Chapter 3
Advocacy Is Easy and Effective – Debunking the Myths

Numerous "myths" of advocacy exist that prevent people from becoming involved in the policymaking process, including the misperceptions that it takes a lot of time, doesn't make a difference, and requires great expertise. You clearly have an interest in advocacy or you wouldn't be reading this tool kit; however, you may have questions, concerns, or preconceived notions about advocacy and health policy. Therefore, we have compiled the 10 most pervasive advocacy myths and debunked them one-by-one.

1. I am too busy—there is not enough time in the day.

ONS makes it easy and fast – just visit www.onslac.org. Sending an e-mail takes less than five minutes, only involves a few clicks, and does have an impact. Just by entering your zip code on the ONS Legislative Action Center (www.onslac.org), you can access a template letter and be automatically matched to your Member of Congress. Remember: if you do not get involved, no one else will on your or your patients’ behalf. Bring your voice forward for oncology nursing and people with cancer!

2. I am an oncology nurse, not a lobbyist.

Perfect! Members of Congress are more likely to listen to you – you are an expert in what people with cancer face and need. You can provide the Member and staffers with substantive and valid information, as you know first-hand what occurs in today’s healthcare system and what is needed to improve it. You are a “legitimate constituent voice” – not a hired gun.

3. Why should I bother? It doesn’t seem to make a difference. I have written before and not received a response. When I have received a response, the letter didn’t address the issue I wrote about or I totally disagreed with the views expressed.

It absolutely makes a difference, even though it may not feel that way. Offices count calls, e-mails, faxes, and mail. Staffers log opinions that are expressed and provide regular reports on constituent communications to the Member of Congress. If you have written and not received a response, write or call and let the office know. Sometimes, with the volume of mail, letters can get lost. Also, if you disagree with the views expressed in a response letter, write again and politely repeat your request and rationale and indicate you are disappointed in the Member’s position on the issue. Usually if you bring it to their attention you get a prompt response. Think about Mothers Against Drunk Driving, “Megan’s Law,” or Amber Alert – persistence and one person/family can result in an important new law or regulation.

4. My Member is a lost cause, doesn’t sit on the relevant committee, or doesn’t care about healthcare.

It is essential to weigh-in and go on record with your Member(s) of Congress. You never know when an issue will resonate with them or their staffers. Cancer is so pervasive that many Members of Congress and staffers have been touched by the disease. Many Members who historically were not interested or supportive of cancer or nursing issues, once touched by the disease, have become our biggest advocates.

5. My concerns or issues of priority are not being discussed in Congress.

Maybe that is because no one is writing/calling about them. You, your colleagues, and your patients can help elevate an issue to the national agenda by communicating with your policymakers about it. Sometimes it takes a grassroots movement to garner Congressional attention. People writing about their HMO horror stories stimulated the development of the “Patients’ Bill of Rights.”

6. I am not an expert in the issue you are asking me to weigh-in on.

You are an expert in the delivery of cancer care and understand first-hand what people with cancer face. Just be honest about how you know personally of the devastating effects of cancer on people and their families. The template letters/talking points provided at www.onslac.org will take care of the rest.

7. I cannot make it to Washington to meet with my Member.

Members and staffers will tell you that developing a relationship with your policymakers and their staffers “back-at-home” is more effective since you can see them in your own community. Coming to Washington is effective but communicating from and at home is even better. E-mails, calls, and faxes from you to your Members of Congress sent to their Washington office are great. Visiting the district office or attending a town hall meeting is terrific. All of these forms of contact are easy, and ONS has tips www.ons.org/lac/tips.shtml to help support your efforts.

8. The process is intimidating. I don’t understand what a substitute amendment is, am unclear on how conference committee works, and cannot remember what a pocket veto means.

The details and nuances of the federal policy making process are difficult to follow, but you do not need to know them all. ONS’s action alerts tell you what you need to know and the template letters include all the relevant details. Do not worry if you cannot remember fourth grade civics – no one can, not even Members of Congress. Just know who represents you in Congress – two Senators (www.senate.gov) and a Representative in the House (www.house.gov), and rely on ONS to give you the rest (www.onslac.org).

9. I am a Republican, and my Member is a Democrat. I am a Democrat, and my Member is a Republican.

Due to the pervasiveness of cancer, it is, unfortunately, a universal scourge. Cancer, unlike other health issues, is not partisan. Do not worry about your party affiliation; just identify yourself as a constituent and an oncology nurse – these are suitable qualifications for your views to be treated with respect. Senators Sam Brownback (R-Kansas) and Dianne Feinstein (D-California) co-chair the Senate Cancer Coalition and Representatives Lois Capps (D 23^rd California), Steve Israel (D-2^nd New York), Sue Myrick (R-9^th North Carolina), and Deborah Pryce (R-15^th Ohio) co-chair the House Cancer Caucus. Similarly, Representative Capps and her colleague Representative Steve LaTourette (R-14^th Ohio) co-chair the House Nursing Caucus. If cancer and nursing can unite all of these policymakers, you need not worry about differing in party affiliation from your Member(s)!

10. I’ve done my part to support the cause. I’ve written and called before about Nurse Reinvestment Act funding and cancer research and requested my Members’ support. I don’t need to write/call/e-mail or meet with them again.

Every day Congress makes decisions that affect you: nurses and people with cancer across the country. Writing, calling, e-mailing, or meeting with your policymakers regularly is essential. Each year Congress determines funding levels for the coming year, so every year oncology nurses again must contact their Members about the need to support programs that address the nursing shortage, cancer research, and other programs. Every year Congress considers changes to the Medicare program that affect oncology nurses and people with cancer. Thus, Members of Congress need to hear from oncology nurses throughout the year. No where is the adage, “the squeaky wheel gets the grease,” more true than Washington, DC. Policymakers often claim the reason for their inaction on matters is that they aren’t “hearing (enough) from home” on the issue. Don’t give them an excuse!

The Health Policy Tool Kit is a project of the Oncology Nursing Society.