Resolution writing to spur change
By Anna Zelivianskaia
Chicago Medicine, April 2016
In a world with rapid news cycles and constant updates, medical students have found a way to make lasting change. Through the Chicago Medical Society they are introducing and advocating for resolutions on issues that are important to them. James Curry, an MD/MPH candidate at the University of Illinois at Chicago, submitted four resolutions for CMS Council approval. All were adopted on February 9. When a resolution is adopted, it becomes part of the CMS policy and advocacy agenda. Depending on the goals of a resolution, its outcome may be a research initiative, lobbying agenda, support for legislation, or another mechanism.
Curry describes this process: “To begin the process, you should ask yourself three questions: ‘what problem exists, what are we already doing about it, and what can or should we do to address it?’ The first and most important step is having an issue you are passionate about. Without that, everything seems like work.” Next, he recommends learning what the current CMS policy is and finding relevant language: “This answers, ‘what are we already doing?’ My process has always been to write the best supported resolution for the problem, regardless of current policy. Then, go back and tailor the resolution around existing policy.”
This process may require you to add a completely new policy, amend, or strike existing policy. Each resolution calls for a general type of outcome and has a specific structure. “There are three outcomes a resolution can seek to accomplish: an action, a position statement, or both. An action is anything that will be done by the organization. A position statement helps solidify or establish policy on what the organization believes. There are two parts to a resolution: the preamble and the resolves. Preambles or Whereas clauses explain the need for the resolution, while the Resolved clauses state what the new policies should be or what actions the organization should take. Resolved statements become the adopted policy; they must be written to stand alone, as self-contained, self- explanatory statements. Each clause is short, clear, and to the point, with appropriate citations.
One of Curry’s resolutions called for support of a single-payer healthcare system in the United States. This issue has been debated vigorously, and he did not feel it was controversial: “I was unaware that a single-payer style resolution was needed at CMS because the majority of medical organizations (student or physician) support so many of its core principles already. We should strive for a clear understanding, endorsement and action to accomplish healthcare for all and health justice. Resolutions and policy are the best starting point to address and materialize single-payer – not just give the impression.”
He based his resolution on one already proposed by Dr. Peter Orris, but with some amendments. Curry was thrilled that “the resolve (action) that survived and was adopted commits CMS to study the “benefits and difficulties of instituting and maintaining a single-payer healthcare system, in Illinois, and in the United States. This study will consider economic costs along with outcomes and improvements in health and health disparities.” Thus, the outcome is a CMS research initiative.
The resolution was subsequently considered by the Illinois State Medical Society, which recently voted to study a single-payer healthcare system.
Resolutions like this provide an example of CMS representing the policy interests of Chicago-area health professionals. These are fluid as medicine and policy constantly change, but guiding change requires speaking up.
Many health professionals and members of the public still feel healthcare reform is needed. It is a fact that the U.S. spends more per capita on healthcare than other developed nations in spite of having some of the worst health outcomes. When asked why he believes single-payer is the best strategy to bring about positive change, Curry answers: “Whether it’s family, friends, or ourselves, we have all fallen victim to thinking our health insurance is good, until we need it most (all the while, suffocated by enormous costs). After succumbing to the traps of bills, denials, approvals, changing physicians and care each year, I see the exact same thing from the other side of the table as a medical student, looking up to residents and attending physicians.”
Many people doubt change will come if there is no catalyst – if no one stands up and asks for it. That is simply untrue because many forces make change inevitable and we, as students and physicians, must work with them to transform our healthcare system into one we will still want to work in 10 or 20 years from now. Curry aptly summarizes: “Classes of health insurance mean classes of health. How am I to determine who to treat based on anything other than need?” Writing CMS resolutions is a powerful way to get heard.
Anna Zelivianskaia is fourth-year medical student at the University of Illinois at Chicago. Anyone with comments about this article may reach her at firstname.lastname@example.org.