Way back when, there was a big fight about whether the sun traveled around the earth or just the opposite. How could the earth not be the center of the universe? This simple but heretical switcheroo– sun for earth — profoundly influenced our science, philosophies, commerce, religious beliefs, you name it.
Now here’s an interesting thing: Most scholars resisted a sun-centered model because it required giving up their prevailing ideas (and hence influence). 
Galileo took these crazy ideas direct to the public– presenting them in a way that people could understand. His trial by the Inquisition captured even more attention from the public, speeding the take up of an idea that we now know to be science 101.
In my initial posting (oh so long ago), I told the story about a Medicare conference. There was one saving grace at that conference. It was a small diagram shown by former Senator Dave Durenberger. It used a triangle instead of the circles of Copernicus and Galileo and it looked something like this:
Well, he didn’t have the MAP 150 part—I added that. But his diagram illustrates what MAP 150 is all about. Policy is typically developed by experts armed with statistics, data, and loads of rules and regulations about how existing programs work, and lobbied heavily by special interests. How else could you come up with a prescription drug policy for seniors that prohibits the federal government from negotiating drug prices? Or an education funding formula so complex that all of three people in the state of Minnesota really understand how it works? Or income support programs that foist multiple case workers on families, when their need, whether it’s for health care, or housing, or food or day care, stems from the same problem—they don’t have enough money.
Can you imagine an architect designing an important building without talking to the clients first about how that building is to be used? How people will function within it? What their primary needs are? That’s what we do all the time in policy-making. We start with existing programs, then tinker with them, mix in a heavy dose of special interest lobbying, and sometimes allow citizens to weigh in through carefully orchestrated processes. Rarely, if ever, do we start by building policies from the ground up based on citizen’s priorities, needs and values.
And we get what we have.
What if, instead, we started by talking to citizens to set the parameters for policies? What if we weren’t beholden to current systems—designed for a different pre-globalism, pre-hightech age? What if we built systems that acknowledge people’s self-interests and the trade-offs they must make in their daily decisions?
In the next few postings I’m going to explore how these questions might play out in various policy arenas…with growth management, or income support or long-term care, for example. I will not be espousing specific policies, but trying to think through a different approach to policy setting, and see where it leads us. As usual, I’d love your comments and thinking.
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