help?

This is where the boldest ideas surfaced, including using Facebook and MySpace to promote prevention and distribute educational materials to using iPhones to monitor workouts and food intake. One of the attendees suggested giving "reward points" for good behavior, and allowing people to develop social capital for healthy lifestyles.

How can public policy promote healthier lifestyles?

There was a real divide between idealists who thought education and public pressure could promote healthier lifestyles and cynics who thought people would never change, and should just be denied heart and liver transplants if they smoked and drank. Holding people responsible for their own health habits and how those habits cost the entire system money is a desire, but everyone thought it would be politically impossible to do.

I found this a personally inspiring and awesome experience, especially since my family came and shared its own experiences, and my ten-day old grandson was in attendance, proving the importance of the subject for the future.☺

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