If Only There Were Time to Taxonomize Healthcare Reform…

05 August

The Tower of Babel by Pieter Brueghel the Elder (1563) (image from Wikipedia)

The Tower of Babel by Pieter Brueghel the Elder (1563) (image from Wikipedia)

Anyone in the mix or even periphery of healthcare reform—and certainly consumers—can’t help but be overwhelmed by the terminology involved in the discussion, whether it’s the language of the politicians and the various competing stakeholders and interest groups or the filtering layer the media applies when trying to interpret what’s happening politically. In a July 22nd interview on The Diane Rehm Show, NPR health policy correspondent Julie Rovner, who authored the critically acclaimed reference book Health Care Policy and Politics A to Z, spoke to the complexity of the nitty-gritty of health care reform and the public’s understandable confusion and difficulty making connections between the political arguments and the substance of the reform. She indicated that the problem existed during the Clinton administration as well, and one 2002 definition of health care reform defines it only with regard to that political effort: “The 'Clinton Plan', proposed by President(s) Bill & Hillary Clinton in 1993, to revamp and address inequities in US health care.” (Sidebar: Interesting that this definition offers the possibility that it was proposed by not just one President Clinton, but two!)

Anybody even remotely aware of current events knows that the definition of health care reform has been updated to refer to the effort under way by the Obama administration to “reform our system by expanding coverage, improving quality, lowering costs, honoring patient choice and holding insurance companies accountable.” If only it could really be as simple as Obama’s mantra. Instead, politicians and stakeholders define the terms in their own way and then disagree over the definitions and hierarchical relationships of pretty much every issue. See, for example, a sophisticated taxonomic approach to the definition of “socialized medicine” by Princeton economist Uwe E. Reinhardt.

As Julie Rovner said in her July 22nd radio interview, “It’s all about language and semantics …”

So what would happen if there were more clarity around the language used in discussions of health care reform? Will we ever see a taxonomy of health care reform? Unlikely in this political effort, but I like the sensible argument and impassioned vision for the use of taxonomies in all arenas where there is both too much data and a need for more data made by Lucy Bernholz, founder and president of Blueprint Research & Design, Inc., a strategy consulting firm for philanthropic institutions and individuals. I disagree with her when she says taxonomy is “the wonkiest buzzword ever”—wonkish for sure! Buzzword: I don’t think so. Taxonomy is here to stay. But she’s spot on with everything else, including the tie-in to health care reform: “And we may one day be able to see how much money from philanthropy, political contributions, corporate sponsors, and the public sector is going into research on various health care reform proposals—but not without functioning taxonomies that can be connected across data centers.”

Anyone trying to make the case for taxonomizing data in STM publishing organizations should read Bernholz’s whole post. Unlike the Babel of health care reform, her message is crystal clear: “All of it is about sense-making. And all of it requires taxonomies.” If taxonomies are critical to the giving away of money, think what they mean to the making of money.

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