What is a Healthcare Policy Advocate?

Healthcare Policy AdvocateOne of the newest professions to emerge in the burgeoning healthcare system is that of a Healthcare Policy Advocate. This person speaks for patients who are at their most vulnerable state in an environment of increasing healthcare costs and privacy concerns that sometimes block access to resources. What does this profession entail and who are the people that work in the advocate position?

Why Advocates are Needed

The average household in the United States spends roughly $15,000 on healthcare each year, according to an article in a New York Times blog. That includes insurance premiums, Medicare taxes, Medicaid expenses and other costs in addition to out-of-pocket charges. The U.S. also spends a sixth of its annual gross product on providing healthcare. The health industry is big business. According to an article found in the Journal of Medical Ethics, the medical profession has, at its core, the goal of promoting a patient’s best interests, but, in reality, that must be tempered with an eye to the good of the community. In other words, what is good

for one might not be in the best interest of many. In addition, hospitals struggle to keep costs down and profits up, just as any business does. Doctors must consider their budgets and nurses deal with the limitations placed on them by economic pressures, limits such as insufficient staffing. Although the medical profession wants to advocate for the patient, it has conflicting loyalties. Medical procedures also are more costly, and limited Medicare and Medicaid reimbursements make some doctors reluctant to suggest the more costly of these. Besides all that, there is an increasingly litigious atmosphere that makes doctors and nurses reluctant to make certain decisions for fear of being sued.

Who are Advocates?

Some advocates work for healthcare facilities, some are employed by insurance companies, some work for “advocacy agencies” and some work as private practitioners. Obviously, the best advocate would be the patient, but advocacy is needed at a point when the patient is most vulnerable. Family or friends are also sometimes advocates. With all of these people, though, there may be a conflict of interests. Even family members sometimes struggle with how the wishes of the patient will impact their lives.

What Do Advocates Do?

There are two kinds of advocates: those who advocate for a class, and those who advocate for the individual.  Nurses advocate for patients by attempting to change the system. Other advocates work on a more personal level, in face-to-face contact with their clients. Some of their duties are:

  • Helping with insurance claims
  • Informing patients of all treatment options
  • Negotiate bills. This is especially true of an advocate who works for an insurance company or a healthcare facility.
  • Support the patient emotionally
  • Support patient decisions and make sure these are expressed to the healthcare providers.
  • Educate the patient about his illness and possible treatments.

The role of the advocate is not well-defined, because the position is so new and there are advocates from so many entities. The focus of the advocacy will depend upon who employs the advocate. In addition, there is a debate over whether the advocate should push for all patient requests or act in a parental capacity to advocate for what is actually in the patient’s best interests.

Related Resource: Doctor of Nursing Practice

The profession is still being defined. There are few degree programs for it and fewer accreditation programs. Even the salary is skewed: advocates in private practice may make hundreds of dollars an hour, while those employed by a hospital or agency may earn the median salary of $1.86 an hour. If you have the desire to help people and have a basic knowledge of medical procedures or are willing to learn, then the profession of Healthcare Policy Advocate may be right for you.