The ICD-10 comment period and the appeal of ordinary

“Life goes on, having nowhere else to go.” – Diane Ackerman, The Moon by Whale Light

These days, in the aftermath of the most discomfiting election season of my life, with its unprecedented polarization of public opinion, I find myself at a loss for something I can say to readers of this blog. I made several false starts over the weekend after the election to try to write a blog post, but the “audience”—you out there, including  people I know and some I don’t know---suddenly seemed more like strangers than just “people.”

That was last weekend. Last weekend was also the end of the comment period for changes proposed at the September ICD-10 Coordination and Maintenance meeting. So on Monday my inbox was filled with the final round of comments, forwarded from CMS. And, like a little gift from the universe, there you were again—the participants in good government I wrote about a couple of blogs ago.

Some of your comments were short and to the point—they said I support this change, or I don’t support this change. Some gave detailed rationale for their support or disagreement. Some recommended tweaks to this or that proposal, and were more detailed yet---clearly you had given the topic a lot of thought.

Normally reading public comment isn’t that enjoyable. But Monday, those comments made me realize that perception of events is inseparable from the kaleidoscopic pattern of our time. And in the current context, reading public comment on ICD-10 was so ordinary… and so wonderful.

Thank you for your comments. This is a standard response in so many situations, and when you see that sentence it is tempting to feel that your voice has not been heard. I mean it quite differently here: thank you all, thank you so much for your comments. I can’t tell you what a difference it made to me personally, that you participated in the ordinary work of government—the ongoing conversation between public comment and government policy which, when it works, produces better results. Though some of you are people I don’t know, none of you are strangers to me. Happy Thanksgiving, everyone.

Rhonda Butler is a clinical research manager with 3M Health Information Systems.