I haven’t talked about policy in a while, but my inbox is telling me it’s time.
I personally believe that patients belong at every table where decisionmakers are formulating new policy because how do you arrive at the best solutions without input from those who will be affected by it? But it can be hard to find ways in, let alone find someone to take you seriously. This is especially true of legislative policy folks, whether at the federal, state, or local levels. We can go to town halls, schedule a meeting with the people who represent us, and some of us even get to testify before a legislative committee.
These are all excellent opportunities, but limited in their scope, if less so in their potential impact. A patient story can open the door to sympathy or empathy, and it can be an excellent tool for policymakers to use in their efforts to sway others, especially if they remember that one patient story can be representative of millions.
But it’s not enough. We patients know that. All of these ways to be heard are influencing policy that has already been written, often without our input, and therefore without our views on what whether it would actually work and unintended consequences invisible to those who don’t have to live a patient (or caregiver) life.
But making inroads into places we have never been invited before is slow. In the meantime, we can add another avenue of influence that is rarely used: public comments on agency policy.
The thing is, agency (executive) policy, including regulatory policy, gets very little attention compared to the passage of legislation. But legislation is only the broad parameter. It is the administrative agencies such as Health and Human Services on the federal side that set the details. They decide what problems to address within the broader law. They have the resources to develop initiatives and guidelines, as well as controls and restrictions in their areas of jurisdiction. And the public can offer their thoughts.
This brings me back to my inbox. Several months ago, I connected with a senior advisor for the HHS Office of the Assistant Secretary for Health (OASH) and learned about their intentions to make a big push to strengthen primary health care. I don’t have to tell you about why primary care is so important. They are often our diagnosers, our best bets for coordinated care (yes, I know this is far-from-perfect, but they’re all we’ve got), and we tend to trust them more since we view them as a part of our communities.
A couple of days ago, I got notice that OASH was sending out a Request For Information (RFI). This is a regular occurrence. The Federal Register keeps track, but few individuals are even aware of this process, so the only input garnered by the RFIs is from larger organizations and industry. I would love to see that change. I promise it’s not hard. You read what they’re asking and give your thoughts, as well as any suggestions you might have. And you can do it from home at 2:00 in the morning if that’s the most convenient time.
This particular RFI aims to establish a foundation to address the lack of primary care practitioners; the shrinking workforce; workforce well-being; and reimbursement challenges that may result in financial instability for primary care practices. What we say in our comments could result in expanding how the OASH policy experts approach this new initiative, as well as what is included and excluded in the policy itself.
A long shot, I know, but what was it Wayne Gretzky said? You miss 100% of the shots you don’t take? Might as well give it a try.