Passionate Pragmatism for Advancing Social Change

By: Myrl Weinberg, CAE

When facing the fear of change, striving for practical benefit can bring sides together.

The perfect icebreaker question at any meeting of association people: Why did you decide to work for an association? Responses may vary, yet everyone will speak with passion and deep commitment. You need both to endure and succeed in the association world. Unfortunately, intense emotions at times may drive us astray.

Last year was a watershed year for those of us who work in healthcare policy. I still don't know how things will shake out as I write this column. What I do know—and what I saw—is that the fear of unintended consequences sometimes held sway over fact. I'm not talking about the misinformation over "death panels." I mean that a sense of fear affected the debate over complex issues, such as how to finance healthcare reform, how to incorporate comparative effectiveness research, and whether to address the production of biosimilars in the final package.

We collectively keep moving forward, because we recognize that our goal is to improve the lives of the patients we serve.

I have members who are both for and against various elements being considered for inclusion in healthcare reform legislation. But at no time did the National Health Council (NHC) face a go or no-go situation. We needed to take decisive action, despite some members' deep-seated, honest concerns.

Every association has its polarizing issues. What we as association executives have to do is to challenge ourselves to create a new dynamic to solve the ever-growing number of complex problems we face. Certainly, we all develop plans and policies with an expectation of positive benefits to the communities we serve. You might say we strive to develop "proposals of the well intended." But there is always the possibility of the negative. Our responsibility is to keep the positives, address the concerns, and seek common goals.

Here's an example of how the NHC tries to build consensus. We created a Government Relations Affinity Group (GRAG) made up of the government relations and government affairs staff of patient advocacy organizations that belong to NHC. This group and its issue teams, which include representatives from all nonprofit and corporate members, research policy issues and advise NHC staff members, who in turn seek input from CEOs of patient groups and the NHC Board of Directors.

GRAG's work is based on primary and secondary research like focus groups, in-depth patient interviews, message testing, and literature reviews. With the help of consultants, GRAG creates a set of principles and related values for each major legislative issue. These documents guide NHC in evaluating bills, drafting legislative language, asking patients to contact Congress, and articulating the NHC position to the public and elected officials. Our clearly defined, written values and principles make it possible for us to see the positive, work around the negative, and be nimble to address changes based on new intelligence.

I can't think of a time when a patient advocacy organization got its way 100 percent on an NHC policy position. Typically, most members get 80 to 90 percent of what they want. But in the meantime, these organizations don't die on their swords. We collectively keep moving forward, because together we all recognize that our goal is to improve the lives of the end users, the patients we serve.

The NHC policy-development process is not for every organization. I present it here only as an example of what we do to address any fears and to strengthen our collective resolve. We need to listen to and glean from different points of view, particularly those opinions that disagree with ours. If data come to light that show a position has threatening implications, we should seek to resolve the issue head-on but not leap to a position of inaction or opposition. I believe the more practical action is to change the language of the situation, restructure the debate, and create an alternative, more nuanced solution. What we must strive for is not a middle ground, but something more sophisticated. I would call it passionate pragmatism.

Myrl Weinberg, CAE, is president of the National Health Council in Washington, DC. Email: [email protected]

Myrl Weinberg, CAE