“Only rich people can afford an advocate.”
Or: “Doesn’t providing private patient advocacy services only to those who can afford them, just create one more division between the “haves” and the “have nots?”
Or: “Not everyone can afford an independent patient advocate. It’s unfair some people can’t be helped.”
Anyone who has worked in advocacy or care management has heard one or more of these statements, or at least one from the same playbook. It’s an objection meant to put us on the defensive, as if, since private advocacy can’t be provided to everyone, then we shouldn’t provide it to anyone.
Don’t let anyone put YOU on the defensive this way! It’s a foolish argument. Here’s why:
We’ll begin with a simple statement: anyone who needs an advocate or care manager, anyone who is challenged by the healthcare system (whether or not the patient even realizes he or she isn’t getting what is needed), anyone who could enjoy a better outcome than will happen with no assistance from an advocate…. deserves the support of an advocate.
Few people would disagree with that statement.
The foolish question is whether everyone deserves the help of private, independent advocates.
It’s foolish because the answer is obvious – of course everyone also DESERVES the help of a private advocate!
The question is whether they can afford to PAY someone to help.
And, sadly, not everyone can afford such a service. That’s true! Not everyone who needs an independent advocate can afford to pay for an independent advocate.
But is that unusual? Not at all! There have always been people who could, or could not, afford what they need and want. Not everyone who needs a home can afford a home. Not everyone who wants a college degree can afford a college degree. Not everyone who needs a lawyer can afford a lawyer. Etc., Etc., Etc.
NO ONE CLAIMS – ever – that since not everyone can afford a home, or a college degree, or a lawyer – therefore no one should have them! It’s just understood that not everyone can. It may not be right. It may be uncomfortable. But it is what it is.
And, similarly, not everyone can afford to hire an independent advocate. But that doesn’t mean that no one should have the ability.
This gets me thinking about other aspects of our lives where the “haves” might be defined a little differently, too.
- Millions of kids go to private schools, including religion-based parochial schools – not because their parents have a lot of money, but because their children’s educations are so important to them that it’s worth the extra expense.
Not everyone can afford to send their kids to a private school. But doesn’t that mean that, therefore, no one should send their kids to a private school.
- We used to get TV over the broadcast airways. Then along came cable TV companies. Their service was superior to over-the-air rabbit ears, but not everyone could afford (or wanted to pay for) a cable subscription. Today most of us have some sort of paid subscription for better service than over-the-air. No one ever suggested that since some of us could not afford such improved service then none of us should have access.
- Another example: when the internet was first available to the public, not everyone could afford it. Only those who could afford an internet subscription had access. No one said then that since everyone couldn’t access the internet, then no one should.
Eventually internet access became available to everyone through local libraries and schools.
Of course, we can also hope there comes a time, even if it’s years from now, when independent advocacy becomes more easily available to those who don’t have the means today.
But for now, I say – don’t let anyone put you on the defensive about your work as an independent advocate. Your work is important to anyone who can afford to pay you. Just because someone else might object, or not be able to afford your services (or would prefer not to, even if they can), doesn’t mean you shouldn’t continue your important patient-client support.
Instead: double down! Defend your profession! Go on the offense! Proudly make it clear that you are there to help those who can afford, and are willing to pay for your services because that’s how you stay in business so you can help even more people.
As a group of professionals, we must continue to assert our incredibly valuable role as being available to those who can afford our help, and dismiss the objections of those who would argue against our role for any purpose.