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    This interview was done with Brad Burk from the American Cancer Society, Great Lakes Division. It was an over-the-phone interview on November 19, 2009 and was voice recorded. It lasted approximately 35 minutes.

    Karen Fox (KF): Okay. Well, I guess what I want to start with first is to find out how you came to work for the American Cancer Society?

    Brad Burk (BB): I have been here twelve years. I came here specifically to work in what we call our advocacy program, which is our government relations program. I had been working at the Indiana General Assembly in the House of Representatives as a staff person and had worked on some political campaigns. So it was a natural transition. I did not come to the ACS to work in not-for-profit, fundraising, programs, or anything that the other 99% of people that work here do. I came very specifically to work in government relations for ACS, and technically I came to work as their lobbyist in Indiana. I came here because I had been working in politics which I really enjoyed mostly because I think there are many opportunities not necessarily in politics but in public policy to really impact society and to make a lasting change to help people.

    .

    But when you are working for a particular candidate or a party, it is very political. It is very unlikely that you find somebody that truly shares all your same views. At a certain point, I realized that I was probably spending a lot of my time helping promote some things I didn't 100% agree with. Or I was working to keep someone in office I didn't 100% agree with. It is nothing against them; I just wanted to be in my own space and to recognize everything I did was in line with what I wanted to see happen or I felt good about doing.
    So, I started looking for an opportunity to work in an organization where I could do policy work, but not feel any tension about what I was doing. The American Cancer Society is really one of the few organizations that had a full-time position like this. I had a lot of friends who worked in not-for-profits, and traditionally the Executive Director of the group might come down to testify on something. There really was not a full time lobbyist; they were not spending that kind of time. So when I heard that they were looking to start something like that at ACS, I jumped at the opportunity to talk to someone and ended up coming here to do that. My first career was as a high school history teacher. Actually, at some point along the way I thought I would end up going back to teach, and this was all a lot of good experience to learn more about how things work to bring it back into the classroom. But that has not ever happened; I am still here.

    KF: That's interesting. How long did you work at each job after you were a teacher then?

    BB: I have been at ACS twelve years, and I worked at the House for three years.

    KF: Okay.

    BB: So it has been fifteen years since I have been in the classroom. At some point and probably more at the college level, I would like to teach again. I don't know if it would ever be a full time gig, but I'd love to teach a class or two per semester.

    KF: I'm sure you could with how long you have been in the interest group society. That is what my class is really based around.

    BB: There is always the academic side right, and then there is real life experience to talk about. The ins and outs, how things happen, and how things don't happen would probably be a lot of fun. Who knows, I don't know if I'll ever get to do it or not. It is hard to commit to something like that because even if you did a night class or something, it is once a week. It is guaranteed at this time, and you have to make sure you can be there. I travel too much to say every Wednesday at six I can be at a certain place, so it's kind of a thing down the road that I would like to come back to because I haven't forgotten that part of me. Fortunately, I get to do a lot of educational work in my job now. It's not classroom teaching, but I am in front of people a lot explaining things.

    KF: Yes. So you explained a little bit why you were attracted to the ACS. What other aspects of the American Cancer Society's background really interested you or are helpful in state policy?

    BB: Well, they are two different questions really. One, it was one of the few organizations that I felt personally aligned with what they were doing, and they had the resources to commit to paying someone to do that kind of work. Two, it is an incredibly trusted brand with a great reputation. I felt immediately that when you go to talk to a legislator and you are representing the American Cancer Society, you have instant credibility. When you are talking to the general public or the news media, you have instant credibility. We are a very old, established, credible organization, and that is very helpful. It was very established, meaning there were millions of volunteers and donors. So we have a ready made advocacy group, and we have tried to leverage those people to get involved in the legislative process. A decade ago, a lot of volunteers weren't contacting legislators in one way or another and now they are. Also, my grandfather passed away from cancer, so there was also a personal side of what ACS was doing that was very compelling and that I could relate to. I assumed and was correct that most people could relate to our mission, including most legislators.

    KF: Yes, it really is a very powerful and credible aspect. That's why I chose health care reform and particularly your organization for my interview. So what have a lot of your recent goals been? The health care reform has clearly been a really big debate recently. What have your goals been in regards to the current legislation and the legislation that might pass today?

    BB: Over the last decade, we really have done most of our work in three areas. One is in tobacco control; another is funding for cancer research and prevention, and third is what we would broadly call access to health care. So any number of initiatives we have been working on in the past decade makes sure that people have access to health care. Just a couple of examples, we have passed some state laws that require insurers to cover mammograms and colonoscopies, things like that. We know there are good cancer screenings out there, but they aren't always available to people because the insurance companies may not cover them. For example, we have worked for a long time on expanding s-chip, which is Children's Health Insurance Programs for low-income kids who do not have health care insurance. There have been opportunities for us and I could go on, like breast cancer treatments and Medicaid, to make sure women are getting covered for treatment.
    One really good example and as a college student you'll really relate to is a bill that was passed last year called Michelle's Law. It was signed by President Bush but took effect last month. Essentially, a young college student was diagnosed with cancer. She ended up being terminal. Her mother and father were trying to get her treatment. She was a full time student and the only way she could remain on her parent's insurance program, like almost everybody else in America, was if she took a full course load. Well, she couldn't take classes because she was under a very rigorous treatment program. Technically, she was going to be dropped from her insurance, so she wouldn't be able to pay for any treatment because she didn't stay in school. She ended up passing away, and her mother became a huge advocate to take this on and make it a national campaign. This law was passed, and we played a big role in that. So now if a college student is diagnosed with cancer or some other disease where they would need to be away from school to be treated, they could do that and not worry about having to be dropped from coverage.
    Again, that doesn't seem like health care reform, but it certainly is. A year ago we would have thought of it as access to health care. When health care reform came about, which I guess now means comprehensive reform or looking at the entire health care system in America and changing all of it or big parts of it in one fell swoop, it is a very different approach than what we have traditionally done. We have always kind of played at a targeted specific level in health care but not having an overarching strategy. Also, I guess I would add we don't have one. The American Cancer Society would not be able to come out with this 200 page document that says this is what health care in America should look like. It is way too big for that. We weigh in where we think we have expertise, which is on the way certain components impact cancer patients and not even cancer patients, but people who don't even have cancer yet.
    Everything lead to us gearing up for the fact that there could potentially be a big orchestrated health care reform effort, and we needed to know what role would we play in that? And we decided we needed to play a pretty significant role because any number of these changes would impact cancer patients throughout the continuum, whether its how people will get insurance, how they will be screened, what would be covered, what wouldn't be covered, etc. How much would insurance cost? Would there be deterrents for people to be screened? Would certain treatments be covered? How would new treatments be covered by insurance companies? If someone were a survivor, which now there are over eleven million survivors, what happens to their insurance rates? Currently, if you are a cancer survivor and you have to find insurance coverage on your own, it is very difficult because no one wants to cover you, or they want to charge you an enormous amount of money for coverage. So, seventy percent of cancer patients trying to buy an individual plan can't afford one. All of these things are being debated, and we feel they are important.
    We have tried to really focus on the elements that we thought were critical to cancer patients and just focused on trying to make sure any and all of those got included in any health care reform bill that would begin to move. Keep in mind, seven or eight different bills have moved at one point or another, and many were passed out of committee. There are many different proposals that are out there, so we have tried to play a part on all of them, if that makes any sense. So instead of us saying this is what health care should look like, we are just trying to be really impactful within the discussions around the things we have credibility on. There isn't an easy answer when it comes to health care reform; it is very complicated.

    KF: Oh definitely; there are a lot of issues to address. There are so many different types of cancer and health issues out there right now, particularly with insurance coverage. But you mentioned some of the things that you focus on and some of your successes in legislation, and you said earlier that you worked as a lobbyist. Is that your main tactic in influencing policy? If not, what type of other strategies do you use?

    BB: Lobbying is part of our portfolio, but it is not our primary tactic just because of who we are as an organization. We do have a lobbyist in every state and lobbyists who work in D.C. They are really there monitoring legislation, serving as experts and helping bring volunteers in to testify, like oncologists, physicians, researchers, or anyone who works with us that has a lot of knowledge. Legislators don't know about cancer necessarily or about health care, so we try to bring in experts who can provide information. We are really lobbying, but I think we are in many cases a soft lobbying group. We are mostly there to help educate.
    In terms of tactics and getting things passed, once we are engaged and working on specific legislation, our strength lies in the hundreds and thousands of volunteers that we leverage from a grassroots point of view. We spend a ton of time educating our own volunteers, not to mention the general public. We are trying to get them engaged, so they can send emails, write letters, send phone calls, make personal visits, or whatever it is to let their legislators know this is how they feel about something. Many times it is "please vote for..." or "please oppose this, that, or the other". We have generated thousands of calls on health care reform. A couple weeks ago over a seven day period, we put in ten thousand phone calls to some targeted members of Congress. That is our strength. We don't endorse candidates. We don't give candidates money. There's none of that interplay with us. So our strength is all of the people who care about cancer. If we can get those folks mobilized, we get pretty amazing results.
    Plus, we remain credible. We don't take a position on a bill unless we have the data and the science to back up our position. These are the facts, this is the reality. This is why this needs to happen. It is never just speculation. It is not political philosophy or theory. It is not our political point of view. It is: look, this is what is happening. We know this about cancer. We know this many people are impacted by this in this way; this is a solution that we have seen or tested, or that this is what other states have passed and this is how that can be approached. So we make that knowledge available to legislators. Hopefully, they will introduce a bill, and we will help them to pass that bill. We don't weigh in on trivial things and that keeps our credibility high. Legislators and volunteers know we aren't going to do something silly. Legislators need to trust that when you show up with your information, they can trust what you say. If you didn't have trust, I don't think you would be very effective with the kind of work we do. So it is a tactic in some degree, to really back up everything we are saying with information.

    KF: Yes, so you're not just blowing steam. It is more information and manpower than money.

    BB: Yes. We have people contact us all the time, saying "Hey, would you weigh in on this bill or would you weigh in on this? It seems to impact cancer patients," because anything around health can impact cancer patients. But, we really don't. Most of the time we stay focused on our own agenda. We are not going to get sidetracked on something that we do not have the evidence to support or oppose. Also, we do not want to spread ourselves too thin. We have a very clear agenda of things we are working on, and we stick to that.
    There was a public opinion poll done last month by Harvard. It was about organizations that support health care reform. They polled for over fifteen groups and industries that were associated with reform, like medical associations, nurses, pharmaceutical companies, insurance companies, certain groups like AARP, and the American Cancer Society. When people were asked about whom they trust to be the most honest and not misleading when it comes health care reform, we came out number one, well ahead of everyone else. So, people in Washington D.C. certainly pay attention to that and so do lots of our volunteers. We have worked hard to build that credibility. That makes it really fun to work here and rewarding to work here because you avoid a lot of the other drama that you might otherwise get because you are carrying a pretty credible business card with you, and it opens a lot of doors.

    KF: Okay. With that credibility and the severity of the health care issue at hand, I really wouldn't think there would be a lot of opponents or challenges besides maybe time because of people running out of time, but what are your typical challenges or challengers on your issues and goals?

    BB: On health care reform, I wouldn't say we have a challenger as in some other organization. Not the way we would have had a challenger on say tobacco control where the challenger would have been the tobacco industry. There are people who are probably opposed to any and all health care reform, but I do not know if they are opposed to it for the very reasons that we support health care reform. Timing is a factor to a degree. I almost feel that timing is a self imposed factor or a challenge within the Congress. We do not have a hard deadline that this needs to happen by this year. But we are trying to impact the system and process that Congress sets up.
    A bigger challenge is honestly keeping our volunteers clear on what our messages are, and there is a lot of information out there on health care reform and a lot of misinformation out there on health care reform. We cannot leverage all our volunteers to be effective advocates if they are not clear what our message is or if they get sidetracked by other information. If the other information is valid, then they have to decide where they are going to come down on something. And it's fine if they chose not to get involved on this campaign, but there are some folks who just are not sure. So it is a very complicated issue, and one of the challenges is just to try to keep it clear for our own staff and volunteers. The bills are constantly changing, and as issues pop up, we need to clearly define the situation, and present our information and our positions.

    KF: So what you are saying is more internal challenges than outside challengers?

    BB: Yes. But there are other challenges that are external, like timing. There are a lot of people playing on this issue. Can your organization be relevant? Do you have the ability to be present in front of legislators? Is the media covering your part of the story? We have a story to tell too, and we want to weigh in on this campaign. So does your competition and everybody else weighing in on the issue. If you do not get the right audience in Washington D.C., like being invited to the White House, or getting invited to certain legislative briefings or meetings with high level committee members, you probably won't be able to impact the process very well. So, we've been very fortunate. We have been at those tables, but only because of our grassroots influence. If you can be active in the early stages and throughout the process, remain credible and keep other people listening to you, then you can have a much bigger impact in the writing and passing of legislation. But it is not always easy to be at the right place at the right time. It's always a challenge to make sure you are recognized and at the right tables. Unfortunately, sometimes we are not. So, really making sure you are visible and where you need to be to make a difference is part of the challenge.

    KF: Okay.

    BB: I don't know if that makes sense or not. It all makes sense to me

    KF: No, it does make sense. I like your thorough answers because I really do not know a lot so it is really helpful for me. But in the middle of that, you mentioned utilizing coalitions. Do you do this? Since you have so much credibility, how often do you really use or join coalitions for your purposes?

    BB: All the time. Constantly. There is a risk obviously. You can have so much credibility that others may think "Oh, you are on your own, you do not need us."

    KF: That makes sense.

    BB: But that really has not been the case. Sometimes of course people want you to join the coalition because you bring so much credibility to the coalition. There are a lot of other really great organizations across the board that we have worked with, and so there are some real natural partners for us, like the American Heart Association, the Diabetes Association, the Lung Association, or AARP. There are some long standing groups that we tend to work with, not only on the tobacco issue, but a lot of these other health care issues that I have talked about that we feel are important at a smaller level. When coalitions come together, you can create a whole group of credible organizations. You are part of that coalition, and again if one of your goals is to be relevant, in front of people, or to compete for media attention, this may or may not be the best route. We can host our own press conference for example. But what if this coalition of groups with ten well-known health care organizations is holding a press conference where we all agree that this needs to happen? That is a big news story, and it is a powerful news story for a legislator to hear that wow, these ten, really credible, big name organizations all just signed on to this. They better pay attention. That sounds like a lot of public support there. So you can really magnify your power and influence when you work in large coalitions. So we do, and we are always eager to partner with other people, even though sometimes you sacrifice your own brand.

    KF: Yes.

    BB: I mean it is not just your name out there. You are one of a bunch of different logos on a piece of paper or in an advertisement or something, but it's worth it. The other thing that I would mention is that I just dropped the word advertisements; we do not have a huge budget to do a lot of public advertising. If you are going to do a full page ad in a newspaper, that can be thousands and thousands of dollars. If you have five or six coalition partners, you can split the costs and still get the big bang for your buck, and you only have to come up with a portion of the price tag. So that is another huge advantage to doing it, and of course you still get to brand yourself by working with these other groups. That is why it is important. But you do not want your logo next to someone who isn't credible, so you have to be kind of picky as to who you work with.

    KF: That is understandable. You don't want somebody else free riding or benefiting from your credibility while you are not getting anything. The last real question I have for you is how your opinions have changed since you came to work at ACS. You joined the Cancer Society twelve years ago and had previously worked in state politics in the House of Representatives, so how have your opinions changed about state politics and policy surrounding your interest group and just state policy?

    BB: I don't know if my opinion has necessarily changed about ACS, other than the fact that we have become a much stronger advocacy group than we were before. I mean we have always been a not-for-profit. Your class is obviously on interest groups. You know twenty years ago, we would not have been thought of as an interest group, in terms of being defined by the ability to impact public policy.

    KF: Okay.

    BB: We would have been a sort of large not-for-profit charitable organization, which is how I think most Americans still view us. I think there are probably a lot of people who still do not even realize that we work on policy or would define us as an interest group. What has somewhat changed is not necessarily my perceptions but the perceptions in general that ACS has become a much bigger player in the advocacy world. When I first started here, it was uncommon for someone from the American Cancer Society to testify or be at the state house. Since then, we have become a standard group that has just been down there year in and year out now for the last decade. So, we are recognized certainly as one of the few health charities that are highly engaged with that kind of work. I always respected the organization before I came to it, but I really respect the fact that we have embraced that side of our work and made it a priority. So, that has not really changed. I think that is what you meant about opinions of the internal organization not politics in general or whatever.

    KF: Yes. But also in relation to your opinions of the organization, from your previous job to your ACS job, have your opinions about politics changed at all or no? Have they just stayed constant?

    BB: You know I had the advantage before I came to work here of working in politics more behind the scenes. So, there was a greater change between my opinions from before I worked in politics and after working at the Capital Building. You will never have that kind of enlightening opportunity until you get a chance to work in that type of system behind the scenes. It really is an education. What I have tried to do is use the knowledge that I have gained about the political system and how things operate at the Capital to be more effective here. So, I do not think my opinion today has changed. Politics is frankly very confusing for a lot of people. I have tried to de-mystify the process to others. There are a lot of people who have never talked to a legislator, state representative, or member of Congress before.

    KF: Wow.

    BB: When they get that opportunity, initially, many are scared. They are just very intimidated by the fact that they are talking to someone they have heard about, seen on TV, or what not. Afterwards, many of them walk away going, "Wow, that was really easy and fun", and it is very empowering to have that meeting. Usually, if it goes well, everyone is really friendly and you get to tell your story, too. These are cancer survivors in many cases. Legislators are listening to what they have to say. They thank them for coming; they are usually very empathetic. At the end of the day, if we are all fortunate, a bill passes, and something changes. You have a life changing experience because you feel like you really did something to help someone else, particularly if you are a survivor or you lost someone to cancer. Our volunteers don't just fall out of the sky; they come to us for a reason.

    KF: Definitely. For sure.


    BB: Our volunteers are very invested in this issue. They have been touched by cancer, like Michelle's mom. She does not want other students to have to go through what her daughter went through. I can only imagine what she must feel like knowing she helped save countless young lives. Being around that is a very powerful way to spend your day. It is pretty cool when you get to have a job like this, when you get to work with volunteers and see them get excited about these kinds of results. But it is kind of hard sometimes because the political process can be nasty, and it can be discouraging for people to watch. The health care reform issue is a good example. There are a lot of things about the system that many people see for the first time. We expose our volunteers behind the scenes a little bit; they see how things work, and things do not always come out favorably. A bill may not pass because another special interest group has a lot more money, rolls into town, and kills whatever we are trying to do. Volunteers can feel frustrated about the process and we have to educate them that this is a tough business. It can be very impactful, but things are going to happen. There is competition; there are lots of other people who have opinions. You have to persevere and stick to it. Sometimes, it takes two or three years to pass a bill.

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    The Michigan Policy Network is a student-led public education and research program to report and organize news and information about the political process surrounding Michigan state policy issues. It is run out of the Department of Political Science at Michigan State University, with participation by students from the College of Social Science, the College of Communication, and James Madison College. 

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    Meet your Policy Fellow: Leah Brynaert

    Leah Brynaert is Health Care Fellow & Correspondent for the Michigan Policy Network. She is a first-year student in Lyman Briggs College at MSU.