Professional advocacy is one of the major professional responsibilities of every physical therapist and physical therapist assistant.
The traditional tools discussed for advocacy are communicating with legislators and donating to the Physical Therapy Political Action Committee (PT-PAC). PTs and PTAs are commonly encouraged to call, tweet, email, or meet with their legislators to educate them about our physical therapy issues and ask for or thank them for their support. Donations to PT-PAC or state level PACs are routinely solicited in order to help elect PT-friendly candidates.
There is another powerful advocacy tool that is rarely mentioned by APTA or PT-PAC. Voting. Voting might be the PT, PTAs, or student’s most powerful tool for political advocacy.
Every vote is incredibly valuable and each year election campaigns spend millions of dollars to try to earn enough votes to win.
In Montana, during the last Senate midterm election of 2014, GOP candidate Steve Daines spent approximately 6.7 million dollars and received about 214,000 votes. He won the election by spending about $32 per vote. PT-PAC has an infamous line: “If every physical therapist gave $20, we’d be the biggest PAC in the country.” If every vote is worth $32….you do the math. The $6.7 million Senator Daines spent in that election does not include the millions which outside groups like PACs and Super PACs spent to help or attack candidates.
Every year candidates and campaigns from both parties spend more and more money. The Center for Responsive Politics reports that for this year’s Senate election cycle, total spending between candidates and outside groups has exceeded 40 million dollars for no less than 9 different campaigns. The most expensive, the Florida Senate race, has spent $113 million between candidates and outside groups. However, this year PT-PAC has spent less than one million dollars ($865,000 to date) across the country. We are a drop in the bucket of political money.
If we neglect to vote it’s like we’re throwing money away or failing to cash a check.
As PTs and PTAs, if our political strategy involves only donating money and emailing legislators we will lose every time; there are many other groups with more money and stronger grassroots networks.
Whether or not the candidate you vote for wins, the legislator will take you more seriously simply because you voted. Voter turnout influences legislators reasoning independent of election outcome. Voting history (not who you voted for, but IF you voted) is a matter of public record and largely determines one’s credibility and importance as a constituent. This information, available to everyone from legislators themselves, to polling firms and political action committees includes name, street address, any party affiliation, and elections voted in- including whether by mail. When attempting to contact a legislator your voting history might be the difference between the legislator returning your call and ignoring you.
No matter how many tweets, emails, or phone calls you make if you don’t vote- it is very easy for your legislator to ignore you.
Research has shown that healthcare providers are less likely to vote than other professional groups. These researchers found that physicians vote at a rate 9% less than the general population, and 22% less than lawyers. More specific to PT, a DPT Research Paper from St. Catherine’s University conducted a qualitative study regarding political participation in Physical Therapy and reached some interesting and relevant conclusions:
It seemed that the majority of physical therapists in this study were overwhelmed with or confused by the political process itself, perhaps discouraging their participation or even awareness….
…physical therapists overall, did not view personal political participation as a tangible part of their professional role….
…they did not seem to identify personal political action with their role as a physical therapist…
…If this sample of physical therapists is representative of the profession as a whole, then physical therapists are not only not representing themselves as a strong voice politically, but are failing to recognize the importance of this process at all.
Election results matter and often every vote counts.
There have been instances in U.S. history where elections have been decided by just a couple votes. In 1974 a New Hampshire Senate race was decided by two votes out of 223,363. The 2008 Alaska congressional race was decided by a single vote out of 10,035 votes cast. More frequently, tight Senate and House races where hundreds of thousands of votes are cast can be decided by just a few thousand votes.
The laws that are passed or (not passed) by Congress matter.
Every year Congress decides funding levels for Medicare and Medicaid or if health insurance will be required to cover rehabilitation or other essential health services. Currently Congress is supporting short term health plans–health insurance without essential health benefits for up to 3 years.
Many elections also have local ballot initiatives or bond measures.
For example, Montana has a initiative to permanently enact the Medicaid expansion of the Affordable Care Act. The initiative, which is supported by nearly all health-care organizations in the state, is paid for by a tax on tobacco products. In Massachusetts, the first question on the ballot pertains to nurse: patient ratio. While this seems out of scope, changes to this may result in payment cuts to PTs and PTAs; the Wall Street Journal Editorial Board excoriates the ballot measure, stating “Massachusetts has some of the best medical care in the world, but a ballot measure next month could start its erosion by raising costs and reducing access.”
Leaders of the Department of Health and Human Services and the Center for Medicare and Medicaid Services (CMS) are appointed by the executive branch and many are approved by the Senate.
All those onerous and unfavorable Medicare rules from CMS? You have them to thank. You can complain to APTA, or remember and consider the rules when it comes time to choose the nation’s next leaders.
Neither APTA nor PT-PAC will tell its members who to vote for. As a bipartisan professional association APTA will not endorse a candidate or political party. APTA has to and will work with whatever Senate and House of Representatives it ends up with, but let’s be honest: The composition of the House and Senate come January 2019 does matter. Some legislators are consistent sponsors and champions of our issues, while others are not. It falls to you to do your research to make an informed decision on November 6th.
Not sure what to look at when evaluating a candidate? Here are some places to start:
- Their voting record, and or public positions on APTA’s key legislative priorities.
- Their voting record or positions on issues that affect our patients such as but not limited to: access to insurance, funding for Medicare, Medicaid, or CHIP.
- Accessibility and responsiveness to constituents.
- And last but certainly not least their personal integrity and character.
Voting is a very personal topic and both the decision to vote and the choice of who to vote for is informed by a myriad of factors, values and beliefs. Consider adding your profession and your patients to your list of reasons to vote and be politically involved. Is voting a professional obligation or a civic duty? It could be both, but for whatever reason you choose on November 6th, just vote.
Want to win a ticket to the PT PAC party at APTA’s CSM? Check out our #PTVotes2018 Contest!