Advocacy Quiz

1. Select any issue that has to do with health, disability, or becoming a healthy fully participating
person and advocate for or against the rule. Your audience is a senator or representative in the
state legislature.
Dear Senator,
I am writing to you in reference of the Short-Term Plan Final Rule, and it’s negative
implications on public health. This final rule allows for short-term, limited duration, insurance
plans to skirt the mandated coverage of essential health benefits that the Affordable Care Act
worked to ensure. The essential health benefits safeguarded the public’s access to rehabilitative
and habilitative services through their private insurance. This is a benefit that is essential to
multiple areas of well-being, including mental, physical, social, and emotional health so that
individuals within our community can actively engage and participate in meaningful and
necessary occupations. In addition to the well-being that is threatened by this Final Rule, it
negates rehabilitative coverage that is necessary for effective and functional rehabilitation after
an individual acquires an illness, disease, or injury. This is placing the demographic that would
purchase these Short-Term plans, likely due to socioeconomic disadvantage and stressors, at a
higher risk. It is our responsibility to protect disadvantaged population through our healthcare
provisions and political legislation, but this Final Rule does the opposite. Please take the time to
thoughtfully consider these implications and take the necessary action to advance our public
health care. Feel free to contact me directly to discuss the topic, I would welcome the
opportunity.
Sincerely,
Angie Blaser, OTS

2. Compare the medical model and the social model, and situate yourself as an occupational
therapist in the argument.
The medical model is a deficit-focused perspective that works to remediate the client’s
deficits to effectively participate in society. This places the emphasis on changing the individual
to suit the environment which is problematic as it suggests that there is a normal standard of
behavior or ability that people should be able to attain. This categorizes persons as disabled and
works to “fix” them. This is an ethical issue as it assumes that there is inherently something
wrong with a disabled person. The Social Model takes a strength-based approach which
recognizes the strengths and abilities that clients have and make the assumption that the
environment should adjust to the clients needs. While I see a lot of benefit in this perspective, I
think that the balance of both is how I see OT functioning effectively. We take multiple
approaches to both remediate and compensate, while continuing to advocate for client’s rights, in
an effort to influence individuals’ contexts and support their successful engagement. This is why
universal design is so important, so that we make an effort as a society to enable people of all
abilities to successfully participate and live engaged meaningful lives.
To elaborate on my stance, I will use an example from one of my classmate’s fieldwork
while working with blind adolescents. The facility had a medical model focus and went so far as
to tell the clients that they need to learn how to “eat normally” so that people don’t think they are
“stupid”. The fact that this was communicated in this way is unacceptable, but at the same time I
feel that the clients would be disadvantages if societal expectations were not addressed or
considered. For example, the most effective way for a blind teenager to eat could involve finger
feeding, or tactually checking to see how much liquid is in a cup, but those strategies will have
social implications in group and public settings. The Social Model would assert that society
needs to adjust to the blind teen’s needs, which is a valid point but might be idealistic. I feel an
ethical OT approach would work to educate the blind client on societal expectations, work to
provide remediation or compensatory approaches as options for the client to utilize that could
help them integrate within society without burden. Along with this approach it is important to
increase the client’s comfort and ability in self-advocating, and as an OT advocating on a larger
level to prevent stigma from limiting the blind populations’ opportunities. If the only approach is
to focus on strength and expect the environment to conform to the patient, how will that serve
them when they come of an age where they are interested in dating? In order to utilize a client-
centered approach, the client needs to have the opportunity to decide which approaches and
compensations align with their personal values, but we need to provide them with education and
the implications of their options. This is just one example, but it serves to illustrate my stance
regarding the importance of having a holistic approach, which essentially addresses the person,
environment, and occupation.