By the Campaign Team
What is a Public Healthcare Advocate?
A public advocate (sometimes called an ombudsman) is an appointed public official who helps protect the people against abuse by private and public powers. In our proposal, a Public Healthcare Advocate would manage an office whose whole staff would protect people’s rights in the healthcare system in Pennsylvania.
What would a Public Healthcare Advocate do?
The Office of the Public Healthcare Advocate would play three main roles:
- Provide direct assistance to people who are struggling to get healthcare, including assistance enrolling in insurance, getting coverage, challenging denied insurance claims, and negotiating bills from medical providers. This assistance would return millions of dollars in unpaid insurance claims from insurance companies to patients every year.
- Work with community groups (including Put People First! PA) and public agencies to educate the public on our healthcare rights, focusing especially on reaching poor and dispossessed communities who are most frequently denied their rights.
- Work with the governor, legislators, and public agencies to report on how the health insurance system is and isn’t working for people, advocate for patients, and provide recommendations to lawmakers to improve policies and practices.
Who would a Public Healthcare Advocate serve?
The Office of the Public Healthcare Advocate would serve all residents, no exceptions. That includes people on all forms of private and public health insurance (insurance through employers, ACA plans, Medicaid/Welfare, Medicare, workers’ comp, the VA, etc.), people who are uninsured, and people who are undocumented and people who are in prison.
Are there effective Public Healthcare Advocates in other places?
Public advocates are a highly effective, proven model for ensuring accountability and transparency in both government and corporations as long as they are given sufficient powers and funding and as long as they remain politically independent. Pennsylvania already has public advocates for long-term care, utilities, and employment and housing discrimination. Several other states have public advocates who hold both private insurance companies and public insurance programs accountable. Connecticut’s Office of the Healthcare Advocate is an especially effective model because it has a) strong powers to assist residents and report on healthcare injustices, b) guaranteed annual funding from a tax on insurance companies, and c) is insulated from political attacks by an independent advisory board and by being an appointed, not elected, position. Our proposal is largely based off of Connecticut’s model, but we’re also adapting it in some important ways, such as by designing our proposal to more explicitly serve people on Medicaid and people who are completely uninsured.
How would we organize to get a Public Healthcare Advocate in Pennsylvania?
Our goal is to get the State Legislature and the governor to pass a law creating a Public Healthcare Advocate. We anticipate that it will take us around two years to win this goal. Once a law is passed, ideally the Public Healthcare Advocate would be appointed through a transparent process in which a Community Advisory Committee would submit a list of candidates to the governor, the governor would nominate a candidate from the list, and the Legislature would vote to approve and appoint the governor’s nomination.
Creating the Office through legislation (rather than an executive order by the governor) will allow us to protect the Public Healthcare Advocate from political attacks. It will allow us to designate guaranteed annual funding for the Advocate and hold the next governor accountable to maintaining the position. This means that the ultimate decision makers in our campaign for a Public Healthcare Advocate are state legislators and the governor. We need to pressure them directly, and we also need to organize individuals and organizations who have influence over state legislators and the Governor, including staff in state agencies and our strategic partners.
How would we make sure the Public Healthcare Advocate is accountable to the people and not to private profiteers?
Whether a public advocate can be strong and independent depends on how much power we build to create strong legislation. Our legislation would need to a) provide adequate, guaranteed funding that is protected from cuts in future years and b) build in accountability mechanisms like a community advisory board, a transparent appointment process, and independence from elections to make sure that the Office isn’t captured by the insurance industry or swept up in partisan fighting. The Campaign Team will coordinate us to identify which exact accountability mechanisms we want to make sure are included in the legislation.
Ultimately, in order to ensure that the legislation and the Advocate are as strong and independent as possible, we need to be as strong and independent as possible so we can push legislators and the governor to pass a bill that meets our demands without being watered down. And if and when we win and pass legislation, we need to stay active and organized to make sure the Advocate remains strong and independent and continues to meet our needs over time.
How does campaign for a Public Healthcare Advocate connect to our other strategies and help build our power?
An Office of the Public Healthcare Advocate would directly help our class not only by assisting people to get healthcare and get their medical bills paid, but also by building more accountability, transparency, equity, and participation into Pennsylvania’s healthcare system. Organizing for a Public Healthcare Advocate is an opportunity to find our people, build our base, grow our Healthcare Rights Committees, develop our leadership, tell our stories, challenge profiteers, hold power-holders accountable, and deepen our strategic partnerships with our allies.
This content originally appeared in Put People First! PA’s semi-annual newsletter, The Keystone. The Keystone is a great introduction to Put People First! PA, our work, and our community. It’s all written by our members for our own communication and education, and for supporters and new relationships to get to know us better. Each issue features reports from our work, news about our victories, stories about the health care system and the other issues affecting our communities, and poetry and artwork. Check out past and present editions here: Newsletter Archive.