Health Care Reunites a Divided Nation

December 28, 2020 by Alec Stone MA, MPA, Former ONS Director of Government Affairs and Advocacy

The November 2020 presidential election saw a historic turnout at the polls. Before election day, more than 99 million of the 240 million registered American voters had already cast their ballots, and some predicted that as many as 155 million voters would exercise their constitutional franchise (http://www.electproject.org/home/voter-turnout/voter-turnout-data) to make their voices heard, a record 65% of the electorate. The distinct differences between the two major presidential candidates indicated that people were engaged and took to heart the grand idea of participatory democracy.

Although the presidential race was determined four days after the official election day, at the time of this writing several congressional races are still being contested. It’s a process, but with patience, it works. Here’s what we know as we look ahead to the future.

Health Care Is Common Ground

The results from November mean that the United States will continue to operate with a divided government, which forces either negotiation or gridlock in policymaking. And yet, as Americans’ gap in ideology grows, one of the few topics that most can agree on is health care. Concerns (https://www.kff.org/health-reform/poll-finding/5-charts-about-public-opinion-on-the-affordable-care-act-and-the-supreme-court/) that both Biden and Trump supporters mutually ranked as “very important” included (https://morningconsult.com/exit-polling-live-updates):

With backing from both parties, policymakers have an opportunity to find common ground for real solutions in areas of importance to ONS and oncology nurses. Going into the election season, a number of legislative and regulatory problems were left unresolved, so as they reemerge, nurses will need to educate decision makers on the adverse impact conflict can have on patients.

Nursing must maintain a role in the policy discussion because the old political adage (https://doi.org/10.1097/NND.0000000000000231) reminds us: “If you’re not at the table, you’re on the menu.” Working through local chapters, the nursing community, and cancer advocacy groups, ONS leaders raise topics like palliative care, oral parity for cancer drugs, Title VIII nursing workforce funding, telehealth, smoking cessation, and many others on the Society’s health policy agenda.

Where We Go From Here

During a late-night victory speech when the results were finally called, President-Elect Joe Biden spoke earnestly (https://apnews.com/article/election-2020-joe-biden-religion-technology-race-and-ethnicity-2b961c70bc72c2516046bffd378e95de) about his hopes for unity.

“Americans have called on us to marshal the forces of decency and the forces of fairness. To marshal the forces of science and the forces of hope in the great battles of our time. The battle to control the virus. The battle to build prosperity. The battle to secure your family’s health care.”

His first priority is to convene a committee of scientists and public health experts who will work to combat COVID-19. Biden named former U.S. Surgeon General Dr. Vivek Murthy and former U.S. Food and Drug Administration Commissioner Dr. David Kessler as cochairs of a coronavirus working group, with other members to join the effort. But we also know that Biden is deeply engrained in advancing oncology science and research through his work with the National Cancer Moonshot and his own Biden Cancer Initiative. After the urgent public health threat from COVID-19 is controlled, cancer care may be a future focus.

What This Means for Oncology Nursing Advocacy

As a new U.S. Congress comes into session in early January 2021, oncology nurses will have many opportunities for advocacy, even if through virtual efforts. The ONS Board of Directors and staff annually review the Society’s legislative and regulatory health policy agenda to guide the role of the oncology nurse in healthcare advocacy. Nurses must take their status as the most ethical profession back to Capitol Hill and educate the newly elected members of the U.S. House of Representatives and Senate.

This is a time to reinforce champions already in the U.S. Congress as well as expand the circle of support with freshman members who are eager to bolster their ties with nurses. Legislators have not yet identified what their 2021 policy priorities will be, but Congress’s previous work offers clues to the important areas that might be coming in which the nursing community can have a voice:

Palliative care: An ONS priority bill, the Palliative Care and Hospice Education and Treatment Act, has passed the U.S. House twice but not the U.S. Senate.

Telehealth: Social distancing requirements have made virtual provider visits a common occurrence, increasing accessibility and affordability for patients.

Scope of practice: Traditional guidelines were waived during the pandemic that allowed nurses to practice to the full extent of their licenses, but those roles are being challenged again.

As the 2020 election season ends, we must look ahead to the policy and political decisions for January 2021, which will bring an inauguration, election of the speaker of the House of Representatives, and selection of committee chairs.

But looking back, we should be proud that so many nurses of so many political ideologies turned out at the polls in November. It is a rare quadrennial American experience that highlights the voice of the people selecting their leaders. “When nurses speak, Washington listens. When nurses post or share, the nation listens (https://joebiden.com/presidency-for-all-americans).” With four million American nurses, we have power in our numbers.

Representing more than 100,000 oncology nurses, ONS is poised to raise awareness of cancer during the next congressional session to reduce disparities and make health care affordable and accessible to all. Just like you did at the polls, raise your voice in health policy and join ONS in advocating for your patients and profession. Learn how you can get involved (http://ons.org/make-difference/ons-center-advocacy-and-health-policy).


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