Health care is an issue at the center of the 2016 presidential election, with cancer among some of the top concerns. Alec Stone, MA, MPA, the health policy director at ONS, discussed the latest on the political and policy scene and  valuated the candidates based on how they line up with the ONS health policy legislative and regulatory agenda. Though he cautioned that with this election, “No one knows how this will turn out!” 

Stone has spent many years legislating on behalf of ONS and has many a time heard nurses lament, “No one will listen to me, I’m just a nurse.” This is not true, he stressed, noting that nurses are the number one most trusted health advisor. They speak on behalf of the patients rather than on personal and economic factors, and because of that are unbiased arbiters of health care policy.

Because nurses play such an important role in the patient-provider interaction, “Advocacy makes a difference. Even just one email to your Congressional office,” is important, said Stone. He stressed that all politics is local and nurses should let their voice be heard. “Be active in your chapter,” he said.

He began by discussing some of the most important health policies he lobbies for on behalf of ONS.

  • Palliative care
  • Access to preventive care
  • Nursing workforce contributions to safeguard the public (e.g., lobbying for recognition of health hazards for nurses who are subject to risk on the job)

As part of his job, Stone noted, “I spend time explaining to legislators the difference between palliative care and end-of-life care. They think both are a transition to death,” though that’s not the case, Stone said.

One of the biggest healthcare components at the center of this election is the Affordable Care Act (ACA). Stone said that “most” U.S. residents have health insurance and mentioned some important aspects of the law.

  • Immediate access to coverage
  • No barriers for preexisting conditions
  • Expanded coverage for dependents until age 26
  • No lifetime limits on coverage
  • Public health and prevention (e.g., preventive care and screenings)
  • Reduction in Medicare Part D coverage gap

Depending on who the next president is, the health law could face some serious hurdles and/or changes. However, Stone said, “More Americans expect some form of health care. Even if [the ACA] is repealed, it will need to be replaced with something [else]. It is going to be very difficult for any politician to put out a plan [for the presidency] that does not include health care.” 

In addition to the ACA, cancer is currently at the forefront of health care with Vice President Joe Biden’s National Cancer Moonshot Initiative recently underway. Many advances have been made in terms of cancer survival, particularly for lung, prostate, and breast cancers. Although the mortality rates from cancer have decreased since 1991 (down 23%), new cases of cancer remain high, as an estimated 1.6 million new cancer diagnoses are made annually.

Some of the goals of the National Cancer Moonshot Initiative include 

  • Targeting federal agencies that can contribute funding and research
  • Preventative vaccines
  • Early detection
  • Genomics
  • Data sharing
  • Immunotherapy and combination therapy
  • Pediatric care.

The Moonshot program is “not a new thing, but [it is] the latest thing,” said Mr. Stone, referring to the early 1970s “war on cancer,” spearheaded by former president Richard Nixon. He noted that even the title “moonshot” indicates that its intentions are “almost out of reach.” With just a few months remaining for this administration, the initiative is “not great timing,” said Stone. “[However,] to his credit [Vice President Biden] has moved quickly” since President Barack Obama announced the Moonshot project earlier this year. The National Institutes of Health (NIH) is looking to move “real” dollars, Stone mentioned, into cancer research very soon with the purpose of accelerated new detection and treatment developments. Vice President Biden says he is keen on cutting through the bureaucracy that slows down grants and studies for healthcare development.

In addition, Deborah K. Mayer, PhD, RN, AOCN®, FAAN, an ONS past president, is the only nurse on the Blue Ribbon Panel, comprised of scientific experts, cancer leaders, and patient advocates that will inform the scientific direction and goals at the NIH for the Moonshot program. Stone said he is “confident that she will make sure nurses are involved,” though he lamented that out of all of the healthcare representatives on the panel, just one represents the nurse’s voice. It appears that the Moonshot program is receiving bipartisan support thus far, according to Stone.

When discussing where the latest candidates stand on health care, Stone gave a brief overview. Senator Bernie Sanders believes health care is a right; however, “He does not really go into how to pay for it,” said Stone. Former Secretary of State Hillary Clinton supports the ACA as is, although she questions the widespread use of opioids in the United States. Stone predicted that she could implement a nationwide crackdown on opioid use, which could negatively affect patients with cancer and survivors who use opioids to manage pain. Donald Trump has noted that he would repeal the ACA and modify the existing law. “His opinions sound a little more Democratic than Republican,” said Stone.

He went on to make some predictions about the election: Donald Trump will become the Republican nominee (he made this prediction but before the other candidates dropped out), if he begins to pivot toward the center after the primaries, he will lose voters in the general election. He predicted that it will be “very tough for him either way to win the presidency.” As for the democratic candidates, Stone noted that Senator Sanders is “losing steam” after laying off nearly one-fourth of his staff just recently before the ONS Congress. Former Secretary of State Clinton has a poor approval rating, he noted, saying, “She can’t win unless she runs against [Donald] Trump.” Predictions aside, Stone concluded, “It will be interesting to see how this plays out. No one knows what’s going to happen.”

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