#StampsfromAMWA Advocacy Campaign Toolkit

By: AMWA Premedical Leadership Team

Background Postal Healthcare, the USPS, and our Advocacy Campaign

Postal healthcare, which refers to mail delivery of medication and medical tests, plays an important role in the healthcare system. An estimated 25% of Americans aged 50-80 use mail-order pharmacies, a number which is higher for Americans who take one or more prescriptions on a regular basis, according to the 2017 National Poll on Healthy Aging. For some respondents, this was a requirement of their health insurance. With social distancing measures in place due to the COVID-19 pandemic, these numbers have likely grown overall and only for certain populations. For example, in August 2020 a senate letter revealed that 80% of veterans’ prescriptions are filled by mail.

Not only is mail delivery of medications important during these difficult times, it has a number of associated benefits, including reduced patient cost of medications, increased accuracy of prescriptions filled. Importantly, on-time deliveries of medication by mail ensure that patients with chronic illnesses do not run out of prescriptions that are necessary for their health. In fact, for some chronic diseases, research studies have shown associations between receiving prescriptions by mail and medication adherence and between receiving mail-order prescriptions and lower emergency department visits by diabetes patients. Additionally, as Dr. Michael Pignone states, utilizing mail for medical testing, such as sending fecal immunochemical tests, is a low-cost effort that can help reduce barriers to medical care for low-income patients. As he argues in his commentary article, one might consider postal workers as an extension of the healthcare workforce, especially in light of the COVID-19 pandemic. It is because mail delays affect medication and testing delivery for so many Americans that the health of the United States Postal Service has a direct impact on our nation’s public health.

The United States Postal Service is unique in terms of delivery services in that its mission is “to provide the nation with reliable, affordable, universal mail service.” While other delivery companies are not required to provide mail services to everyone at a uniform price, no matter where they live, the USPS is required to do this by law. The USPS is therefore uniquely positioned to deliver to rural communities, which may not otherwise be serviced by mail delivery companies and whose residents may be underserved by the healthcare system. And with patients increasingly relying on delivery of medications and tests by mail, especially in light of the COVID-19 pandemic, the USPS’s lack of necessary finances and subsequent mail delays are a public health issue that should be of concern to patients, physicians, and other healthcare providers alike.

Although the USPS provides an essential service to all Americans, it is entirely self-funded and does not receive funding through tax dollars. Unfortunately, the USPS has been experiencing financial difficulties for years with losses in revenue. Reorganization through the 2006 Postal Accountability and Enhancement Act created a greater burden on the organization. More recently, the COVID-19 pandemic has exacerbated the difficulties the USPS is facing, with their mail service sales declining significantly during the pandemic. Although much of the reporting on this issue happened months ago, this continues to be an ongoing public health issue, and ongoing action is being taken to try to ameliorate the difficulties that the USPS is facing. On November 17th of this year, The American Postal Workers union held a day of action and asked Congress to pass a financial support bill for USPS.

Our #StampsfromAMWA campaign is designed to support USPS and build community during this time of social distancing by sending letters to AMWA members across the country. We would like to invite you to get involved in both our community-building effort to support USPS, as well as to research the difficulties that USPS is facing and to consider signing petitions and/or writing to your legislators on behalf of this issue.

Getting Started on Advocacy

AMWA encourages you to become active and exercise your 1st Amendment right in advocating for any causes that you have an opinion on, either in favor or against. Exercising your political voice is an excellent way of staying morally engaged and holding government officials accountable for maintaining transparency and the rights of the people they serve. Some causes have obvious impacts on the healthcare system, however, keep in mind that the causes that may seem unrelated to healthcare can still affect patients’ wellbeing and can impact the healthcare system as a whole.

We highly encourage you to do your own research before getting started on any advocacy effort. Regardless of what your stance is on any topic, your voice matters, so make sure that you are informed and able to speak about the issue at hand. Take the time to read up on the issue from multiple reputable sources; try to see the situation from multiple angles; and ultimately, come to your own thoughts and opinions about what you think should be done regarding the issue.

One way you may want to get started on reading about this issue is to look at the references at the end of this document, which were used to write the background section. However, we encourage you not to limit yourself to these sources and to continue to research this topic on your own, so that you can develop your own informed view and opinion. After you have done that, read on to see what sorts of action steps you can take.

In addition to reading background information on the topic, if there is legislation regarding the topic, make sure that you familiarize yourself with the relevant legislation.

Know the specifics of the bills or programs that your legislators will be voting on. You can search for current, upcoming, or past legislation on various topics to familiarize yourself with the bills relevant to your topic, so that you can specify to your legislators what actions you would like them to take.
Make sure to consider the personal, local, and regional impacts the legislation may have, and be clear about the action you would like your legislator to take.
Regardless of one’s political ideology or stances on different issues, the key to communicating and taking action is to always be polite and respectful; this is the best way to make sure that your views are being expressed appropriately!

Signing a Petition

Signing or creating a petition is one way to engage politically on a topic and to make your opinion heard. Petitions have power in numbers, and even though it may seem like a simple thing to do, getting signatures on a petition signals to lawmakers and the press that people care about the issue at hand; it builds a list of people who are united by a common issue and spurs people into taking further action.

If you feel inclined to participate, sign a petition on behalf of supporting the USPS given the financial setbacks they are facing. Here are some current petitions:

Contacting Senators and Congresspersons

The legislators that are elected to represent you in Congress are your representatives and are working on the interests of the citizens that they represent. Don’t be afraid to contact their offices and have your voice heard regarding current issues that affect you and your community. Only by hearing from their constituents can legislators accurately represent the interests of their communities.

In the following sections, we will discuss how to contact your Senators and Congresspersons either by mail or by phone. We know that this USPS-related advocacy campaign we are doing is a letter-writing campaign; however, if you choose to contact your legislators, you should feel free to contact your legislators in whatever way is most convenient and comfortable for you.

Difference Between Contacting a Senator and a Representative:

The Senate is composed of 2 elected officials from each of the 50 states, making a total of 100 senators serving the country. Senators serve for 6 years at a time, so 1/3 of the Senate is up for reelection every 2 years. In contrast, all 435 members of the House of Representatives are up for reelection every 2 years – that is, in the years of midterm and presidential elections. Representatives are elected from different congressional districts; your elected representative may not be the same as that of someone from a different part of your city or state, so this is important to keep in mind when contacting a congressperson.

Finding Contact Information:
- To find the contact information of your senators, find your state on The United States Senate Website under “Current members of Congress.” Your senators’ email addresses will most likely look something like this: [First Name][Last Name]@[Last Name].senate.gov, but keep in mind that many legislators have specific messaging tools on their websites from which they may prefer correspondence to be received.
- Contacting your U.S. representative entails an additional step, since you will need to find the representative specific to your congressional district. Find your representative by entering your zip code at the “Find Your Representative” section of the United States House of Representatives Website – once you have done so, their contact information is available at The United States House of Representatives Website.
- If you would like to quickly find both of your senators as well as your representative(s), you can also enter your zip code at CallMyCongress. In the case that your zip code falls within multiple congressional districts, you may be prompted to enter your address to find which one you are a constituent of. For those who prefer to use social media, CSPAN also keeps a running list of elected Congress officials’ Twitter handles here, where you can directly tweet them to inform them of your concerns. You can also comment on their Facebook pages if they have one. The public nature of social media makes it a great platform to initiate dialogue among constituents and increase awareness.
- If you want to contact your state governor, you can find their information at https://www.usa.gov/state-governor.

Letter & Email Template:

Addressing a letter or email to a legislator can differ based on who you are contacting. Use the format below to make sure that your (physical) letter reaches the correct place.

To contact a senator, address your letter as follows:

The Honorable [Full Name]

[Room #] [Building Name] Senate Office Building

United States Senate

Washington, D.C. 20510

Dear Senator [Last Name],

If the senator you are contacting is the chairperson of a Senate committee, address your letter like so:

The Honorable [Full Name]

[Chairman/Chairwoman], Committee on [Committee Name]

[Room #] [Building Name] Senate Office Building

United States Senate

Washington, D.C. 20510

Dear [Mr. Chairman/Madam Chairwoman],

To contact a representative, address your letter as follows:

The Honorable [Full Name]

[Room #] [Building Name] House Office Building

United States House of Representatives

Washington, D.C. 20515

Dear Representative [Last Name],

If the senator you are contacting is the Speaker of the House, address your letter like so:

The Honorable [Full Name]

Speaker of the House

[Room #] [Building Name] House Office Building

United States House of Representatives

Washington, D.C. 20515

Dear [Mr./Madam] Speaker,

When researching the specific issue you wish to discuss, you may be able to find many letter samples or templates online, but if you cannot or wish to draft one on your own, you can use this format (adapted from ALTA) to structure your letter logically and concisely – you will need to include your name and address if you wish to receive a response!

Dear [Use above guide to address congressperson],

My name is [First Name] [Last Name] and I am from [City, State]. The legislation addressing [describe issue concisely, or use exact name of bill before legislature] is of paramount interest to me because [BRIEFLY describe importance] and I would like to express my [support/opposition] to [bill/issue]. This issue directly impacts [my profession, the way we as professionals will be able to function effectively, my family, etc.].

I am primarily concerned about [describe major specific concern within the larger issue] because [state reasons or examples succinctly, with only as many relevant details as necessary to make your point clearly]. I will look forward to your reply expressing your opinions, and your current stance on the issue.

Thank you for your consideration of my viewpoint on this matter. I believe it is an important issue, and would like to see the legislation [pass/fail/be amended] to ensure [outcome of interest].

Sincerely,

[Your name,

Address

Phone Number

Email Address]

Calling Your Legislators

Letters and emails aren’t always the most efficient when faced with urgent issues. If you are concerned about a particular cause or bill and want to increase the chances that lawmakers may take quick action to act in the interest of people like yourself, consider making a phone call to their offices.

Apart from finding a congressperson’s phone number from their profiles as described above, you can also call the Capitol switchboard at 202-224-3121, where an operator can direct you to the office of the individual you wish to contact. Be sure to know who you’d like to speak to!
When it comes to calling a representative, it is said to be more effective to call their local offices rather than their D.C. offices, so taking the extra step to go to their websites and finding their local phone numbers may do more to ensure that your voice will be heard. You can also find any phone numbers they have at CallYourRep.
Once you have successfully been connected to the respective office, you might not be able to speak directly to your representative or senator, but you should nevertheless be clear, succinct, firm – and above all, courteous – in your message. Making a personal call can be daunting, but scripts for the specific issues you are interested in can often be found online! Below is a basic example of how to structure a voice call to a lawmaker’s office – you can then tweak it to suit your needs.

Phone Call Template:

Here is a general script you can personalize and use when calling your legislator’s office:

“Hello, my name is [First Name] [Last Name]. I’m a constituent from [State], zip code [XXXXX]. I don’t need a response. I [support/am opposed to] the [legislation of importance]. I strongly encourage the [senator/representative] to please vote ‘[yes/no]’ on this bill. [BRIEFLY describe the potential impact of their vote; i.e. more/less jobs, protection/violation of fundamental human rights, etc.]. Thank you!“

Sources & Further Reading:

“Mail Delays May Affect Medication Supply for Nearly 1 in 4 Americans Over 50:” https://labblog.uofmhealth.org/lab-notes/mail-delays-may-affect-medication-supply-for-nearly-1-4-americans-over-50
“The Postal Service helps keep millions of Americans alive and well:” https://www.popsci.com/story/science/us-postal-service-keeps-americans-healthy/
“Examination of the Link Between Medication Adherence and Use of Mail-Order Pharmacies in Chronic Disease States:” https://pubmed.ncbi.nlm.nih.gov/27783552/
“A Retrospective Database Study Comparing Diabetes-Related Medication Adherence and Health Outcomes for Mail-Order Versus Community Pharmacy:” https://pubmed.ncbi.nlm.nih.gov/30816817/
“America’s Unrecognized Health Workforce: Postal Workers:” https://link.springer.com/article/10.1007/s11606-020-06080-x
“About USPS: Our Mission:” https://about.usps.com/strategic-planning/cs09/CSPO_09_002.htm
“The Postal Service and its Obligation:” https://www.uspsoig.gov/blog/postal-service-and-its-obligation
“USPS: Going Where Others Don’t:” https://www.uspsoig.gov/blog/usps-going-where-others-don%E2%80%99t
“USPS Delivers the Facts:” https://about.usps.com/news/delivers-facts/usps-delivers-the-facts.pdf
“U.S. Postal Service Reports Fiscal Year 2020 Results:” https://about.usps.com/newsroom/national-releases/2020/1113-usps-reports-fiscal-year-2020-results.htm
“Postal workers call for support after a rough financial report:” https://www.federaltimes.com/management/2020/11/17/postal-workers-call-for-support-after-a-rough-financial-report/

#StampsfromAMWA Advocacy Campaign Toolkit