On Becoming An Advocate For Sound Health Policy
Viewpoint by Paul Krissel, Chair, NWHF Board of Directors, 2006-2007
On November 7th, 2006 Oregon voters passed Measure 44, which expanded the state prescription drug program to cover all residents without drug coverage. They also defeated 41 and 48, measures which would have decimated funding for critical health programs. At the Northwest Health Foundation, expanding access to health care is part of our mission, yet we were silent on these measures. Our Board confronted this dilemma and decided that in the future, we cannot remain on the sidelines when voters face important issues that will impact the health of the people of Oregon and southwest Washington.
For a grantmaker, becoming a policy advocate is hardly straightforward. Even when some issues are relatively uncontroversial, the prospect of getting involved raises a slew of questions: How do we support our grantees in mobilizing a constituency to press for good legislation? How does a funder like the Northwest Health Foundation choose which issues to take on? What is the process for getting to Board consensus on the positions we will take? How do we build visibility and the credibility necessary to insulate us from resistance or attack from the opposition? Foundations are great at publishing white papers that sit on shelves, but how can we get better at achieving systemic change?
We haven’t resolved these issues yet, but here is what we do know: The health care system fails hundreds of thousands, and costs for those of us with coverage are escalating out of control. Public health is misunderstood and grossly underfunded. All the health foundation money in the country can’t fix that. If we know the system is broken, yet we only nibble around the edges, why do we exist? For me, this issue is both philosophical and practical. The Northwest Health Foundation isn’t likely to stop funding direct services, but to be true to our core mission, we must be willing to advocate for sound public policy.
As we assess the risks and responsibilities of leadership in this arena, the Northwest Health Foundation is changing. In 2004 our Board included support for advocacy and policy development as a critical step in our focused funding initiative process. We adopted a position statement and revised the NWHF guiding principles to reflect our stance that social change to improve health can be achieved through advocacy efforts that influence public policy. And our Grants Committee identified advocacy and policy as one of three priority funding areas for the 2006 Community Grants cycle.
The Northwest Health Foundation is encouraging collaboration and supporting policy-related work in the areas of public health and access to health care. For example, we are funding staff for the Archimedes Movement, an effort led by John Kitzhaber to restructure Oregon’s health care system. Every month we convene, with the Oregon Health Policy Commission, a dozen groups working on health reform in the state to help them identify ways to work together and develop a common policy agenda (see www.oregonhealthreform.org). And this year we awarded our first grant to a 501(c)(4) organization, Oregonians for Health Security, to develop primers on the drivers of skyrocketing health care costs as a starting point for conversations with legislators on potential solutions.
We don’t have all the answers, but as we grapple with the reality of the worsening health care crisis, we know we have to redouble our efforts to respond in ways that reflect the Foundation’s historical strengths while acknowledging our untapped potential to effect change. More than ever, it’s a task we welcome.
Paul Krissel is Board Chair of the Northwest Health Foundation. After retiring from the national AFL-CIO, Paul earned a Master’s degree in organizational development from American University in Washington, D.C. and has established a private consulting practice.