Top Ten Posts on New Media and Health Care

As I do do every few months, I thought I ‘d blog my top ten posts — this time on new media and health care — for your review. For me, this exercise helps to flush out common themes or ideas lurking within these posts that I’ve assumed or taken for granted in the rush of everyday business. It also allows me to put together my posts from here and the World Health Care Blog into a connected thought stream (a debatable notion I agree!). In any case, here are the top ten:

  1. Health Care’s Blogging Manifesto
  2. How to Read a Blog (With a Nod to Mortimer Adler)
  3. Miscellany, Messiness and Medicine
  4. What is Journalism in the Internet Age?
  5. Slowing Down the Health Care Debate
  6. The Value of Being in the Middle
  7. Social Entrepreneurship, New Media and Health Care
  8. Wiki Media, Expert Systems, Free Culture and Health Care
  9. Studying Plague in the Virtual World
  10. Is Second Life Just Playing Doctor or What?

In China, People are Not What they Used to Be

I was reminded recently of a quote by David Levi Strauss in his book, Between the Eyes, that went,

People are not what they used to be, but then, they never were.

He argues that “any image of democracy must begin with an image of ‘the people’.” This notion has been highly contested throughout history as new groups struggle politically — women, ethnic minorities etc. — to become part of “the people.”

In China, there’s a different problem as we see here in this bridge post by Oiwan Lam thanks to Global Voices Online.

Lao Tuzaizi said he is a “citizen” not “people” because the meaning of “people” is very confusing in China. All government bodies claim to be People’s institutes, however, no individual can represent “people”, in the end the definition of “people” is up to the authority, while the concept of citizen is based on individual’s right.

Well Lao is right about one thing, the definition of “the people” has always been up to one authority or another, but the official appropriation of the term presents unique challenges for the democratic practice.

Top Ten Posts on China, Health Care and Globalization

Time once again for another blog retrospective — My Top Ten Posts — on what we have been talking out about on global health care developments and those in China over the last several months both here and on the World Health Care Blog — just in case you may have missed a few.

  1. Red Package Health Care in China
  2. Cacophony, Change and China
  3. China’s Cyber Civil Society
  4. Blogs and the News from China
  5. Health Care and China’s Grassroots
  6. Cell Phones, Laptops and China’s Rural Health Care
  7. Global Health Care Standards and China
  8. China’s Internet Use and Rural Health Care Reform
  9. Soft Power and US Health Care Revisited
  10. Thinking Global in Health Care

Health Care’s Blogging Manifesto

Why do we blog? What is the purpose of blogging about health care? Why should we care? Is there a point to it all? The Seven Tasks Blogging Manifesto was written to help build a unity of purpose among health care bloggers who desire to be of service to the public. The Seven Tasks are:

  1. Be Cautious in Debate– The first principle here is to “do no harm.” Health care is a serious business and we should speak about it as if our opinions mattered. In this business, people are sick, injured and dying. There is no space for the self serving, the opportunist or the extremist.
  2. Seek Clarity –The terms of the debate that we use must be understandable to each other. Politically ambiguous or unexamined language that smothers the real meaning of things should be avoided.
  3. Build Comprehension — The use of private vocabularies, cryptic technical terminologies and impenetrable statistics just muddy up the waters and divide us into the haves and have-nots. Perplexing or indecipherable arguments that go nowhere, increase nobody’s understanding or simply rant on should be trashed. Proposals within the health care debate must be comprehensible to the rest of us.
  4. Promote Compassion — People must assume more individual responsibility for their health and to a certain extent, be incentivised or otherwise socially pressured, to do so. But there comes a point when all the psychological gamesmanship must end, and human compassion must enter. To speak ‘truth to power’, bloggers must connect to the reality of human suffering in some personal way if they want others to take a meaningful interest in what they say.
  5. Identify Conflicts of Interest – Commercialism has insinuated itself so covertly in the health care debate, that it is quite often impossible to separate private interest from the public interest. The debate should not be deprived of the many intelligent voices that the health-industrial-complex has to offer. But the voice of self-interest should not embed itself so deeply in the debate that it mistakes itself for the people’s voice.
  6. Make Contact with the Real — Globalization threatens health care that is local, indigenous and personal. Health care bloggers should root themselves in healing’s real world, making contact one-on-one, and speak from that experience.
  7. Find Consensus — Democracy is not about elections but about collective decision making. Health care impacts everyone. Everyone has a stake in health care development and public health policy. No consensus means no progress, no action. Building consensus, finding the common ground, is the priority task for the health care blogger.

Blogging Goes to the Chinese Country-Side

See this fascinating  account of “reporter for the citizenry“, Zhang Shihe, who set off earlier this month on a “bicycle blogging tour” that will take him through through four impoverished provinces in north central China’s country-side (Shanxi, Shaanxi, Inner Mongolia and Ningxia). He’s looking for news — and finds some — posting photos, video and reports of who and what he encounters along the way.” Thanks to Global Voices Online for this heads up.

DHHS’s Mike Leavitt’s New Blog: Let’s Not Blow It

Thanks to Bob Coffield at Health Care Law Blog as well as iHealthBeat we now learn that DHHS Secretary Mike Leavitt has started a blog. It’s personal, thoughtful, seems not to written by staff or handlers, and well. . . interesting. So does this mean all us policy wonks will have a direct line to the top? Probably not. But does it mean that when a new administration comes in, a blog from the Sec will be the norm? Maybe it’ll take hold and President Obama (Would Hillary do this?) will write his own behind-the-scenes blog. Hey he could do that right now!

Seriously, the thing to be done now is to make this effort by Mike work. By that I mean to help make it a valuable exercise for both health activists and for the Secretary: to make it a meaningful conversation about where America’s health care is going. This could be an interesting experiment. Mike is taking chance here. Let’s not blow it.

How to Read A Blog (With a Nod to Mortimer Adler)

First let us agree that there are at least two strikingly different views on the blogosphere. One (I have discussed before) is that held by people like Andrew Keen. He complains that the internet is transforming our culture into a cacophony of “infinite filibustering”, a noise of “hundred million bloggers all talking about themselves; a place where truth is “flattened”, where “ignorance meets egoism, meets bad taste, meets mob rule … — on steroids.” And more to the point, this “chaos of useless information” is not just pop culture entertainment, but a threat to civil public discourse, “encouraging plagiarism and intellectual property theft and stifling creativity.

Almost polar opposite to that view are those of people like David Weinberger, who argues that “Web conversations look to many like echo chambers because of the nature of conversation itself.” The blogosphere “tells a story of constant conversation, elaboration, and disagreement that is not visible in a simple map of links” and is in fact a “powerful force for democratic institutions and open markets, not a polarizing and simplifying medium. . . This is how meaning grows. . . (and that) the public construction of meaning is the most important project of the next hundred years.”

If the blogosphere is as Keen describes — a pit of electronic ‘nattering nabobs of negativism‘ — then why bother to waste time reading blogs? Well, there is the occasional illicit entertainment value they offer or the niche-group (cult?) information they collect. And of course there’s the simple pleasure of witnessing the decline of civilization itself. Ok. Good reasons all. But if the blogosphere is as Weinberger observes — a postmodern wellspring of democratic practice — then we have a duty to get right in there and do our part for the betterment of the human race.

But seriously, most would agree that the blogosphere is here to stay, at least for a little while (even the two authors above have blogs), and if we say for the moment that the phenomenon is a modern day ‘meaning-construction project’ in process, then why and how should we read blogs?

To get some perspective, I went back to the wisdom of an ‘ancient’ text (paper-based, of course) written by Mortimer Adler in 1940 (a bestseller no less) entitled, simply enough, How to Read a Book. Yes, I know, blogs are not books, — or magazines or newspapers — but we do read (and often listen) to them and want something from them as well. So let’s look at some of Adler’s observations and see how they hold up to today’s demands.

Why Read?

  • Adler: There are two distinct senses of reading: one is the the reading of “newspapers, magazines, or anything else that , according to our skill and talents, is at once thoroughly intelligible to us. Such things may increase our store of information, but they cannot improve our understanding. . . The second sense is the one in which a person tries to read something that at first he does not completely understand.” Through reading, one begins to understand more, and not just remember more information. “There is a sense in which we moderns are inundated with facts to the detriment of understanding.” Adler believes there is a deep difference between reading for information or entertainment, and reading for understanding.
  • Blogosphere: Blogs are great information and entertainment devices. But we often do start to confuse those attributes with understanding. The sheer volume and weight of a voice does not, in itself, mean an enlightened one. The challenge is how do we plunge into this cacophony, using all the intellectual and technical tools at our disposal to build understanding? Readers and their books build understanding one person at a time. Weinberger argues that blogs build shared understandings, because most of us “think by talking with others.” Knowledge “isn’t in our heads: It is between us.” Is Weinberger’s shared knowledge the same as Adler’s “understanding” ? Is a college student’s assemblage of a term paper from snippets of Wikipedia (or any other super-library) the same as the struggle to think through a complex series of intellectual relationships? I don’t think so.

What is reading?

  • Adler: The art of reading is “the process by whereby a mind, with nothing to operate on but the symbols of the readable matter, and with no help from the outside, elevates itself by the power of its own operations. The mind passes from understanding less to understanding more. The skilled operations that cause this to happen are the various acts that constitute the art of reading. “
  • Blogosphere: No problem here except for two points: Adler talks about “no help from the outside” and in another passage talks about the “essentially loneliness of the reader”, a solitary conversation with a solitary author. In the blogosphere, no reader has to be lonely. In fact the ability to be lonely is hard to do and contravenes the cultural and technological everyday social networky machinations of blog world view. Second, the blogosphere rides on the back of a particularly postmodern orientation to reading which Weinberger alludes to in his book. Adler sees that there are authors and readers. In the world of perpetual remix, there is no author, no distinction from the reader, and no content ownership.

What is Active or Good Reading?

  • Adler: Many make the”error of assuming that to be widely read and to be well-read are the same thing.” There are way too many “literate ignoramuses who have read too widely and not well.” Good or analytical reading is a silent conversation with the author. “If . . . you ask a book a question, you must answer it yourself.” But what are those important questions? Adler says four: What is the book about as a whole; What is being said in detail – and How; Is the book true, in whole or part; and finally, What of it? “And that is why,” according to Adler, “there is all the difference in the world between the demanding and undemanding reader. The latter ask no questions – and gets no answers.”
  • Blogosphere: I don’t think anyone would say that these questions and active reading are foreign to the blogosphere. But there are differences in how this all gets acted out. Adler’s silent and solo conversation with the book (implicit and tacit as Weinberger says) is now public, explicit and consequential: private thoughts are now a never ending reality show that has social impacts. “Reading will cease to be a one -way activity. . . All that metadata, and every use of metadata will enrich the context within which we make sense of what we read and learn” (Weinberger) If everything is meta, how do we meta-read that? Do we achieve a meta-understanding? And what the hell is that anyway?

Good Books, Bad Books

  • Adler: Good books must make demands on you. “You must tackle books that are beyond you. . .Only books of that sort will make you stretch your mind. And unless you stretch, you will not learn. . . A good book does reward you for trying to read it. . . (a bad book) is not worth the effort of trying. You receive no reward for your struggle. . . The great majority of the several million books that have been written in the Western tradition alone – 99 percent of them – will not make sufficient demands on you.” As you become a skilled reader, you get better at discerning which are which.
  • Blogosphere: Good blogs must make demands on us as well if we are to view them as Weinberger does. And like Adler, we complain that the blogosphere is clogged with bad blogs. But as we become a skilled blogger and blog reader, we get hints from our RSS feeds, begin identifying the best bloggers for our interests — those that both agree and disagree with our perspective — and throw out the trash. We just have to spend a lot of time and a lot of technology doing just that. It seemed simpler back then.

Arguments

  • Adler: “An “argument begins somewhere, goes somewhere, gets somewhere. It is a movement of thought.” But “you have to recognize an argument when you see one, and there may be some people who are argument-blind!” Authors make propositions. They have personal opinions. Yet authors should have reasons for their views and arguments as to why we should be persuaded to accept them. And then there is arguing. “For the disputatious and contentious, a bone can always be found to pick a quarrel over.” Adler believes in an intellectual etiquette. Something can be learned in good conversation. Disagreements are “arguable matters” taken with the supposition that when all is said and done, the original issue can be “resolved.” A reader must be able “to carry on a civil, as well as intelligent, controversy.” Talking back to an author should focus on four (once again) possible areas of disagreement: “You are uniformed, or misinformed, or illogical or your analysis is incomplete.”
  • Blogosphere: There is a certain pride in the contentiousness of blogs. The blogosphere is often a messy, name-calling, blustering, ideological jungle of bad posts, bad arguments, constant misunderstanding and intellectual laziness. Sure, there is a fledgling blogger’s etiquette of sorts bound to grow as the culture develops and (should I say it) the blogosphere becomes more institutionalized. So there is a lot to learn from the old school, and a history of thoughtful debate that should be appropriated into the blogosphere. The focus should be on the quality of the argumentation and not on the volume. This is definably happening as blogs continue to move from outlaw status to a mainstream form of social expression.

WHCB: “Wiki Media, Expert Systems, Free Culture and Health Care: Imagining the Convergence Horizon in Developing Countries.”

“The title of this post is a mouthful, I know. But I’m hoping that the murky possibilities embedded in this elongated title will stimulate finer minds than mine to think about the connections that could exist between these various fields of endeavors. I’m often drawn into these explorations by a long standing drive to find the edges where intractable problems (say, in health care) and the emerging (and often peripheral and below-the-radar) stew pot of new thinking bump up against each other –I must add doing so most when you’re not paying attention of course.”

See my complete post over at the World Health Care Blog.

What is Journalism in the Internet Age?

On the heels of the publication of Andrew Keen’s provocative book on the internet’s devastating impact on the traditional press — as well as on political and civic discourse (see earlier posts here and here) — comes a new thoughtful volume by Scott Gant, “We’re All Journalist Now.” Unlike Keen, Gant says the seeds of current problems were planted well before the attack by the internet’s army of citizen journalists.

The increasing public distrust of the media, corporate focus on profits, the shift to celebrity and entertainment news programming, proliferation of cable TV programming, along with an accompanying decrease interest by the public in serious news – all have contributed to the present woes of traditional journalism. Because of these forces, the notion of journalism as a public service has “vanished” with the traditional press frequently failing to do its job as the publics’ watchdog. It is “in this deepening void” observes Gant, that “citizen journalism has emerged – in big way.”

Gant, an attorney, goes directly to the question of ‘who is a journalist?’ In this new context of nonprofessionals and nontraditional journalists (including many bloggers) becoming significant force in defining and distributing the news, do old definitions still hold? Apparently not. So Gant wants us to re-think just what a journalist is. He argues that journalism is an activity not a status or an institution; that it’s an activity specific to the intent of an individual to disseminate news, ideas, opinions or analysis to the public.

By examining the constitutional backdrop to the “freedom of the press”, Gant reminds us that the freedom of the press is a personal right and not one confined to media organizations. And that “the Constitution does not confer on ‘the press’ any right of access to information greater than the right of the general public.” It is in this battle space that Gant fights for the reexamination of all the rights and privileges traditional journalists are afforded but are not available to citizen journalists.

Keen and Gant come from opposite directions on the impact of the net on journalism and culture. But in the end both eventually arrive at a call for balance and the integration of what is best in from the two worlds. Neither wants to turn the clock back nor, of course, could they.

One fault of both books, as I have mentioned before, is that they do not have a view of world beyond the U.S. and the West. This electronic revolution in journalism is having radically different political and cultural effects — from promoting democracy to jihad — depending on the national and international contexts through which it is viewed. “Citizen journalism” as a globalization phenomenon is where we really have to go next if we want to understand how to cope with all that it will bring to the political table.

WHCB: “Blogs and the News from China”

“While this may be a little off-topic, it really has a lot to do with how we get information on what is happening in China including what’s going on in health care. Rebecca Mackinnon, an Assistant Professor at the University of Hong Kong’s Journalism and Media Studies Centre, recently completed a revealing study titled ‘Blogs and China Correspondence: How Foreign Correspondents Covering China Use Blogs’.”

See my complete post over at the World Health Care Blog.

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