A recent Journal of Personality and Social Psychology article reviewed studies about reactions to complex social policy issues. Health issues were not included in those studies. Surely they qualify. ACA implementation? ACA Delay? ACA Congressional exclusion? ACA Repeal? States ‘in or out’ of exchanges? Employers ‘in or out’ of insurance markets? Yes, they qualify.
The studies say people react to simple issues well. They’re willing to learn more, take charge and act on what they know.
When the issues are complex, however, even the college-educated avoid learning more. They also avoid taking personal actions. Rather, they are more likely to depend on and trust in governments to resolve the issue. This trust goes so deep people avoid information suggesting government can’t and focus on reassurances that government can.
A sense of urgency makes it worse. When the issue is both complex and pressing, people are even more reluctant to learn about it. Ouch! Solve a health crisis, anyone?
The authors were stunned. All things being equal, they believed people would have less trust that someone, anyone (including government) could manage a complex issue. The studies suggest the opposite: People psychologically “outsource” management of complex issues.
There’s a threat here, but also an opportunity. Given straightforward, bite-sized chunks of relevant information, people are willing to learn more and take action. Complex issues can become safer territory if communicated well.
The research squares with a something issue I worry about: Most important health policy decisions are made by non-experts when the experts are not in the room. Given these studies, I have to wonder if those same people might be likewise overwhelmed by complexity. Might this create opportunities for too large a dose of political mischief – rather than sound policy thinking – in the decision-making mix?
I think there’s something we can do:
- We manage complex issues in health care and need to “up our game.” That means making our issues simpler for the public and for non-expert decision makers. This means developing a new skill set, one that perfects the art of creating relevant, bite-sized pieces of information that help people (including in Congress) remain engaged and willing to learn about the complexity in our field.
- At a practical level, we should routinely run readability scores on what we write. It’s not unusual to find policy documents that require 22+ years of formal education to understand. Even if we have that much education (and most of us don’t) we’re busy, we deal with many issues and they’re all complex. So, let’s work at making it simple. The score on this note, in case you’re wondering, is (grade) 8.6.