Changing social policy: Grassroots to legislation

Abstract

Health care in the United States has evolved into a multimillion dollar business. As the health care industry has grown, so too has government regulation and involvement. As both insurers and patients vie to get the most for their health care dollars, federal and state governments attempt to mediate, prevent fraud and abuse, and protect all parties involved. Consumers feel the effects of this “tug of war” in the form of higher copayments, premiums, and out-of-pocket costs, as well as denial of coverage. This denial of coverage sparked a very successful grassroots effort to stop commercial insurers in the state of Connecticut from defining ostomy supplies as cosmetic and thus denying reimbursement. A tremendous amount of collaboration between Connecticut WOC nurses, state legislators, local American Cancer Society advocates, United Ostomy Association chapter members, and health care providers resulted in a powerful mobilization and support for House Bill No. 5120. This bill went beyond defining ostomy supplies as medically necessary but also set a minimum rate for reimbursement. Social policy changed, improving the lives of Connecticut citizens with an ostomy. Although many people fear they do not have the power to make necessary changes in government, this experience proved otherwise. The collaboration that occurred was patient advocacy at its best. This article describes the process that allowed this successful collaboration to take place with the hope that others will be inspired to get involved with patient advocacy through political involvement. It is the intention of this work to capture the essence of dedication of a grassroots campaign involving a small group of well-organized, highly focused participants who were responsible for changing public health care policy in the state of Connecticut. (J WOCN 2002;29:149-63.)