Some years ago, I lobbied to change a Medicaid system predisposed to nursing homes rather than the state providing much less costly equivalent care in a person’s home. Being heard in committee just ahead of mine was an unrelated bill to expand the scope of practice of non-physician health care providers, mainly advanced practice registered nurses (APRNs), to prescribe medications.
Specifically, certified pain medicine specialists were in cities but not in this largely rural state’s poor hollers. The bill would facilitate APRNs filling the health care gap.
Rows of physicians dressed in white lab coats faced the committee. They warned only medical doctors could prescribe opioids and APRNs would kill people. A few lawmakers countered that their constituents weren’t going to get pain relief without APRN help.
As the hearing devolved into a “turf war” – physician vs. APRN, urban wealth vs. rural poverty – a committee member turned on his microphone and addressing the doctors said, “My constituents aren’t the kind of people who come to the capitol in their Escalades to tell me how to do my job.” He seemed to be ignored.
The average viewer might not have caught more than a lawmaker’s peevish word. But so much more was being said. His sentence acknowledged the turf war. And in a word he said the bill was dead; so dead APRNs even in the remote mountain counties hardest hit by opioid abuse couldn’t prescribe the anti-addiction medication buprenorphine.
Of course, most committee meetings are just theatre. (Fundamental number 15 on Effective Lobbying Is Getting Votes! 27 Fundamentals for Successful Lobbying) The bill likely had been defeated earlier in private. Perhaps that was why he seemed to be ignored. He wasn’t in on the deal. Our 27 Fundamentals may help your members, staff, and clients better understand and deal with what’s truly going on in plain sight. It’s available for free at insiderstalkwinning.com.