Greetings!
As project director for MAP 150, I offer this periodic posting to reflect on the progress and philosophy of MAP 150. It will be personal-my musings-not because my person has much of brilliance to say, but as a means of provoking discussion to help guide the project. Erin Sapp, project staff, will be contributing as well. So please comment on what we or others have to say. Offer your thoughts. Ask questions. Tell me I’m nuts (but please articulate why!)
MAP 150 is a journey without a map. Like the early explorers, we think we know where we headed, but we’re not sure how to get there, and we’re not sure exactly what we’ll find when we arrive. For all of you control addicts out there, we like it this way. Not because it makes us comfortable. It doesn’t. But because this is how it needs to be. MAP 150 is about discovering what isn’t known now, and so in all the best traditions of artistic creativity or scientific discovery, we must remain open, and allow the process to unfold.
So where are we headed? The best way I can describe it is with a story. A few weeks ago I attended a Medicare Part D conference. The luncheon speaker was quite eloquent in describing all the hurdles and challenges that were overcome to sign up tens of thousands of seniors for coverage by the deadline. Clearly, congratulations were in order. When the speech ended, the first questioner stood. He said, “I’m a senior citizen. If I didn’t have diabetes before your speech, I think I have it now. Quite simply, I should be able to take my Medicare card into any pharmacy and have my prescription filled. End of story.” After a brief stunned silence, applause broke out.
Public policy has become extremely disconnected from people’s lives, with serious, serious consequences. Manufactured by “experts,” bureaucrats and vested interests, it creates huge costs and red tape where none belong (like Medicare administration or the response to Hurricane Katrina with estimated fraud and waste of $2 billion). The root of this is a distrust of people to act responsibly. We displace the opportunity for people to act responsibility with the requirement that people conform to a system because otherwise they’ll act irresponsibly. Inevitably that system is complicated and frustratingly alien. The unsurprising response is that some people tune out, some try to game the system because that’s the structure that’s been put in place for them to contend with, and for many, many of us, we lose sight of the connection between our own actions and the results of those actions for our fellow citizens.
Our four journalists are having an interesting time. To launch MAP 150, we have asked them simply to describe “what is.” What is the starting point in Minnesota for a collective policy-making process that regards citizens as co-producers of public outcomes, not recipients of them? It may sound like an easy assignment, but it’s not! A case in point is a very preliminary theme that is emerging from the interviews: people have a hard time imagining how problems might be addressed without deferring to expectations that “leaders” should bring about better government programs. We have become so indoctrinated into thinking that public policy outcomes must be a result of government programs, that we can no longer imagine a role for ourselves other than showing up to vote or attending a city council meeting.
This is not a laissez-faire argument. The point is not whether government should be involved, but how. If we want people to act to promote the common good, we need to give them the means to do it. But we’ve slipped into this culture of citizens being recipients of government. For example, I drive into City Hall in a well known suburb, and the sign in the parking lot says “Customer Parking.” Citizens are not customers. Yes, they have a right to be heard and treated respectfully like customers, but they are not customers. Yet this is the prevailing notion.
Many people interviewed by our journalists will quickly assert their own self-responsibility and their willingness to make sacrifices for the broader good. But for many, if not most, it’s as if they don’t know how, or have become convinced that their contributions are no longer valued. We’ve become so accustomed to following the lead of a society shaped by government programs that we fail to see how our choices matter and that the strongest leadership may well come from ourselves.
But think for example of the choices we make everyday that have some larger societal impact. I demand specialized medical tests when I don’t feel well or my diet is poor, and then wonder why health care costs are rising so rapidly. I commute long distances to work, and wonder why the freeways are so clogged. I haven’t saved enough for retirement-so exactly what’s the plan for my future care? I worry about dependence on foreign oil, but I drive an SUV.
Don’t get me wrong-I’m not blaming people for making the choices they do. For the most part these choices are highly rational given the systems we live in. Instead I point to these examples to illustrate how powerful the citizenry could be if government would structure things so that people had the incentives and support to do the right things for themselves, their family and society at large. We don’t have such an incentive structure right now, because our notion of government is not built on the idea of responsible action, but minimizing irresponsible action.
I thank all the people out there who take the time to share, with refreshing honesty, their thoughts with our journalists. Another thing they tell us: Yes! We should be consulted more often about these matters.
Like Paige Overby, age 19 of Prior Lake, who believes that it’s important for people her age to have a voice in public policy. “It’s a little early for 19 year olds (to be involved in policy decisions) but this is cool, I mean, you’re giving us a change to speak. No one asks US.”
That’s what MAP 150 is all about.
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There are new medicare plans for 2008. I would strongly recommend reviewing your current plan each year as there are sometimes dramatic differences. If you think outside the box you will find some great health plans. The big companies such as Blue Cross will charge whatever they want because they assume people will just go with the name and they spend a ton of money on advertising which reflects in the premiums and benefits. If you look at some other companies you may be pleasantly surprised with the benefits you will find.