Blog 7: The Public Sphere, Old and New.

Public sphere as a construct is introduced by Habermas.  The public sphere represents a neutral common where people can share opinions and thoughts engaging in democracy outside of governmental or organizational influence (Habermas, 1989).  Its formation can be traced back to 18th century Europe when feudalism and church power were both dissipating creating a vacuum.  Initially dominated by the bourgeoise, coffee houses and saloons served as public spheres and newspaper helped to further disseminate information.  However, a transition occurred with participants in the public sphere shifting from the bourgeoise to people in general.  It became more open and all that was required for participation was mutual interest to discuss matters of public importance.  Public spheres can be successful in the absence of hierarchy dependent on the extent of access and quality of discussion.

Habermas feared that with the formation of large organizations and governments that characterized the Industrial Revolution, the influence of the public sphere would be decreased due to the “refeudalization of power.”  Power would again be concentrated among the few (Khan, 2014).  Organizations would attempt to maintain the facade of open discussion to influence people, but people would no longer have real say.  Even the media can be viewed as consistent with this concept because they represent organizations rather than public interests.

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Network society as used by Castells refers to social structures characteristic of the Information Age.  No longer are bureaucratic and hierarchical institutions the dominant force.  In their place, decentralized networks are prevalent and growing, fueled by microelectronic communication technologies (Castells, 2003).  This decentralization of the generation and spread of information within society has become the new public sphere.  Network societies are viewed by Castells to facilitate communication outside of hegemony.  It opens the minds of the people involved because it presents a new forum where education can take place.  In turn, this education can lead to social movements.

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This new public sphere draws on the power of communication (Fuchs, 2010).  Fear is the oppressor of mobilization and to counteract its effects, information must reign free.  The network society as characterized by decentralization, means that this knowledge and information comes from the people (Sampedro & Martinez, 2007).  The spread of such information puts power back into the hands of ordinary citizens.  It enables them to have a voice that others can galvanize around helping them to exert influence over governments, economies and healthcare systems.

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The hyper-connectivity characteristic of network societies can be harmful as well as beneficial.  We must be vigilant.  As we discussed earlier in our course, this type of connectivity allowed the porn industry and white supremacists to reach a broader audience.  However, of greater significance, it allowed for greater coordination across societies because discussions could take place helping to reshape the structure of society according to what people value.  By placing power back in the hands of ordinary people, over time, it has the potential to significantly improve lives.  Communication is the essence of social organization and we must keep it free of special interests.

Can you think of ways that this new public sphere may again be encroached upon?  Has this already happened to some degree or are people mostly able to communicate in a public sphere?

Bibliography:

Castells, M. (2003). The internet galaxy: Reflections on the internet, business and society. Research Policy. https://doi.org/10.1016/S0048-7333(02)00012-4

Fuchs, C. (2010). Communication Power. Information, Communication & Society. https://doi.org/10.1080/13691180903390885

Habermas, J. (1989). The structural transformation of the public sphere: an inquiry into a category of bourgeois society. Contemporary sociology. https://doi.org/10.2307/2072652

Khan, M. Z. (2014). Revitalization of the Public Sphere: A Comparison between Habermasian and the New Public Sphere. Acta Universitatis Danubius. Communicatio.

Sampedro, V., & Martinez, M. (2007). The Digital Public Sphere: An Alternative and Counterhegemonic Space? The Case of Spain. International Journal of Communication.

Blog 6: AHA PAC in response to HVBP

My research project will attempt to answer the question of how the American Hospital Association Political Action Committee (AHA PAC) has responded, in terms of political financial contributions, to the introduction and implementation of the Hospital Value-Base Purchasing (HVBP) Program by the Centers for Medicare and Medicaid Services (CMS).  More specifically, three time periods will be studied.  The first period includes three years prior to the announcement of HVBP by CMS to Congress, from October 2004 to October 2007, to establish a baseline of pre-HVBP spending.  The second period includes the announcement on November 2007 and follows spending patterns up till July 2011, when financial incentives took effect.  The last period, from August 2011 to August 2014, will follow AHA PAC spending patterns after the full implementation of HVBP.

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My data will be obtained from the Federal Election Commission (FEC).   This source was selected because of the extensive amount of validated information available.  Professor Pastore will be instrumental in providing cleaned useable data that is ready for analysis.  The network(s) nodes will consist of political organizations or other entities, and the edges will include financial contributions that are both sent and received.

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A systematic review of databases PubMed, EMBASE, and ABI/INFORM did not produce any peer reviewed articles specific to the “Federal Election Commission” and “American Hospital Association.” However, a similar analysis was conducted regarding the American Medical Political Action Committee (AMPAC), a division of the American Medical Association (AMA), in terms of campaign contributions from 1989-1990 and 1991-1992.  They specifically looked at the spending patterns of the AMPAC in relation to the “gag rule,” which limits discussion of abortion in federally funded clinics (Sharfstein & Sharfstein, 1994).  The approach of their analysis is parallel to what we propose in our current study.  Political contributions will be tracked for a specific organization to determine sending and receiving patterns as it relates to a political issue.

Despite the very large amount of literature that HVBP has generated, until our research, no one has studied how the AHA has responded to the political climate.  Our research will build on the very limited amount of work that exists between healthcare related legislature and healthcare political action committee spending.  The hope is that our research will increase transparency and insight, providing us with a more comprehensive understanding of politics in healthcare.

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From our readings, our approach to data collection is very similar to that proposed by Fu (Fu, 2005).  In the article, daily contacts were followed over time to develop sophisticated contact diaries.  In essence, the FEC data is providing us with this daily contact information and we can analyze the data according to the relevant time periods.

References:
Fu, Y. C. (2005). Measuring personal networks with daily contacts: A single-item survey question and the contact diary. Social Networks. https://doi.org/10.1016/j.socnet.2005.01.008

Sharfstein, J. M., & Sharfstein, S. S. (1994). Campaign contributions from the American Medical Political Action Committee to Members of Congress. For or against the public health? The New England Journal Of Medicine. https://doi.org/10.1056/NEJM199401063300107