Congressman 'Crowdsources' Healthcare Bill

Texas Republican John Culberson has posted the House healthcare bill online and invited constituents to annotate it using a Web 2.0 collaboration tool.

John Culberson, a Texas Republican Congressman, says if people actually knew what was in the healthcare bill, they'd oppose it. So he posted the entire text of the bill to the Internet, using a Web 2.0 tool that allows people to annotate the document and comment on it.

"It's incumbent on me as a representative to make the process the most transparent and open to the public, so people can actually see what Pelosi and Obama are prepared to do with their healthcare, and their relationship to their doctor," Culberson said in a phone interview with InformationWeek Thursday, hours after the document went live.

The Congressman's office is using technology from SharedBook to host the bill. SharedBook allows users to make notes and comments on a document, but not to alter the document itself.

Comments appear inline, and can pertain to the entire document, or individual sections, paragraphs, sentences or even words and dollar amounts. Only the residents of Culberson's district are permitted to comment electronically on the bill.

"The SharedBook software allows my constituents to log on and analyze the healthcare bill word-by-word, sentence-by-sentence, and have a realtime debate about what the healthcare bill means," Culberson said. "I'm crowdsourcing the healthcare bill in order to make it as transparent as possible to make it easy to see what Obama and Pelosi are proposing."

The bill (H. R. 3200) is also available on the Congressional Thomas Web site, but can't be annotated there.

The commenting system is similar to the tracking feature in Microsoft Word. Users click and drag the mouse cursor over the section of text they wish to comment on, then click the "comments" icon on a window at the bottom of the document, and enter their comments, which appear in a tabbed area. Users may also reply to comments left by other users.

Comments appear in a window underneath the document. The user can click on a comment, and the document view jumps to the section of text being commented on.

One comment on the healthcare bill, from someone identifying himself as "rcondon," said: "This represents an absolutely improper use of the Federal government's resources, not to mention a usurpation of States rights."

A user named "docwright" said: "The proposed healthcare legislation that the democrats are trying to push down our throats is ridiculous. Name one government program that is efficient and that works well. Medical residencies are full of foreign medical graduates. The brightest young Americans are not going to choose to go to school for all of those years to become a doctor. Soon, you will not be able to find a doctor with an Anglo-Saxon name."

Many of the comments simply discussed details of the plan, without expressing an overall preference pro or con.

The bill posted on the site does not include recent amendments from the Energy and Commerce, Ways and Means, and Education and Workforce committees. Culberson criticized those committees for failing to release the amendments to the public. "None of us has been able to see the bill as amended by committee," he said.

"My first and strongest objection is the secrecy with which this massive legislation is being pushed, jammed through the Congress with virtually no public scrutiny," he said.

While Obama has driven use of Web 2.0 technologies for opening government, Republicans have also been using social media, and Culberson has been a leader of that effort. "Social media allows you to be a better representative by communicating better with constituents, and bypassing the old elite media," he said. "We're not too far away from achieving realtime democracy in America, and that can only be healthy for Congress, the country, and the restoration of the Constitution."

Culberson started on Twitter May 26, after being shown the service by one of his constituents, Erica O'Grady, in a Starbucks. "She showed me Twitter and Facebook and a light switch went off in my head -- just like when I saw SharedBook," Culberson said. "I thought, 'This is essential. This is going to become a fundamental part of the job." He said he signed up that day for Twitter, Facebook, and Qik, a service which allows posting realtime video to the Internet. He's @johnculberson on Twitter, with 12,773 followers and following 12,342; has 2,013 Facebook friends; and is johnculberson on Qik, with 120 videos totaling 18 hours, 22 minutes.

A team of researchers from the University of Maryland studied Congressional Twitter postings, and rated Culberson the top Congressional Twitter user, saying he has the most active Twitter account in Congress, engaging regularly with constituents and challenging Democratic leadership.

"Communicating through social media in a personalized way that is tailored to our constituents' interest will become an expected and normal part of the future as elected representatives," he said. "It's self-evident and a lot of fun."

He added, "The time is coming when a member of Congress will walk onto the House floor, and most if not all of their 651,000 constituents will walk onto the floor with them, watching and listening, even though they're thousands of miles away.

Culberson said he is intrigued by the possibilities of Google Wave, which he described as an attempt "to recreate on a single social media Web site all the intricate inputs we experience in person-to-person conversation, and expand it to a large group."

Google Wave, which is currently in preview, will allow people to have conversations in big and small groups, with interactive presentations, including embedded spreadsheets, reports, and videos. "I had a chance to see it in a visit to Google headquarters over the summer. It's got extraordinary potential."

Crowdsourcing government policy decision does have its problems. The White House has seen its efforts to crowdsource policy decisions dominated by groups favoring such causes as legalizing marijuana, taxing the Church of Scientology, and questioning Obama's citizenship. But Culberson dismissed those problems as nothing new; small, focused groups have always sought disproportionate interest by manipulating the media and letter-writing campaigns, and it's part of the representative's job to detect those sorts of campaigns.

SharedBook, the platform Culberson is using to host the healthcare bill, is the product of a six-year-old company of the same name, used for personalizing and customizing documents and books.

"All the annotations are attached to the document as footnotes," said company CEO Caroline Vanderlip. "The original document is locked down by the author. It's not a wiki, where everyone has the ability to make changes."

The software is optimized for making printouts at the chapter level or the whole document, with comments from the community, to make a permanent record--often required by government regulations, Vanderlip said.

The software is four years old, and is frequently used for making custom books, such as printed books of online guest books for obituaries from It's also used by Google to allow users to make books out of Google-hosted blogs. It formats text in style suitable for printing out. And book publishers such as HarperCollins are using it to create digitally inscribed copies of books.

SharedBook entered the government market two weeks ago.

InformationWeek has published an in-depth report on e-health and the federal stimulus package. Download the report here (registration required).

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