Featured Articles: Healthcare Reform

The Fierce Urgency of Now: Advocating for the Right to Health Access

Monday, October 16, 2017   (0 Comments)
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Ana Grande, Policy and Community Organizing Director, Clinica Monsenor Oscar A. Romero


Ana will be presenting on this issue at the Fall Primary Care Conference


This year has been marked by the fierce urgency to advocate for the right to health access. Partisan discourse has become the daily water cooler conversation and, simultaneously, an anxiety ridden dialogue of what can happen next.  As community health centers, the political divisiveness is unappealing but we cannot watch from the sidelines. With the Affordable Care Act consistently on the chopping block, 330 funding, and the Children’s Health Insurance Program (CHIP) in peril, community health centers across the nation do not have the luxury to sit this out.


Advocacy, is the wielding of democracy in its purest form. Lives - over 22 million according to the Congressional Budget Office (CBO) – are at stake.  How each community health center engages in advocacy will depend on their means and organizational makeup. While some of us have the resources to have staff make calls, or engage patients, others are developing Political Action Committees. There are choices and budgets to match them.


Take for example, Clinica Monsenor Oscar A. Romero (Clinica Romero) with 12,000 patients, 140 staff and two sites serving two neighborhoods in Los Angeles. Our advocacy has taken different levels of engagement. The first level involves elevating our patients' plight and voices and engaging our patients in a threefold manner: leadership development, patient stories, and patient advocacy day. The second level requires engaging our providers. During the Affordable Care Act’s repeal and replace or repeal and delay, our providers handwrote postcards giving expert experiences as to why the ACA has worked. These, alongside over 300 patient written cards, were delivered to our Senators.


We have traveled to the State and Nation’s Capitols to amplify our patient voices to ensure that our leaders do not forget easily.  In a recent trip to Washington D.C. to advocate for 330 funding and the impending fiscal cliff, the number one thing legislators asked was – why aren’t there more clinics on the Hill? Why is no one in our district contacting us with stories like yours? We asked– “how many stories would you hear before it makes the difference?” The answer, the magic number, was 100. And so, we collected scores of stories, over 100 per legislator. We presented these stories on postcards, petitions, and social media videos. We presented the voices of Clinica Romero to our legislators and they listened. This year alone Clinica Romero’s advocacy efforts have allowed us to engage over 1200 patients. Each one telling a story on the successes of healthcare access and Medicaid expansion.


Patient stories carry a lot of weight. They are directly impacted by the decisions and implications of any proposed legislation, and as important – patients are voters. In the scurried effort to collect stories and signatures, we often can miss what the stories are and how to highlight them. In the last attempt to advocate around 330 funding, a particular plight stood out to us. Her name – “Susana.” A 58-year-old patient who put her heart and soul in a 4x6 card. Susana penned a brief and poignant plight that should Congress fail to renew MACRA funding, her ability to access health care would cease. The cost of her diabetes and heart medication would skyrocket, and she would eventually end up in an emergency room costing the state twice more. We placed this story on the top of the pile.


Susana’s story was followed by a provider’s statement on how the National Health Service Corp. (NHSC) grants him the opportunity to serve his community. A community that is designated by the Federal government as a Medically Underserved Area (MUA).   Without the NHSC, “Dr. X” would have two choices. The first choice would be to remain at a community health center and keep his debt; the other option would be to work in a prestigious for-profit health center that would give him a sign-on bonus and a lofty salary.  Dr. X’s postcard laid out facts on how each diabetic patient he helps argues with him about eating one more tortilla but through his intervention is controlling his chronic disease. Advocacy matters as it gives everyone the opportunity to participate and gives legislators firsthand accounts of lived reality.


We have not won any battles single-handedly. As clinics advocate for their patients, our fierce urgency becomes everyone’s democracy, and together we ensure millions continue to live.



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