spencercramer’s Articles at WOW Fellowship Blog

(3) A Summer of Work in a Policy Advocacy Organization

During my internship experience this summer with the National Consumers League, I have not only learned a lot about health policy, but I have also gained a greater understanding for what life is like in a real office job. Before this experience, I have had different jobs and internships, but none that involved a traditional work schedule in an office setting. My internship has given me a much better understanding of how one’s daily activities are structured in a workplace, and how people within an organization or company work together to accomplish the overarching goals at hand. I have experienced how coworkers coordinate and delegate tasks, and how communication occurs effectively between them. Being able to see how a professional organization works on a daily, weekly, and monthly basis will be very beneficial going forwards as I begin a professional career after graduation.

Additionally, I learned how one aspect of social justice work is conducted. There are many avenues for social justice advocacy. These can include grassroots approaches, nonpartisan/apolitical organizations, and the nonprofit advocacy establishment, which would include my organization. I was able to see how an established social justice advocacy organization works largely behind the scenes to push the policies it supports. I learned how they work with like-minded advocacy groups, government and legislative staffers, and various stakeholders throughout society to push their issues to the forefront and get positive policy changes enacted.

I also learned of the challenges that this type of social justice advocacy faces. These challenges can include securing funding for work that often occurs behind the scenes and away from the public eye, and balancing the interests of various stakeholders who often hold conflicting views. All of this can result in advocacy efforts that are not as robust or transformative as many would prefer. It has been really interesting to see all of these tradeoffs, and how social justice advocacy works in the face of these challenges.

In my time on the job, I have made an impact on my organization by helping the health policy department work on long-term projects that they normally would not have time to complete, and by helping them get through a particularly busy time without reducing the amount of work and materials produced. One thing that I contributed to was updating some of the health policy position statements for NCL’s website. Some of them had not been updated in over twenty years, so my work went a long way in helping NCL to revise their content for the present day.

Before I started this internship, I wish I had known more about how the D.C. advocacy establishment functions as a whole so I could have been more prepared for the environment as a whole. My advice for someone looking to get into the field of advocacy, particularly health policy advocacy, would be to continue getting educated, as the people with the most success in this field often have some kind of advanced degree. I would also suggest that they always seek to learn more about the policy area they are advocating for, and to make connections with people from a wide-range across the industry.

(2) Considering Social Determinants of Health in Health Advocacy

Through my education at Brandeis as a Health: Science, Society, and Policy major, one topic that I have learned quite a lot about is the social determinants of health. Social determinants of health are the elements present in our society and environments that contribute to someone’s health. They are not controlled by individual behavior, and are largely out of the control of any single person. Social determinants of health can range from somebody’s income, to their race, or to what zip code they live in.

In real-world situations, they may manifest in several ways. A family without much money may not be able to afford healthy foods. Someone living in a poorer neighborhood may not have access to green space and parks. A Black person living in America has to deal with the daily stresses of racism. All of these social factors can have a tremendous impact on our health that is largely out of our personal control. The concept and impact of social determinants of health have been an integral part of many of my HSSP courses, and they have informed my thinking and reasoning in other courses and in the ways that I see the world.

The idea of social determinants of health is an important lens for viewing the world of public health because it is very beneficial to understand that such a large component of our health is not a matter of personal choice. While we can make individual decisions that impact our well-being, many of the public health problems plaguing our society exist outside of this context. In order to solve our public health crises, we must fix the structural societal problems that contribute to them.

The concept of social determinants of health informs the health policy advocacy work of my organization, the National Consumers League, in almost everything we do. For example, when advocating for safe, effective, and affordable prescription drugs, there must be an understanding that people need to live in a neighborhood where they can easily stop by their local pharmacy, or even have their drugs delivered. It also involves understanding that rich Americans do not need to worry about affording the drugs that they need like poor and middle class Americans do.

Likewise, when advocating for increased vaccine confidence and uptake, we must understand that people living in certain environments do not hear from trusted medical information sources nearly as much as people who live in other places. There are also people who worry about the cost of a vaccine, whether a direct payment, or the indirect cost of missing work to travel to a faraway vaccination site. To encourage vaccination, we must consider the many social factors that may be contributing to peoples’ hesitancy to get vaccinated.

What I have learned about social determinants of health during my time at Brandeis informs my thinking about every issue in public health and health policy that comes up during my internship, and I never miss a chance to mention to those who I am working with about the importance of considering them. I recently wrote a blog that was published on the National Consumers League’s website about treating gun violence as a public health crisis. While writing this blog, I had the concept of social determinants of health at the front of my mind. Everyone dealing with public health issues would be wise to take a greater consideration of social determinants of health.

(1) Advocating for Healthcare Consumers

This summer, I am working as a Health Policy Intern with the National Consumers League (NCL). NCL is a nonprofit advocacy organization based in Washington, D.C. that represents the interests of consumers in a number of policy areas, including healthcare and prescription drugs, fraud, labor, and food safety. I chose to work at NCL because I believe that it is important that we ensure consumers are protected from high costs and bad practices when they seek medical care. Any effort to fix our broken healthcare system must put patients at the center. NCL seeks to address injustices of all kinds that are committed against consumers. These can range from direct scams to broken systems that profit off of consumers’ suffering.

In terms of health policy, NCL works to fix injustices related to anti-vaccine misinformation, pharmacy benefit managers (PBMs) that fail to pass drug rebate savings onto consumers, unregulated CBD, and prescription drug access, among many other initiatives. To address these injustices, NCL uses many different strategies: pushing for specific bills and policies to lawmakers and government officials; engaging in coalition-building with other stakeholders to advocate for issues; and providing educational resources directly to consumers, as with their medication adherence program Script Your Future, and their website with information on the unregulated CBD market 4safecbd.org, among others.

I have been responsible for a variety of different projects including writing statements in support of or opposition to multiple bills, conducting research on health policy issues, creating profiles on key members of Congress, and updating NCL’s health policy positions for their website. One of the statements that I helped to write was in support of the Protecting Seniors Through Immunizations Act, a bill making its way through Congress that would eliminate copays for all vaccines covered under Medicare Part D. Currently, vaccines are covered with no out-of-pocket costs under private insurance, Medicaid, and Medicare Part B. Unfortunately, the vaccines covered under Medicare Part D come with copays often totaling over $100. I was very happy to be able to advocate for increased vaccine access, an issue that I believe is very important for our society, especially as we emerge from the COVID-19 pandemic.

Through NCL’s efforts in support of this bill, I have seen how bills are passed behind the scenes. I have valued the opportunity to sit in on meetings with other advocacy groups, stakeholders, and congressional staff as we attempt to ensure that this bill becomes law. All of these smaller actions are what push policy through government. Additionally, while small fixes like those provided in the Protecting Seniors Through Immunizations Act are not nearly enough to fix America’s horribly broken healthcare system, they certainly have the potential to improve people’s lives and create a healthier society for all of us. And even the big, sweeping changes that so many of us desire require behind-the-scenes policy and advocacy work to successfully implement them.