Law, Policy, and Advocacy: Why Should We Care in Pharmacy?

Erin Albert, MBA, PharmD, JD, Esq.

Delivery of HealthcareButler University COPHS

4.9.14

Objectives1. Define, compare and contrast the following

terms:

policy, law, and advocacy.

2. Explain the role of associations in policy and

advocacy.

3. Identify options for association membership.

4. Describe policy institutes (think tanks) & their

role(s) in law, policy and advocacy.

5. List ways to get involved in policy and advocacy

for pharmacy practice.

The Current Climate

• Pharmacy is one of THE most regulated industries in the U.S.

• The GDP of healthcare in the U.S. is nearing 20% of our entire economy.1

– The most expensive healthcare systems on Earth1

– Drugs are approximately 10-15% of total healthcare GDP in the U.S.

• Is this sustainable?

1. http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS

Source:OECD Health Data 2013http://www.oecd.org/unitedstates/Briefing-Note-USA-2013.pdf

See Health Expenditure as a Share of GDP,OECD Countries:

Q: Who writes law and policy in the US?

Q: Who writes law and policy in the US?

A: THE LAWYERS!!!

60% of the Senate are lawyers37% of the House of Representatives are lawyers

Overall, 43% of Congress are lawyers!

Policy vs. Law• Policy: A “guiding principle used to set direction

in an organization,” …a “course of action to

guide and influence decisions.”1

• Law: The “system of rules” that a particular

governing body (local, state, federal

government) “recognizes as regulating the

actions of its members and enforces by

imposition of penalties.”1. http://www.bizmanualz.com/blog/whats-the-difference-between-policies-and-procedures.html

2. Adapted from Google’s definition of the word “law.”

Advocacy

• Advocacy: Public support for a

recommendation of a particular

cause, policy or proposed law.

• Advocacy can influence BOTH

– Law AND

– Policy

Law vs. Policy – Examples:Law

• The Federal and StateControlled Substances Acts

Policy• A pharmacy chain with a policy to call the doctor before filling a CII Rx

• A prescription has legal refills still on it.

• An insurance company will not cover the prescription

• Plan B may be legally sold OTC

• A pharmacist refuses to fill Plan B due to religious reasons

Law vs. Policy – Examples:Law

• The Federal and StateControlled Substances Acts

Policy• A pharmacy chain with a policy to call the doctor before filling a CII Rx

• A prescription has legal refills still on it.

• An insurance company will not cover the prescription

• Plan B may be legally sold OTC

• A pharmacist refuses to fill Plan B due to religious reasonsADVOCACY

Who May Create Policy?

• The government (local, state, federal)

• Companies - employers

• Other Organizations – non profits, hospitals, think

tanks, etc.

• Professional Groups or Societies

– APhA, ASHP, ASPL, ASCP, AACP, ACCP, NACDS, AMCP,

NCPA, FDLI, DIA, etc.

• Y-O-U

Let’s Discuss One of YOUR Personal Professional Policies

• What is your personal professional policy on

Social Media?

– Do you “friend” patients? Can they “friend” you?

– Do you “friend” co-workers or colleagues?

– Do you “friend” your boss? Your parents? Your

professors?

– What if you can’t tell WHO is following you?

Healthcare & Social Media Policy

If you were going to start crafting

your own Social Media Policy,

where would you start?

Mayo Clinic

• Mayo Clinic:

http://sharing.mayoclinic.org/guidelines/for-

mayo-clinic-employees/

• ASHP’s statement on social media:

http://www.ashp.org/DocLibrary/BestPractic

es/AutoITStSocialMedia.aspx

• Others?

Advocacy & Policy Resources

http://www.pharmacy.vcu.edu/programs/post_grad/publicpolicy/advocacy/

Example: Provider Status

http://www.medscape.com/viewarticle/464663

Am J Health-System Pharmacy:

How Nurse Practitioners Obtained Provider Status: Lessons for Pharmacists

What is a Think Tank?• “A think tank is an organization that sponsors

research on specific problems, encourages the

discovery of solutions to those problems, and

facilitates interaction among scientists and

intellectuals in pursuit of these goals.”1

• “A public policy think tank explicitly focuses on

government policies, usually for the purpose of

improving those policies or creating viable

alternatives.”1

1. http://www.ncpa.org/pub/what-is-a-think-tank

Examples of Healthcare Think Tanks

• Center for Health and Economy (new)

Top 10 global health policy think tanks:1

1. Harvard School of Public Health, Dept. of Health Policy and Management

2. Brookings Institution

3. American Enterprise Institute

4. RAND Corporation

5. Urban Institute

6. Cato Institute

7. Johns Hopkins Bloomberg School of Public Health Research Centers

8. Kaiser Permanente Institute for Health Policy

9. Fraser Institute [Canada]

10. Council on Foreign Relations Global Health Program1. According to the American Hospital Association: http://aharesourcecenter.wordpress.com/2012/04/04/top-health-policy-think-tanks/

10 Ways to Get Involved in Pharmacy Policy & Advocacy

1. Vote

• Are you registered to vote?

• Where to learn how to register to

vote and requirements for your state:

http://www.eac.gov/voter_resources/

default.aspx

2. Write

• Write articles about topics you care about in

pharmacy practice.

• Write a blog.

• Tweet and post in social media about pharmacy

topics you care about.

• Write your representatives about pending

legislation.

• Answer during notice & comment on pending law.

3. Talk to Your Reps

http://www.nann.org/uploads/files/Getting_Involved_in_Health_Policy_and_Advocacy.pdf

4. Join

• Are you a member of any pharmacy

organizations, like BSAP? IPA? Pharmacy

fraternity?

• Consider joining up to 3 professional

organizations when in the profession. (1 local, 1

state and 1 national)

• Attend one national pharmacy meeting per year

(see page 58 of The New Pharmacist book).

5. Get involved in a Cause or Candidate

• Contact your local party:

– www.gop.com

– www.democrats.org

– www.lp.org

• Contact a campaign

• Sign up for emailshttp://www.ena.org/government/EN_411/Documents/PoliticalCampaign.pdf

6. Sign &/or Start Petitions

• Change.org• We the People – White House• DoSomething.org

7. Consider a Fellowship

http://www.pharmacy.vcu.edu/programs/post_grad/healthcare-policy-fellow-program/

http://www.healthpolicyfellows.org/home.php

http://www.healthandagingpolicy.org/

8. Work in Policy or Advocacy

• Policy = think tanks or professional

organizations

• Advocacy = professional organizations

– Many non profit organizations have an executive

director with a “CAE” designation – a Certified

Association Executive:

http://www.asaecenter.org/AboutUs/contentCAE.cf

m?ItemNumber=16097

9. Law School &/or Lobbyist

• Many law schools have health law programs

– Including IU Robert H. McKinney School of Law

– Top health law programs:

http://grad-schools.usnews.rankingsandreviews.com/b

est-graduate-schools/top-law-schools/clinical-

healthcare-law-rankings

• What is a lobbyist?

http://www.youtube.com/watch?v=F0psWOfgN80

10. Run for Office3/7/14 – Article in the NY Times about more physicians running for public office:

Real World Examples of Pharmacists Running for Office:

1. Hubert Humphrey – VP under Lyndon B. Johnson – highest ranking public office pharmacist

2. Curt Gielow – From IN, St. Louis COP – Mayor of Mequon, WI

3. Leticia Van De Putte – TX, pharmacist, currently running for Lt. Gov of TX

4. Buddy Carter – Pharmacist/entrepreneur of independent pharmacy, running for Congress in GA

http://www.nytimes.com/2014/03/08/us/politics/doctors-confident-in-their-healing-powers-rush-for-congress.html?_r=0

Training on Running for Office

The Women’s Campaign School at Yale:http://www.wcsyale.org/

The Richard G. Lugar Excellence in Public Service Series:http://lugarseries.com/

The Indiana Leadership Forum:http://www.indianaleadershipforum.com/

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"Never doubt that a small group of

thoughtful, committed citizens can

change the world; indeed, it's the only

thing that ever has."

-Margaret Mead