Technology to Teach Healthcare Law to the Layman (Commentary)

By La Terra Cole ’14

There are two types of people: those who understood the nuanced reasoning in the 193-page ruling the Supreme Court justices delivered last week on healthcare reform, and the rest of the population. Undoubtedly the latter far outnumbers the former. But to what extent is this because creative technology wasn’t employed to make the decision more accessible to legal non-experts?

As many seek to understand both the legal ruling and the Affordable Care Act itself, educational tools like word clouds and mind maps can help to simplify the sophisticated ideas contained within the often-dense legal language. By illustrating legal concepts visually in ways that show relationships between details and the “big picture,” the legal community can empower citizens to more easily form their own opinions and thereby enrich the democratic process.

One simple yet powerful visual aid is a word cloud, which turns text into a graphic rendering that shows the relative weight of various topics discussed within a given document. The font size of each word corresponds to the number of times it appears in the text, with more frequently-used words appearing larger and bolder than their more sparingly-used counterparts. A glance at the juxtaposition of large and small words in a healthcare decision word cloud, for instance, gives a quick visual guide to the relative degrees of emphasis in the Supreme Court ruling. (text continues below graphic)

The word cloud above serves as a sort of visual table of contents, illustrating some aspects of the decision that media outlets have tended to overlook. Understandably, the lion’s share of media attention has been paid to Chief Justice John Roberts’ argument that the individual mandate requiring nearly all Americans to possess health insurance was constitutional under Congress’ taxing power. Writing for the majority, Roberts stated:

 ‘Congress [has] the power to impose the exaction in §5000A under the taxing power and [that section] need not be read to do more then impose a tax. That is sufficient to sustain it. The question of the constitutionality of action taken by Congress does not depend on recitals of the power which it undertakes to exercise.’

But it’s also clear from the word cloud – note the size of the words “Federal,” “States” and “Power” – that the decision also contemplated whether the states or federal government had the necessary authority to enact or repeal the law. The relatively large “Medicaid” in the word cloud is a quick visual indicator of another lesser-covered issue: that Congress could not take states’ existing Medicaid funds in order to coerce compliance with the new program.

To be sure, a word cloud alone does not convey the court’s decision in its entirety, and a textual supplement is necessary for full understanding. A simple graphic doesn’t explain, for example, Justice Ginsburg’s characterization of Roberts’ argument as a ‘rigid reading’ of the Commerce Clause; the dissent by Justices Scalia, Kennedy, Thomas, and Alito arguing the healthcare overstepped the ‘structural limits upon federal power’ by extending power over virtually all individual activity in addition to increasing costs to the insurance industry; or Justice Thomas’ contention that the individual mandate was a regulation of economic inactivity, which he argued is outside of the Congress’ express power to regulate ‘commerce among the states.’

But perhaps if a more digestible reference point like a word cloud were available at the outset, non-experts could more easily assimilate the various crosscurrents of the legal reasoning swirling through the lengthy decision.

A more comprehensive teaching tool is a concept map, or mind map. These graphic roadmaps allow users to explore complex ideas in great detail without losing sight of the bigger picture.

A concept map of the Affordable Care Act, like the one here, uses various colors, sizes, and an intuitive spatial arrangement to help navigate through what some consider a morass of legislative language. Coverage requirements, health plan specifics and other details are captured in one application, as opposed to reams of paper, an alternative that might be especially appealing to people who favor global and visual learning styles over other types of learning.

If citizens have difficulty understanding the primary source material, then they’re forced to rely on characterizations by members of the media – many of whom are non-experts. The fact that CNN and Fox News initially misreported the healthcare decision as having struck down the individual mandate, or that media organizations often stumble over healthcare provisions, shows that even those tasked with explaining legal concepts to the world at-large could benefit from supplemental tools that explain the law more simply.

The point is to mitigate the intimidation that dissuades many non-experts from even attempting to understand legal opinions or complex laws. Inaccessibility of legal opinions should not be an accepted feature of our judicial or legislative systems.



  1. dtiley · · Reply

    This was really well written and helpful! Thanks for posting.

  2. Mike Brown · · Reply

    Ouch @ the font used in the wordcloud. Remember, graphics should impart information as simply and easily as possible. It would be really interesting to compare word clouds for the majority, concurrence, and dissent. Great article!

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