Providers as the “Grass Roots”
Using the Medicare bill just passed in the US Congress as an example, providers understand the
larger issues Congress faced in putting the bill together. Factors such as co-payments, out-of-
pocket expenses, drug formularies, and drug pricing are all issues providers face daily. One cost
containment provision of the bill, however, limits coverage to Americans who are dually eligible for
both Medicare and Medicaid. Many medical providers around the country explained to their
legislators how that one provision would negatively impact individual patients currently in care. Since
then, Health and Human Services Secretary Tommy G. Thompson has pledged to correct the
language before it takes effect. Advocacy at work!

Providers themselves are a “grass-roots” community and can be a powerful force when working
together. Most people equate grass-roots activism with images of seasoned campaigners, political
junkies, and angry protesters, who seem overly involved in the political process. The truth is that
voicing your opinion and speaking your mind does not demand painting signs, attending conferences,
or devoting yourself to the political process. Being an advocate can be as intimate as a phone call.
Your representatives in Congress care what you have to say. They depend on your vote and bank on
your ability to sway others to your side. Further, as medical providers, our voice—right or wrong—
does carry a particular weight. And when we voice ourselves in concert with one another, our
influence rises exponentially.

Illustrating the Power of Collective Voice
The American Academy of HIV Medicine (Academy) recently galvanized its members on drug
access for its patient population. Currently, we are facing a financial crisis in the AIDS Drug
Assistance Program (ADAP), a program that provides treatment to underserved populations
throughout the country. A mass coordinated letterwriting campaign among members of the
Academy led to a groundswell of participation among HIV providers. Of the 1600 members of
the Academy, 800 of them participated—generating more than 2400 individual letters to both
their senators and their representatives, urging that the program be appropriately funded—to
stamp out the program restrictions that endanger the very lives of our patients. To have a
50% response rate in an advocacy campaign illustrates not only the extent of provider concern
for our patients’ wellbeing, but also our increasing interest in the political process.

Individual Academy members continue to lobby for action on a number of issues. Academy
members are visiting local Congressional offices, faxing letters, making phone calls to encourage
the passage of the Early Treatment for HIV Act (ETHA), which would give states the option of
expanding Medicaid coverage to people living with HIV disease that are not yet fully disabled by
AIDS, as is dictated under current law.

How to Learn
Medical providers’ participation in political advocacy has less to do with their motivation and more
to do with their education. Providers want to voice their opinions, but we need to give them the
tools to do so. We have a responsibility to educate one another on the issues that are important.
ADAP, ETHA, and other acronyms will forever dull the interest of the medical provider if we don’t
stay compelled to teach each other what these acronyms mean and how they play out in our centers
of care. There are a number of front-line issues that affect many of our patients with which we need to
shape federal policy, such as viral load testing, resistance testing, and substance abuse treatment.

The Academy is looking forward to more member-wide campaigns next year, where the voice of the
HIV medical provider can effectively sway legislators on the federal, state, and local levels to do the
right thing.