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Chapter
2
What Is Health Policy Advocacy?
Advocacy is defined as the support or defense of a cause and the act of pleading on behalf of another person. Oncology nurses engage in advocacy everyday on behalf of their patients.
Turning Outrage Into Action
Every day, people have experiences that are frustrating, unbelievable,
or so outrageous that they think, "How can this be? There ought to
be a law!" Oncology nurses often experience this frustration in their
day-to-day practice—fighting with managed care companies, facing
inadequate Medicare reimbursement, and cobbling together adequate care
for uninsured patients.
• Health policy advocacy means channeling this sense of outrage about inadequately conceived laws, policies, and regulations or about the absence of a law when the need for one is clear.
• Advocates let policymakers know what they, as citizens and constituents,
believe elected officials should do.
Ruth Dennison, the ONS Pennsylvania State Health Policy Liaison, first became involved in health policy advocacy by "accident." As she tells it, she is "just one regular oncology nurse who turned her outrage into action." Ruth had a patient in a very dire condition who needed laboratory work done, but his insurance would not cover it. Ruth had one of those moments of "How can this be? This patient needs this lab work and the HMO isn't covering it. This is crazy." So what did she do? She had been taught by her father that if you have a problem, you call your Congressman. So Ruth found her Congressman's local phone number in the phone book under the "blue pages" (government information) and called his office. The woman who answered got an earful from Ruth. Ruth left her name and number, and the staffer told Ruth she would call her back. Ruth hung up thinking, "I'll probably not get a call back, but at least I feel better…I called somebody." Later in the day, when Ruth was paged by the front office staff that the Congressman's office was on the phone, she thought her colleagues were playing a joke on her. However, it was the Congressman's staffer with whom she had spoken, and she said the Congressman was concerned and would like to meet Ruth.
Ruth did meet with her Congressman to discuss a variety of oncology and healthcare issues, and he subsequently became very responsive and helpful with the issues Ruth brought to his attention. Since that time, Ruth has become very involved in health policy advocacy by volunteering as her state's Health Policy Liaison, writing and calling her elected officials about issues of concern, and helping to train and recruit oncology nurses to advocate for nursing and people with cancer. Of her experience, Ruth says, "ONS gave me everything I needed to be successful in advocacy - it's easy and fun!"
Ruth Dennison the "Accidental Advocate"
Despite its simple definition, advocacy is multifaceted, and the types of advocacy activities in which ONS and its leaders, members, and supporters engage are diverse. Through health policy advocacy efforts, ONS seeks to influence the outcomes of local, state, and national policies, laws, and regulations to reduce and prevent suffering from cancer. Specifically, ONS seeks to:
1. Bolster and expand the nursing workforce to safeguard public health.
2. Ensure access to quality care and reduce suffering for people with
cancer.
3. Advance cancer prevention and early detection.
4. Increase federal appropriations for improved and expanded cancer research,
early detection, prevention, treatment and related care, and tobacco control
to reduce and prevent suffering from cancer.
Nurses are professional advocates. They regularly represent and work on behalf of patients, as well as their family members, physicians, and, sometimes, healthcare insurers. In addition, oncology nurses lead busy lives, have competing responsibilities and priorities, and every day give themselves to their jobs. Understandably, ONS tries to choose activities that provide the most "bang for the buck." When short on time and resources, not engaging in activities that could be futile or will require new, additional, or specialized knowledge and understanding is a rational decision.
Recognizing this, ONS makes it easy for oncology nurses to get involved in health policy advocacy. The ONS Legislative Action Center provides template e-mail messages that can be personalized and offers suggested talking points for phone calls to elected official’s offices.
“As registered nurses and oncology specialists, we have a responsibility to not only care for our patients, but to advocate for them on all levels. Health policy advocacy is a vehicle to shape change in health care at all levels of government. While it does require some effort - you need to be well informed and committed- it is exciting and a great way to learn more about how we are governed. Personally, being involved has been very rewarding and has exposed me to information and activities that have assisted me to grow as a leader and change agent. The resources (information, education, strategy) provided by ONStat and on the ONS Legislative Action Center are great and make it as easy as possible. The issues we face in health care are serious, and I am grateful for the opportunity to become so involved in addressing them.”
Ellen F. Zupa, RN, MS, OCN, CNAA
So, now that we have convinced you that advocacy can be easy and make a difference in the outcome of our nation's policy discussions, we will move forward into the nuts and bolts of the policymaking process and discuss how you, as an individual oncology nurse, can get involved.
Advocacy Is a Right and a Responsibility
The McCormick Tribune Freedom Museum poll found that Americans’ knowledge of television shows such as “The Simpsons” and “American Idol” far surpasses their familiarity with the First Amendment.
Only one of the 1,000 adults polled in the telephone survey could name all five freedoms granted under the First Amendment. Yet more than one in five (22%) could identify all five major characters in Matt Groening’s cartoon family.
The First Amendment of the Constitution guarantees freedom of speech, the press, and religion, as well as the rights to peacefully assemble and to petition the government for a redress of grievances.
- The Washington Post Survey
Think about it – the U.S. Constitution grants us the right to tell our elected officials our concerns and request them to take action to address them!1
If we took the time to think about it, we all could come up with a list of grievances we would like our public officials to address.
Remember: Policymakers work for the citizens. Your tax dollars pay their salaries and for their health insurance, retirement benefits, and travel (they even get to keep the frequent flyer miles!). After all, you are held accountable by your employers. Therefore, you have every right to hold them accountable for their actions, tell them what you want them to do, and give them feedback on how you think they are doing at their jobs. Entire systems are in place in Congress for the recording of your opinions. The ultimate job review you can give your public officials is by voting—either returning them to office or ending their service.
In the United States we have a participatory democracy and representative government. Becoming involved is not only a right but also a responsibility.
1United States Constitution, 1st Amendment, "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances."
The Health Policy Tool Kit is a project of the Oncology Nursing Society.
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