Planned Parenthood provides birth control, screenings for cancer and sexually transmitted diseases, and other forms of preventive care. These services are funded by Medicaid disbursements. Abortion services – which represent 3% of the healthcare they provide – are privately funded. Despite the constitutional right women have to legal, safe abortions, the federal legislation known as Title X and the Hyde Amendment prohibit federal funds from being used on abortion.

Planned Parenthood’s response to the current controversy is that it provides tissue with the consent of the mother, and the recipient pays for the cost of the procedure to procure the tissue. Some would argue that’s semantics. Either way, it has led to the withdrawal of Medicaid funds by four states—Alabama, Louisiana, Utah, and Arkansas. The federal government has already warned that this tactic violates federal law as states are prohibited from restricting providers available to Medicaid recipients. The Department of Health and Human Services also sent a letter to Congress assuring that no federal law is being broken and no criminal charges have been laid.

The people who most need sex education will be the most hurt if Planned Parenthood closed its doors. They are the ones who have the least voice in our community — young and low-income women, women of color, minority women. They will have a much harder time finding the services that Planned Parenthood provides, and that have helped protect the health of our children and families during the economic downturn.

Planned Parenthood provides a range of services that are outside of the spotlight of the cameras and the notoriety but these are the things that will make a difference, including helping women and families get insurance coverage, educate teens about pregnancy prevention, and even help improve high school graduation rates.

Contraception is the best anti-abortion, poverty-prevention program we have. Addressing the situation into which children are born needs to be a key component in our fight against poverty across the US.

Yet, many Republican state legislators, and presidential candidates are bragging about how they have slashed state funding for pregnancy prevention services and plan to shut down Planned Parenthood. Asheville Congressman and Tea Party champion Mark Meadows (R-NC) has elevated his standing as a member of the House Pro-Life Caucus, by signing on as a co-sponsor to H.R. 217, which would eliminate taxpayer funding for Planned Parenthood under Title X. With the controversy against Planned Parenthood proving to be a political stunt, Congressman Meadows efforts now look as ill-informed and unsupported as his plans to take away the gavel from House Speaker John Boehner.

The long-term impact of regressive and punitive policies and refusal to put resources behind data-driven solutions will increase child poverty rates and ultimately increase budgets for the government-funded health and social services Republicans already treat with contempt. These facts may be helping deflate the anti-Panned Parenthood campaign by states and GOP candidates.

Both sides agree that we must improve knowledge and attitudes about ways to prevent unintended pregnancies so that women can make better-informed decisions. One approach would be to direct the U.S. Department of Health and Human Services’ Office of Population Affairs (OPA) to use Title X monies to fund education of women about the safety, effectiveness, and convenience of long-acting reversible contraceptives, targeting low-income women between the ages of fifteen and thirty. If the current controversy sparks actions like this, it could be a milestone in advancing women’s health and reducing child poverty.

48 years after Roe v. Wade, when the U.S. Supreme Court declared pregnant women would have access to abortion until the end of the first trimester without any interference by the state, abortion rights may trigger a government shutdown this fall, and will continue to be part of the presidential election campaigning over the next year.

A month after the videos became public, the allegations against Planned Parenthood are proving unfounded. Despite the heated controversy about abortion, making this an election issue is an important opportunity for progress in women’s health, poverty and reproductive justice. And with the added and unintended consequence of keeping the doors open at Planned Parenthood and reducing abortions.

To go big, you have to think big. To think big, you need aspirational goals.

David and Goliath

Aspirational goals are those big ideas that people and groups need to succeed in the future but lack in the present. Malcolm Gladwell wrote about the power of aspiring to be more than you are in his bestselling book – David and Goliath – Gladwell describes how, people labeled as “underdogs” use that status to leverage unconventional powers.

For the David and Goliath-like community coalitions that I work with, joining forces around big, aspirational ideas is the driving force for change.

Coalitions – when they are at the top of their game – can be far more powerful than any single organization working alone. They can share and apply more resources, build sustainable support for the long haul of policy change, and will often attract and develop new leaders.

But the reality is that emerging coalitions are fragile. They bring together strangers – people from diverse backgrounds and different viewpoints, who have to figure out how to trust and respect each other’s differences and get something big accomplished. Its not all faith and kumbaya – coalition members often know one another first as adversaries with a history of having to compete for authority, power, funding, members, and media attention. In fact, frustration is one of the prime motivators for coalitions to emerge – leaders cannot lead when they don’t make progress. They loose followers and funders. Organizations who can respond to the leadership challenge by overcoming differences and foraging values-based partnerships are seen as skilled innovators and leaders.

Leadership Skills for Coalitions

There are numerous theories and models that help coalitions develop and overcome challenges, but leadership skills are central to success – especially in the start-up stage.

The core members of successful coalitions share several common characteristics – experience, commitment, diversity, and lack of conflict. Equally important to effective coalition building is the ability to stay focused on the external problem – on the mission – rather than on the internal politics and dynamics – the internal problems. Simply stated, growing big requires a razor-sharp focus on increasing community participation in advancing the mission. In doing so, coalitions decrease conflict and improve their chances of success.

Aspirational values or disingenuous claims?

A client recently asked me if some of the aspirational claims I had written into a draft report to funders might be viewed as being oversold.

She wrote that several of the funders were likely aware of the fragility of the emerging coalition and suggested toning down the aspirational claims, wisely noting that any “funder who has worked with community groups knows that coalitions take time to build and would be unlikely to go from 0 to 60 in (trust and function) in such a short time.”

That observation signaled that it was good time to take stock of the aspirational values I had touted in my draft report. The immediate opportunity was to reflect on what the coalition was willing to stand-by, and commit to with integrity, without being disingenuous. That on-going process of dialogue and reflection is what makes coalitions and their big ideas come alive.

Stretch Goals

Knowing that the purpose of an aspirational goal is to make you stretch – to feel uneasy, and inspire others to see the shared purpose and throw themselves into the fight along with you, helps make it clear that not only is your big idea possible, but that it’s exciting and worth stepping up for.

Cherokee Elder Wisdom

The late social justice advocate and journalist June Callwood shared the following parable at a conference, where a coalition was struggling with its aspirational goals.

A Cherokee elder was sitting with his grandchildren. He told them, “In every life there is a terrible fight – a fight between two wolves. One is evil: he is fear, anger, envy, greed, arrogance, self-pity, resentment, and deceit. The other is good: joy, serenity, humility, confidence, generosity, truth, gentleness, and compassion.” A child asked, “Which one will win?” The elder replied, “The one you feed.”

George Clooney

Back-Pain-Sufferer

“A nationwide survey found 53 percent of us don’t believe chronic pain exists. On the other hand, an Angus Reid Poll found 70 percent of us believe that there is intelligent life on other planets (and 54 percent think extraterrestrials have already paid us a visit). So…aliens from outer space? Sure. Chronic pain? No way.”

Sydney Loney

The Scary truth about our pain problem

Chatelaine Magazine

Feb. 4^th, 2013

http://www.chatelaine.com/health/wellness/the-scary-truth-about-our-pain-problem/

Chronic pain is a common complaint among Canadians, occurring in an estimated 30% of the adult population. Despite its high prevalence, only 32% of Canadian medical schools provide formal training in pain management, including training in the safe and effective use of potent analgesics, most notably opioids.

Not surprising that with so much pain and so little medical expertise, Canadians are struggling to find relief any way they can, including thru the maze of medical marijuana options.

According to Health Canada, about half of the 400,000 marihuana users say they use cannabis for medical purposes – mainly for chronic pain caused by arthritis, back pain, migraines, insomnia, depression and anxiety. Complaints of pain are the most common reason we go to our family doctors and to the ER, costing billions every year in health care expenses and lost productivity. Yet we invest far less in educating medical students about pain, than we do in educating veterinarians.

While doctors are doubtless always sympathetic to their patients pain and suffering, most are also skeptical and uncertain about how to advise patients who prefer to use medicinal marijuana for relief.

Safe and consistent access is a real problem

“We’re trying to treat marijuana as much like any other type of medicine as possible. A lot of patients out there who are potential candidates for it are having difficulty accessing this.” 

Dr. Danial Schecter

Toronto

According to at least one recent study, the Cannabis Access for Medical Purposes Study (CAMPS), funded by the UBC Institute for Healthy Living and Chronic Disease Prevention, many seriously ill Canadians are choosing to access medical marijuana of unknown safety though an illegal market rather than participating in a program they deem cumbersome and ineffective, suggesting that safe and consistent access to medical marijuana is a real problem. 

Canadians and our doctors are part of the gradual social transformation away from decades of stigma and marginalization about cannabis and moving towards an evidence-informed understanding of the risks and benefits.

Canadian public is voting with its feet

While much of the media attention has focused on the debate within the Canadian medical community about more and better research and guidelines, and the questionable marketing practices the new medical marijuana sector is porting over from the pharma sector, the Canadian public is voting with its feet in favor of medical marijuana.

Galvanizing the Medical Marijuana Movement in Canada

What medical marijuana patients and healthcare providers and the industry have in common, and may not yet recognize, is more powerful than what separates them. The common goal is relief of pain. The unifying power is a passionate commitment to relieve unnecessary suffering, improve and apply knowledge, and finally, wherever appropriate to reduce use of opiate-based painkillers. These goals should be clearly articulated in a comprehensive Canadian Pain Strategy – a strategy that’s been circling the drain for several years, in need of a both a business plan for goverments to implment and a compelling advocacy effort.

The War on Pain

As Globe and Mail policy reporter, Andre Picard said:

“We pay far too little attention to the effectiveness of medications used for legitimate purposes like pain control. At the same time, we fret incessantly about drug abuse while doing virtually nothing to prevent or treat addiction. Worse yet, we behave as if these challenges are somehow unrelated when, in fact, they are intricately linked.

The OxyContin story (OxyContin alone kills an estimated 1,000 people a year in Canada) is a prime example of this public-policy hash and underscores the crying need for a plan, a strategy. We need a War on Pain a lot more than we need a War on Drugs.”

Picard is right. But right now, it’s a war in need of champions.

The medical marijuana industry in Canada is in the process of figuring out who all the relevant stakeholders are and how to segment markets, build demand, differentiate companies and build their businesses.

Call to Arms for the National Pain Strategy

In picking up on the Call to Arms for the National Pain Strategy, I’m offering some advice to the medical marijuana industry sector from a steely-eyed veteran of a thousand advocacy campaigns.

1. When you position your brand as a throw back to “Wayne’s World” and the “stoner culture era” or make exaggerated claims about being a pharmaceutical company you’re flaunting the rules and disrespecting public opinion. Play with your reputation and your chances of surviving in a competitive market will be crushed.

2. Decide if you’re in the business to serve the best interests of Canadians right now. Then bring your business story and values to life through a core set of programs or initiatives that primarily focus on what your company stands for that brings added value to Canadians beyond just your products/services.

3. Stop playing fast and loose with the rules. Right now the only legitimate market is the medical marijuana market. Help to build demand for excellence in pain control – the primary reason Canadians give for using medical marijuana – by demonstrating your company’s understanding and support for a comprehensive National Pain Strategy that will include advancing understanding about the risks and benefits of medical marijuana.

Kicking off the GYST blog series is my #1 choice for how not to run a healthcare campaign – brought to you by Health Canada.

This GYST post offers Lessons Learned from a wrong-headed and bad-hearted campaign targeting drug use among young Canadians. Here’s the take-away on what to do and what not to do:

1. Know what works before you start spending.

Young Canadians are big pot consumers, making this an important health issue.  In an effort to fix the problem, the federal government launched a taxpayer-funded TV and Internet ad campaign that used ineffective, outdated messaging, unsupported by leading medical organizations. Health Canada spent more than $7-million on ads – more than the entire 2013 communications budget.

The 10 week ad campaign was targeted at parents of teens, despite evidence that what works are long-term programs designed to counter social influence and improve teens decision-making.

GYST Take away

Health Canada requires rigorous evdience from any group that asks them for money, so its hard to understand how they missed the boat so completely on this campaign.  Clearly they did and they didn’t have to.  There’s a wealth of free resources available for developing innovative, evidence-informed campaigns – check out the Center for Disease Control, Health Communications Tools for developing social media campaigns at https://cdc.orau.gov/healthcommworks/ and the Public Health Agency of Canada Portal for Best Practices Planning Public Health Programs 

2. Mistakes are valuable. Learn from them. Then let them go.

For decades, campaign strategies to prevent drug use have centered on warnings about negative consequences, including the famous “This is your brain on drugs” fried egg commercial.

A 2013 study showed that scare tactics focused on reducing teens’ use of drugs and alcohol were ineffective. If anything, it may cause them to consume more.

Despite the recent evidence, Health Canada’s ad was posted in October on YouTube and features ominous music and dark images that highlight drug impacts on the brain and make “scary” claims about lowered IQ that have been widely challenged by researchers.

GYST Take away

Make new mistakes, not the same ones you made before.  See Lesson One GYST Take Away.

3. Anticipate & Avoid Becoming Social Media Roadkill

When you share something on social media or in real life and people respond, that’s influence.  You Tube, Twitter and Facebook comments can help build your reputation and provide a direct feedback loop.  Which is all good news – it means your message hit your target audience.  But that audience can now hit back.

The Health Canada ad has had over 1M views, over 1000 Thumbs Up and 8,000 Thumbs Down votes and 2000+ comments, mostly negative.

GYST Take away

There is nothing wrong with using social media as a vehicle for your message.  There  is growing evidence, that, when used smartly, both social media and traditional media alone can promote ads that have significant positive influence on improving health-related attitudes, beliefs, and behaviors.  Health Canada’s anti-marijuana ad isn’t one of them.

Your message, your brand, your values and your reputation are all on the line in a public campaign. Check out this link from the advocate marketing experts at Zuberance to learn more about avoiding and fighting negative word of mouth

4. Influence Is Priceless

Influence is the ability to drive action and it’s the coin of the realm in politics. Healthcare professionals have a lot of sway with the Canadian public, which is why Health Canada wisely sought partnerships with medical associations that could add to the credibility and reach of their message. But the main groups representing Canada’s doctors decline to join anti-marijuana campaign calling it a political football. They were right to do so.

The Health Canada ads ran at the same time as Conservative party ads that attacked Liberal Leader Justin Trudeau over his promise to legalize, regulate and tax marijuana.  Federal marijuana policy is likely to be a key point of political debate ahead of the 2015 federal election as Trudeau calls for Canada to legalize marijuana for recreational use.

The Conservative Party says the proposed Liberal policy would put kids at risk.

The question that begs asking is what impact current policies have had on young Canadians becoming the biggest pot consumers in the western world?

GYST Take Away

Complex health issues like drug use among young Canadians will require the efforts of many powerful players across all social systems. Check out CoalitionsWork to learn more about building and sustaining partnerships and coalitions.

Health Canada’s “No-Brainer” Anti-Drug Campaign GYST Score – 0/3

One bad campaign probably won’t destroy Health Canada. But you would think that a government agency, which has the money to translate knowledge into action, would be a no-brainer to GYST with its own campaign. Sadly, even with $7M, this time they did not.

The combination of science ignored, a missed target, alientating experts, a hefty price tag at taxpayer’s expense and the public shaming on their own You Tube channel, leaves Health Canada with a GYST Score of 0/3.

POSTSCRIPT

Canadians will have the official score of the anti-marijuana post-campaign evaluation required under Treasury Board Guidelines, possibly in time for the next federal election in the fall of 2015.

Pat Kelly is the Principle with Pat Kelly & Associates, who specialize in building healthcare movements. www.patkelly.co

Demand for a national plan to reduce the suffering caused by daily pain is becoming a rallying cry for the generation now known as the Silver Tsunami.  One in five Canadians suffer from chronic pain, and direct costs are estimated at more than $6 billion per year.  Many pain sufferers are baby boomers – Canadians born between 1946 and 1964.  The generation that tackled civil rights, women’s rights, AIDS and breast cancer, will reach 65 between now and 2019 and many more will experience often-painful chronic diseases that the health care system isn’t ready to handle.

SIZE MATTERS

Boomers have a long history of tackling big problems and fixing them.  Using the clout of an enormous population size, and the high value they place on wellness, health and fairness, baby boomers have changed the way society responds to social and health issues including AIDS, cancer, pregnancy and birth, ageing and end of life care. As they get older, boomers want to be physically, emotionally and spiritually well until they die.  They expect and will demand access to the full range of treatment options – from massage to opiods to medical marijuana – that are effective in reducing pain and suffering.  They will not be stoic or silent about pain.

VISABILITY RISING

Invisibility is a big problem for the seven million Canadians who endure chronic pain every day, all day. No one believes them. Not their friends, their family, their coworkers; not even their doctors. A nationwide survey by the Canadian Pain Coalition found 53 percent of us don’t believe chronic pain exists.

This frustrates Dr. Mary Lynch, director of the Pain Management Unit at the QEII Health Sciences Centre in Halifax. “In Canada, pain is under-recognized and under-treated,” Lynch says. “It’s a huge problem.”

Which explains why pain doesn’t get the attention it deserves when it comes to research or education of doctors and nurses. Boomers who didn’t accept the status quo of indifference to AIDS and cancer are unlikely to accept poor pain care.  A growing number are speaking out to destigmatize the issues and to galvanize others.

Some famous baby boomers are joining them.

FAME CHANGES THE FACE OF PAIN

Canadian hockey legend Wayne Gretzky (b. 1961) joined a pain awareness campaign when he began to experience early symptoms of arthritis. “I didn’t think people my age had arthritis,” Gretzky said. “I want to help others realize that arthritis pain is not restricted to the elderly, and effective treatment is available.”

Actor George Clooney (b. 1961), suffered severe chronic pain from head and back injuries, telling reporters that, prior to a number of corrective surgeries, the pain was so bad that he thought “ending it all” seemed like a viable option.

Like the breast cancer activists of the 1980s and 1990s who came out of the closet after hearing Happy Rockefeller and Nancy Regan speak publically about a cancer diagnosis, people who live with chronic pain are becoming emboldened.

MOVEMENT FOR GOOD

Boomers lifelong experiences as activists have sharpened their skills at mobilizing for good.  They know governments will react when the irresistible force of public opinion and media attention reaches critical mass.

The emerging pain movement in Canada is demanding a national strategy rooted in compassion, informed by evidence and delivered in the communities where Canadians live and work.

A national pain strategy isn’t a sure thing yet, but don’t bet against the Silver Tsunami.

PAIN IN CANADA – 3 WAYS THE SILVER TSUNAMI IS HITTING BACK

1. SIZE: There will soon be 8 million baby boomers over 60 – more than 1/3 of the almost 24M eligible voters. Canadian political parties will continue to aim their messages at these voters – including responding to demands for strategic changes in health care that demonstrate improved outcomes and cost effectiveness.
2. VALUES: Boomers have embraced technology, complimentary healthcare, wellness, youth and an active life-style and refuse to passively accept pain, the aging process or inefficient care.  Boomers’ willingness to adopt what’s new and better may speed progress in patient-managed pain care technology, such as mobile health.
3. COLLABORATION: Boomers know how to find their tribe when they want to be heard, to make their opinions matter, and to make a difference in the lives of their communities. They are leveraging their collective clout and media attention to fast track the development of policies and technologies that can effectively manage expectations aligned with those values.

Pat Kelly is the Principle with Pat Kelly & Associates, who specialize in building healthcare movements.   www.patkelly.co