Planning a Campaign to Take On the Health Insurance Industry: Initial Lessons
Over the last three months, a working group of GlobeMed Alumni have been designing a new campaign to help end the practice of profiting off of people when they are sick.
As organizers and advocates, all of us have had first hand experience with the United States’ unjust health care system. Many of us have seen our own families and communities struggle to get health care because the current health system puts US industries profits over people’s health.
But many of us have also spent enough time working and studying in other countries that do guarantee health care as a basic right to know that something better is possible for our country. So we’ve been working on designing a campaign to help make that a reality.
Below is a summary of our work and learnings from our first 12 weeks of designing this campaign. If you’re interested in helping us develop our campaign further, we hope you’ll find the information below useful.
Our Starting Point
The foundation for our campaign has been three core beliefs:
- It’s Morally Wrong to Profit Off of People When They’re Sick: We believe it’s deeply wrong that corporations (e.g. health insurance, for-profit hospitals, big pharma) profit off of people when we’re ill and at our most vulnerable. We believe that health is a human right and want to change our health care system in the U.S. to reflect justice and basic human dignity.
- A Social View of Power Leads to Transformational Change: History shows us that large scale, transformational change doesn’t come by persuading political leaders at the top to change their minds, but by reaching a tipping point of ‘active popular support’ for an issue among the public. Like the Civil Rights movement or the fight for marriage equality, we aim to ‘change the weather’ of what’s politically possible to create systemic change.
- Our Generation Has A Core Role To Play: As millennials we all have a particularly critical role to play not only as the generation that will be affected by the health care system for years to come, but because young people have often played a leading role in making large scale change possible.
What We Worked On
From January — April, 2017 we began designing the following materials to help us launch our campaign:
- A “DNA” for our campaign (including the campaign’s strategic objective, story, strategy, structure, and principles)
- A 90-minute online training and a 75 minute in-person training introducing our core beliefs and a crash-course on the insurance industry
- A guide on health care in the US, and the effects of a partial or full repeal of the ACA.
To help provide a structure for our DNA, we’ve drawn on the DNAs of Movimiento Cosecha and IfNotNow — two contemporary movements using a social view of power to demand dignity and justice for undocumented immigrants, and end support for the occupation in Palestine.
What We’ve Learned So Far
Through the process of beginning to create and test the materials above, we’ve learned a number of lessons that are helping us design this campaign:
#1: Our Moral Framework Resonates Strongly With Our Core Audience
Our moral stance resonates very strongly with our core audience — millennials who care about health equity. From the conservations we’ve had and surveys we conducted, all of our training participants agree that health is a human right and that it’s wrong to profit off of people when they’re sick, suggesting that the moral foundation for our campaign is solid.
#2: Health Insurance Is The Right Focus For Our Campaign
This was one of our biggest learnings. Early on in the process we identified the main industries that profit off of people when they are sick in the US: the insurance industry, the pharmaceutical industry, and certain private providers. Initially, we considered focusing on pharmaceuticals because of high drug prices. But we also felt that while there are alternative systems for drug development, they are far less clear than those for health insurance (such as single payer in the UK or truly nonprofit insurance in Switzerland) potentially making change in health insurance more possible.
As we continued our research, we also saw that the push by Congress to repeal the ACA and the growing threat of insurance becoming unavailable in certain places across the country, was raising a general awareness among the public about health insurance. We even began to read articles that suggested that Americans of all political stripes may support single payer.
In addition, we started seeing other health advocates gain momentum for the right to health care, and felt that our campaign could play unique role at this moment in time; we can build active popular support among our generation to end support for the health insurance industry, and other groups can use that momentum push forward policy reforms such as single payer health care. Leaders at health advocacy organizations like Public Citizen affirmed this, telling us that the insurance industry was a good and unique target for us to focus on.
Lastly, it was clear from the surveys we conducted of GlobeMed alumni and students that they saw the insurance industry as “most responsible for health inequity in the US” compared to other industries. This number grew even higher (by about 20%) after participating in one of our trainings, suggesting to us that there was strong support among our core audience for a campaign focused on health insurance.
#3: The Social View of Power Is Not Most People’s Default View
From our earliest conversations it became clear that understanding the social view of power is difficult and most of us hold a monolithic view of power. At the end of our first training we tried to have a discussion with participants about where we might have power to change the system, but most kept suggesting tactics that assumed a monolithic view of power (e.g. lobbying elected officials).
To remedy this, we added an additional section emphasizing the social view of power in our second training, drawing heavily on the work of the Momentum training institute and movement incubator.
As a result, at the end of the second training we did see more participants adopt social view of power compared to those taking a monolithic view of power. However, our initial difficulties in achieving this suggests that it is not most people’s default view and requires continual emphasis.
After our second training, 94% of participants agreed that “social change happens through nonviolent protest” and that “social change happens through encouraging widespread non-cooperation with unjust systems,” compared to only 89% agreeing that “social change happens through citizen lobbying” and only 74% agreeing that “social change happens by targeting politicians to change their minds” suggesting a preference for the social view of power.
#4: Finding Where We Have Power Is Challenging
Once we identified health insurance as our focus, we attempted to determine where our generation may have power to non-cooperate or otherwise withdraw tacit consent from the current unjust system. We have brainstormed different ideas where we may power, such as the fact that some of us provide our labor to the health insurance industry, but it has proven to be challenging to find where we give tacit consent in the system.
However, one key insight we did receive from feedback in our trainings was that the reason our generation matters in particular, is because we largely help subsidize the costs of health care for the rest of the system. As a generation, we require less healthcare than other age groups and therefore the money we pay health insurers (through premiums, taxes, etc.) does NOT ultimately come back to us in the form of health care, but instead goes to pay for the high administrative costs and profits of the health insurance industry. This gives us a moral claim to say that we want our money to be used not to line the pockets of insurance company CEOs but to provide health care for as many people as possible.
Lessons Learned About How We Work Internally
As a team that is spread across two continents and multiple states we have found that it is just as important for us to pay attention to how we do our work as the content of our work itself . Some things that have worked well so far are: having a core set of group principles and norms including “time-boxing” ourselves and maintaining a “golden circle of trust” in our discussions; splitting up work into discrete projects and communicating clearly about responsibilities for each; and frequently communicating through videoconference calls and Slack. Areas of improvement include keeping group members updated about what is happening in the rest of the projects, and not letting any one person become a bottleneck for the team as a whole.
Open Questions & Upcoming Work
These initial 12 weeks of work have helped us answer many initial questions about our campaign, and left us with new strategic questions as well:
- How much should we emphasize “health is a human right” — which fewer people may agree with — versus only emphasizing that “it’s wrong to profit off of people when they’re sick,” which more may agree with?
- What kind of structure do we want for this campaign and what kind of legal, staffing, and financial infrastructure do we want? What is our position on accepting money for the campaign and from whom?
- How broad or specific do we want to be in each of these and other areas of our campaign?
Over the next 3 months, we will continue working to answer these and other strategic questions through further developing and beta-testing our DNA as we move closer to launching our campaign. The need to take action is clearer and more urgent than ever, and we hope that through being thoughtful and continuing to learn we can build something truly powerful together.
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