• 12/13/2003
  • Los Angeles
  • Torie Osborn
  • Los Angeles Times

Every year at this time, news stories appear about needy nonprofits doing God’s work and modern-day good Samaritans-great men and women with names like Kroc, Gates and Annenberg-giving millions to worthy causes. We celebrate our generosity. We affirm that we are good people doing good things.

But if you look beyond the rim of your rose-colored glasses, you’ll see a bigger picture this year, one that is neither joyous nor heartwarming. Nonprofits are desperate. Need is up. Giving is down. Nationwide, charitable giving decreased last year, the first drop in 12 years. This year’s numbers aren’t expected to be any better.

But the disaster-in-the-making we face is bigger than this. Its magnitude came into focus after I read a story this year about the mayor of Somerville, Mass., going to that city’s nonprofits, pleading with churches, charities and nursing homes to make donations to the city to pay for the police and fire departments. A week later, I read another story about city officials in Pittsburgh doing the same thing. In Los Angeles, we’ve only just put our toe in the water. The city recently began charging nonprofits a $750 fee for park use (tables, clean-up, and utility hook-up not included). This time next year, nonprofits may be asked to adopt a cop. But all the nonprofits in Christendom can’t make up what government increasingly leaves unfunded.

Our crisis in public services is not simply a result of the economic downturn. The nation’s commitment to public infrastructure and the taxes that pay for them have been shrinking for some time. Expecting charity to “make up the difference” of what government fails to provide was never more than a pipe dream. When the economy heads south, the well-to-do reach for their wallet-and it’s not usually to open it. A recent Wealth + Values study found the wealthy feel they should give to charities more than they did three years ago, but because of the economy, they won’t.

Philanthropic institutions are searching for an appropriate response. A recent study of nonprofit funding conducted by Venture Philanthropy Partners in collaboration with McKinsey & Co. predicts tough times and recommends that more charitable dollars be directed to advocacy. Policy change, they conclude, is the only way to get beyond increasing demand for nonprofit services and a decreasing supply of money to provide them. In fact, philanthropic spending priorities are shifting as foundations begin to place greater emphasis on changing the policies that have brought us to this brink. Traditionally, philanthropy preferred to steer clear of advocacy and fund social services instead, but that reluctance is waning. The Ford Foundation has placed new emphasis on “Strategic philanthropy” focused on policy change. The Pew Charitable Trusts recently decided to change its legal status from a private foundation to a public charity in part because public charities are constrained by fewer rules regarding advocacy and lobbying.

Individual philanthropists-many of whom are middle-class people, not gajillionaires the media swoon over-might also respond to this crisis by reevaluating their traditional giving patterns and putting more emphasis on change, not just charity. Next year, incredibly, we face proposals for more federal tax cuts that will further shrink government’s ability to provide basic services. Nonprofits will stagger and fall under the weight. Where and how will this end? Your checks this year could make a difference.

OCF Note: OCF has been through several incarnations in its short existence. First I wished for it to become a content rich web site that contained all the information that I could not find elsewhere as I traveled the path of diagnosis, treatment, and recovery. We have made great strides in this area and continue to build upon the strong foundation that exists each month. As I moved into recovery, I realized the need for emotional support myself, and except for my wife who never skipped a beat or faltered, I could not find it anywhere… the genesis of the survivor/patient forum was the result, which today may provide more than face to face small support groups, due to the true generosity of the regulars who make it live and breathe with their insights and understanding which they share with newcomers each week. But over the last year my, and OCF’s efforts, have been singularly driven towards advocacy. We must change the system, one that continues to allow dentists, doctors, and the professional societies that they belong to live in the status quo with a disease that responds well to early detection… if only someone was taking the time to look for it. Unfortunately too few are. How many lives would be saved if all dentists and primary care physicians were up to speed on oral cancer and were finding it as highly curable stage ones and twos, instead of the stage threes and fours that make up almost 66% of all diagnosis (and which have correspondingly lower survival rates). This year OCF has spent efforts lobbying state licensing boards to make oral cancer screening protocols a mandatory continuing education requirement for re licensure of dentists in various states. I have been an outspoken critic at the Centers for Disease Control in Atlanta, an organization who could make opportunistic screening and early detection a priority but have not. We are beginning to work on a training CD for dentists to be followed by one for primary care physicians on recognizing these early lesions and pre cancerous tissues, and specifically what to do about them when they find them…. (which for anyone who has not been reading my editorials (click here) etc., means not treating them with what can only be called watchful neglect, and instead of sending them for referral or biopsy letting them bloom into late stage killers.) Hopefully we will find the funding to finish this project in 2004 and have a training CD in the hands of every dentist in the US soon there after. Next year I will be meeting with the heads of the NCI, NIH, and with the Surgeon General to try and garner support for our efforts, which relate to the underlying reasons this situation has gone largely unchanged for almost 5 decades. We are not waiting for a new cure or drug to be invented, we are not waiting for a new diagnostic procedure to be developed, we are not looking for a disease that is hard to find buried somewhere deep within your body, we are not asking for individuals to endure painful or expensive examinations… none of this is necessary to make a major dent in the death and morbidity that is associated with oral cancer, by finding the disease at the early stages, and saving lives in the process. As cancers go, it is right there in plain sight, available to be seen by the naked eye or felt with the fingers, out in the open right under your nose!! We are only asking that those who have the opportunistic ability to screen people they come into contact with each day, dentists and primary care physicians, do so with both regularity and with educated thoroughness, and when suspect tissues are found, to immediately refer the patient or biopsy the tissues so a definitive diagnosis can be immediately made.

But I cannot do this alone. It will take funds, letter writing campaigns, public appearances from myself and others who desire to be heard, to make the difference in whether this disease continues it’s deadly drumbeat or is brought down from it undeserved high standing as a killer. It will take real advocacy. With over 12 million hits on our web site each month (certainly not one that is looked at much by those without some contact or direct interest in this disease), we have the numbers to make a difference. It is within our power if we are acting together. There must be a change, and each of us must be the change we wish to see in the world.