Recent months have cast a glaring spotlight on the most insidious fault line in our culture: racial inequity. It pervades every corner of society. But healthcare leaders are uniquely positioned to address this intractable problem in two important ways.
First, with health disparities. We are privileged to work in service to the most basic human desire: wellness over sickness; life over death. Any inequity is horrifying; but inequity in physical and mental health is tragic.
Second, as enterprise leaders, we have the power to drive meaningful and sustainable change. In many communities, we are the largest employers and carry enormous economic weight.
Health disparities are an appalling consequence of racial inequity. Providers must do a better job of reaching at-risk populations, developing effective intervention strategies, and making it easier to engage with our systems. We must collaborate with community partners on elder care, education, housing, food security and economic opportunity.
But we can’t close the disparities gap without fundamental change—not just change on the margins. It requires policy and public investment. We must break free of the trap of fee-for-service that disincentivizes access, early intervention, affordability and patient outcomes. The fact that hospital revenue is plummeting during COVID-19 illuminates the dysfunction of the economic paradigms around healthcare.
Reform is easier said than done. Healthcare is the hottest of hot-button issues and enflamed by special interests vested in the status quo. There is no uniform delivery model or data gathering across the country. COVID-19 revealed the flaws of this fractured health system. Past efforts at reform tried to accommodate everyone’s perspective, watering down the solutions. We need political willpower. We must dismiss the rhetoric and disinformation stifling an honest national discussion about how we spend 18% of our gross domestic product on healthcare, using an unsustainable model.
Political fortitude will only happen at the insistence of an informed and engaged public. We need a nonpartisan national commission to holistically reimagine healthcare. The commission should be made up of leaders from healthcare, business, social services and the federal government with one goal—creating national policies to improve health outcomes.
The commission should develop and coordinate initiatives designed to address the social determinants of health to target infant mortality, mental health, healthy aging, substance abuse and other chronic issues. It should emphasize the importance of public health, articulate a national target for healthcare expenditures, and outline the path to achieve that goal.
Closing the racial divide means we must also look inward. As leaders of large institutions, we have the ability to economically empower millions of people when we fully embrace diversity and inclusion at every level, including the C-suite, medical staffs and boards. We must do better to reflect the communities we serve. It requires creating a culture to drive this change and being fully committed instead of simply compliant.
Real change comes through systems that ensure pathways of upward mobility, including training, education, mentorship, and a road map to better and higher-paying positions.
Real change can only happen when we ensure that minority suppliers are considered—and all suppliers are committed to diversity and equity within their own operations.
Real change can only happen when we expand spending among all minority vendors, not just in construction and janitorial services, but in financial, banking, consulting and legal services.
Real change can only happen when we support community partners who are also working to bridge the equity divide. Our work must be deliberate, always asking how every investment of our time and money is helping to heal the community.
Healthcare can’t solve everything alone. But these inequities demand our attention. And if we can make progress, we will have helped reconcile our nation’s long and painful history of racial injustice. We know what ails us. We must find a way to act.