Healthcare Dialogue: Constructing Electronic Interaction to Maximize Decision Quality in Deliberations among Citizens, Issue Publics, and Elites

The interplay of mass and elite opinion raises theoretical issues about democratic rule, as well as practical issues surrounding the proper formation and implementation of public policy. Many argue that mass opinion is the product of largely unreflective judgments. When complex or technical issues are at stake, such as those involved in the reform of America’s health care system, popular input is often deemed untrustworthy. Better informed and considered opinion – expert or elite viewpoints – may prove a more valid basis for wise policy choices. Participatory democratic theorists, on the other hand, argue strenuously for serious involvement of ordinary citizens in shaping government policies (Dryzek, 1990, 1993; deLeon, 1995; Fishkin, 1995).