There is a vital voice missing from the debate over healthcare reform. We’ve heard plenty from posturing politicians and well-heeled corporations and corporate front groups with specific agendas. We haven’t heard much – certainly not enough – from the nonprofits whose services constitute a significant portion of the U.S. healthcare system.

A huge nonprofit network delivers essential health care every day. Those who simply cannot afford insurance rely on this network when they confront a medical concern. Those who are employed but receive no healthcare benefits use the same network. Together, those two groups make up the overwhelming majority of those now outside the system.

When they need care, they go to emergency rooms or a community clinic.

Some ER care flows from corporations which treat healthcare as a business, but most is provided by nonprofits, religious institutions, foundations or tax-funded facilities. The same is almost universally true of community clinics, which exist only to serve, neither turning a profit nor created to do so.

This nonprofit network is critical to our healthcare system. Without it, hundreds of thousands would have no healthcare at all. These providers have vital knowledge: They know what day-to-day medical care demands, what the challenges are, what works and what doesn’t, what reform might or must do.
So why was this voice missing from the debate?

First, mainstream news media tend to rely on readily accessible sources and those sources are those which have the savvy and the resources to feed media. Hand-outs, briefing papers, well-timed releases and well-trained spokespersons (always available because they’re paid to be always available) are simply easier for reporters to use, so they do.

At the same time, healthcare nonprofits tend to shun advocacy. Most clinics simply provide care, pouring every dime they raise into services, not media. They are dedicated to their central mission and they resist dedicating any resources – time, staff, talent, funds – to anything but that mission. Some probably believe that their voice cannot compete with the wealthier, more clout-laden “big guys.”

Nothing will drive news media away from their reliance on the usual sources, but nothing prevents nonprofit healthcare providers from being one of those sources. The nonprofit healthcare sector is probably the most well-informed and vital in the debate on reform. If media have access to that sector, they will use it. In the current debate, the nonprofit sector has not banded together to create a unified voice or to generate valuable input. There is little evidence to suggest the nonprofits made an effort to reach out to media at all. The debate has therefore been deprived essential knowledge, experience and information.

Lots of folks are going to be unhappy with the final version of healthcare if and when it passes. It will be easy to blame “the media,” but the nonprofit healthcare sector hasn’t used media well. Their failure to contribute significantly may be understandable. It is also wrong.