After three decades of patient advocacy, the movement has achieved notable victories, yet it remains fragmented. Matthew Zachary, a 30-year brain cancer survivor and founder of Stupid Cancer, argues that the next breakthrough requires a fundamental shift: organizing patients not by diagnosis, but by a shared civic identity.
Zachary acknowledges the work of major organizations like Families USA, Protect Our Care, and Healthcare Now, calling them effective and committed. But he contends that they have largely relied on two strategies: moral witness and policy advocacy. While both have won concessions, he says the system adapts faster than reform, leaving structural change elusive.
A July 2026 Families USA poll found that 94% of Americans want Congress to act on healthcare costs. Zachary argues this shows awareness is not the problem. The missing ingredient, he says, is identity.
Currently, advocacy is organized around specific diseases or benefits—cancer patients, rare disease communities, Medicaid families, Medicare seniors. Each group fights separately, while the healthcare industry presents a united front. Zachary proposes uniting all patients under the single identity of "patient," regardless of condition.
He points to the numbers: 18.6 million Americans with a cancer history, projected to reach 26 million by 2040, plus the chronically ill, caregivers, and the uninsured. This constitutes one of the largest untapped constituencies in the country.
Zachary argues that a movement does not need a majority, only a committed minority that shows up consistently. Patients have the numbers, but they have never been asked to see themselves as a political force. Their shared experience of insurance denials, prior authorization delays, and navigating Medicare is not just personal hardship—it is political capital.
He emphasizes that this is not about creating a new organization, but about adding a tool to existing efforts: helping patients recognize their collective power. The goal is to move from reacting to harm to preventing it through leverage.
Zachary, who is running for Congress, wants to lead by example. He believes that if patients see themselves as members of one civic constituency, they can transform their anger into political influence. This is a non-partisan identity, rooted in common interests and shared experience.
He concludes that the patient constituency does not need to be invented, only named and activated. The next chapter of advocacy, he says, is not about persuading Americans the system is broken, but about persuading patients they have been a constituency all along.
