Learning to Effectively Advocate

We are about half-way through our service term, and the New Year has just begun, a perfect time to reflect! These last 4 months of service have been a worthwhile, challenging, and eye-opening experience. Above all, I have learned that navigating our healthcare system is not easy, and my role here, however modest, is to try to make the lives of those I serve healthier and less complicated.

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I serve as a Patient Advocate at Health Center 3, and most of my patients are low income and either uninsured or underinsured. These factors make navigating our healthcare system even more difficult. I have had patients come into my office stating they must choose between buying medication or putting food on the table. Not surprisingly, the choice is often the latter. This is where my role as an Advocate comes in, alleviating some of the challenges associated with our healthcare system, by addressing barriers to care head on. Most of my job revolves around helping patients obtain prescription medications at low or no cost. Sometimes this process can be quick and painless, but more often it requires significant communication between doctors, nurses, pharmaceutical companies, and the patient, for which I act as the liaison.

Through assisting patients in trying to get appropriate medicine, I have learned first hand how tied our healthcare system is to insurance coverage. It seems that virtually every medical decision is made within the patients’ insurance parameters, a frustrating but illuminating insight. This means that advocating on behalf of underinsured/uninsured patients is crucial.

I’ll never forget one of my first patients from back in September. This patient qualified for insurance under the Affordable Care Act, something that most people would see as a positive thing; if the patient is insured, problem solved, right?  Wrong. The patient was paying a high premium, was making minimum wage, and could not afford the medication co-pay even with insurance. After we applied for prescription assistance, the patient was denied due to insurance coverage. As an advocate I had to challenge this decision, and drafted an appeal proving that the patient could not afford the co-pay and still pay the bills and buy groceries. Even after all of that, the patient was still denied the discounted medication.

I got in touch with the patient’s doctor, and we discussed several medications that the patient could take. Though there are often multiple medications that work in the same way, the price of different medications can vary greatly. We eventually found a new medicine for the patient that was free of cost, and the entire process took about a month. It is through experiences like this that I see where our healthcare system must be improved, and I realize just how impactful strong advocating can be. It is unknown how exactly the healthcare industry will be altered in the coming years, but I know for certain that in order to make change and to make this country healthier, advocates must relentlessly work to support those who need access to affordable care, one patient at a time.

This blog post was written by NHC Philadelphia member Blaire Frett.
Blaire serves as a Patient Advocate at Philadelphia Department of Public Health Ambulatory Health Services - Health Center 3.