Our Role in Creating an Equitable Health Care System

Our country is at a pivotal moment. The COVID pandemic has highlighted historic inequities in our health care system. The murders of Ahmaud Arbery, Breonna Taylor, George Floyd, Rayshard Brooks, and too many more, ignited an awakening across the U.S. to discuss and address structural inequities faced by Black Americans. Racism as a social determinant of health has long been talked about among leading experts. The need for a national commitment to real change is overdue – we must examine our systems and address structural barriers and disparities that have existed for far too long.

Our Role

At United States of Care (USofC), our role in this moment is to both stand in solidarity with the Black community’s broader fight for racial justice, and actively tackle inequity in the health care system experienced by marginalized communities. Systemic solutions must address the inequities in the health care system, or we will not be successful in ensuring everyone in the country has access to affordable health care. Our role in health reform must center policy solutions around the needs of people by listening to and collaborating with individuals and communities that face barriers to accessing quality health care. Our role is to understand and raise up persistent disparities and advocate for policies that eradicate existing barriers and entrenched biases for long-term change. We are determined to use our understanding of the implications our work will have for underserved communities to inform the solutions we create, promote, or recommend. In order to be effective advocates for health equity, we know that we must re-examine our own efforts and continue to educate ourselves on past and present issues. We must seek partnership with groups which have been raising these issues for decades, while also offering our platform and network as a way to amplify those messages further.

We acknowledge that the health care system, as it’s currently structured, doesn’t work for a lot of people, across demographics. Our listening research reveals that:

• The American public is calling for effective solutions addressing both the immediate challenges and the long-term gaps in our health care system.
• If leaders fail to meet people where they are and do not address their needs, our health care system and elected leaders will miss the opportunity to develop effective solutions that serve people, rather than the health care system itself.
• People need to feel heard and that the health care system is here to support them.

USofCare is committed to ensuring that every single American has access to quality, affordable health care regardless of health status, social need, or income. The solutions we prioritize will address (1) inequities that are disproportionately impacting specific groups of people and (2) shared needs that are felt across demographics.

What are we doing to create a more equitable health care system?

While listening to people and their needs has been core to our philosophy at United States of Care, we need to ask ourselves: “What more can we do to ensure that health care is equitable? What can we do to combat structural racism in the health care system? How can we be more intentional to seek diverse perspectives and focus on inclusion?”

Like many organizations, we are reflecting on how we can do more to build an equitable health care system. While equity, diversity, and inclusion have been, and continue to be, core to our work and mission, we know that we must intentionally infuse these priorities into our work both internally and externally. We will elevate the need for change and push for long-term solutions through six primary efforts:

• Listen. Intentional and authentic listening to diverse voices must come first. This will guide how United States of Care works to address the impact of racism and other prejudices on health care in order to develop sustainable solutions for a more effective system going forward. We will prioritize listening to the voices and expertise from community leaders and residents who face systematic barriers on a daily basis. We know we do not have all the answers and this listening work will inform our work across the organization.

• Understand common and diverse needs in order to define policy priorities for long-term systemic change. Systemic solutions must address inequities. All too often, the design and implementation of policies create gaps and leave people’s needs behind. Policy priorities, then, should not neglect those who may be most impacted by change, but rather solutions must address these needs. United States of Care’s proactive policy portfolio will be developed from research, ethnographic “listening” interviews, and public opinion to identify needs and disparities as shown by data, as well as lived experiences. We aim to address inequities that are disproportionately impacting Black, Indigenous, and people of color populations, LGBTQ+ communities, people with disabilities – and the intersections between each of these identities – in order to elevate common and diverse needs felt across demographics. By understanding how different populations experience the system and what solutions may help close the gap on disparities, we can build a foundation for our work and generate solutions from these findings.

• Create and analyze policy solutions to close gaps. By understanding inequities and which policies may magnify them further, our ultimate goal is to design policy solutions that are co-created with people who are most impacted. Our policy design will:
  • Be clear about which populations will benefit, as well as potential unintended consequences, from the solutions we develop by utilizing quantitative data.
  • Strive to identify and address the root causes of the challenges people face with the health care system and which perpetuate the disparities.
  • Be transparent about who evidence is based on when highlighting the effectiveness of a proposed policy.
  • Support efforts to develop an evidence-base based on all populations.
  • Strengthen our process for seeking and taking diverse input in our policy work, both internally and externally, drawing on the diverse perspectives of our Board and Founder’s Council, Entrepreneurs Council, Voices of Real Life, and other partners.

• Advocate for change. We recognize that listening and policy analysis are not sufficient alone, and that we must pursue an active role in pushing solutions to change systemic inequities. To do so, we must engage with diverse perspectives during all parts of the policy process, through proactive outreach to the public and external partners, and leveraging our Board and Leadership Councils. We will seek to build and join broad and diverse coalitions to advocate for policies at the state and federal levels. We will continue to seek partnership with individuals and organizations that have perspectives different from our own to ensure we are accounting for our own biases, as well as broadening our understanding of the impact issues have on multiple populations.

• Strategically share our platform. For decades, people and experts have fought inequity and racism in our health care system, yet disparities persist. We will continue to utilize our platform to raise important issues and voices necessary for true change. We will offer our platform to encourage people to share their own stories and views in order to lift up and highlight new perspectives pushing for an equitable health care system.

• Foster a diverse and inclusive workplace. We understand that to make real change we must have diverse perspectives. Our commitment is to build a team that reflects the diversity of the United States, understanding and incorporating the intersection of identities. We will continuously strive to build a culture based on inclusion and diversity, that constantly grows and questions our own conventions and lines of thinking. This will include an intentional pipeline for leadership development and retention, with set benchmarks for our staff, leadership team, Board, and Leadership Councils. We will formally engage experts to advise this work.