What is Giving Compass?
We connect donors to learning resources and ways to support community-led solutions. Learn more about us.
America's healthcare sector spent $509 million in 2016 lobbying the federal government on behalf of hospitals, drug makers, doctors and health insurers. It spent another $266 million in 2015-16 on political contributions to sway federal elections. It devoted tens of millions more to influence policy in the states.
No other industry spends more money for a seat at the table with elected leaders and regulators at every level of government. In contrast, political and advocacy health spending on behalf of consumers and the public is negligible. Such spending is so small that it's not included in the federal lobbying and election expenditures databases. Consumer health doesn't even register as a category.
At stake is the direction of a $3 trillion U.S. healthcare system and the well-being of 320 million Americans.
This lack of alignment between the public interest and political influence on health issues has long concerned some foundations and philanthropists, and there's a long history here. But lately, we've seen an uptick in giving as new mega-givers try to level the playing field.
But Jake Williams, the executive director of Healthier Colorado, a 501(c)(4) created by the Colorado Health Foundation, believes that more funders need to get political—and he shows a way to this.
In a recent white paper, Williams writes that "Americans do not have a focused political apparatus to effectively advocate for their health interests. This void is conspicuous given that Americans have dedicated advocacy infrastructure working on behalf of their interests in realms including environmental, civil rights and reproductive issues."
Williams sees a critical role for philanthropy in empowering citizens at both the national and state levels when it comes to health issues. He sketches out steps that could be taken both nationally and in the states, and how such work could be coordinated and funded over the long term by foundations.
He explains, "Once these structures are created, 501(c)(4) funders or those with (h) election capacity can fund at least part of the lobbying activities of these advocacy organizations. Finally, many expenses incurred by these advocacy organizations are not expenses for which lobbying-eligible dollars are required, and thus any funder could fund those activities through an attached 501(c)(3) organization."
A bottom line, says Williams, is that politicians must come to understand that votes on healthcare will be remembered at election time, and that won't happen absent a strong advocacy infrastructure that works on behalf of the public's interest. Philanthropy can and should help build that infrastructure.