CHAT: A Computer-based Tool for Public Deliberation
CHAT® (Choosing All Together) is a simulation exercise, allowing participants to use their own experiences, beliefs and values to create the best possible coverage for themselves and others.
CHAT was created by bioethicists at the University of Michigan and the National Institutes of Health who understood that the public needed more information and opportunities to participate in policy discussions that impact them and their communities. CHCD has customized the CHAT process and utilized it with four unique projects in California. CHCD has also worked with four other states to help them design their own CHAT board and engage their state residents in this social decision-making exercise.
How CHAT Works
- On individual computers, participants consider 12-15 categories of coverage displayed on a pie chart. Each category offers one or more benefit levels.
- Participants have more coverage options than they have resources to spend.
- Participants make coverage decisions for a whole population, not just themselves, moving from “What do I want?” to “What makes sense for all of us?”
- A skilled facilitator encourages participants to explore their views and values in an engaging, interactive environment.
This is both a qualitative and quantitative process. The goal is to better understand what participants most value and why. Data from all sessions are collected and analyzed, along with pre- and post-session survey questions.
CHAT Projects in California
- Just Coverage (2006-07). To define ‘basic’ coverage, more than 900 insured and uninsured Californians identified the core components of an essential health plan.
- Medi-Cal CHAT (2004). Adults with disabilities identified the trade-offs they regarded as most acceptable if budget cuts are necessary in California. Results were shared with leaders at the Department of Health Care Services.
- Capitol Region CHAT (2003). Seventy-one (71) local companies learned their employees’ priorities regarding trade-offs in health plan benefit design. Employers sought this information as they faced increased costs of coverage.