Healthcare Access and Quality

00:06 Health care access and quality is another one of those determinants of health.

00:10 With this one, about 1 in 10 people in the United States don't have health insurance? Well, we know there's a lot of political stuff going on around federal funding.

00:22 And we need to not, again, stigmatize and label people.

00:26 How can we get people to a space where they can go from federal benefits into if we get people jobs, right.

00:34 And we offer health insurance, because I also see exploitation of people in these work environments where health insurance is unaffordable.

00:44 So how can companies? How can we, as healthcare providers, partner with companies, and help them to see the benefits of keeping the people that work for them healthy? A big thing I want to point out too, is that the assumption is usually that access is the problem.

01:01 Well, in some places, there are those federally qualified health centers in walking distance for people in some of those impoverished or financially exploited neighborhoods, and people don't go.

01:13 Why? Because oftentimes, again, because they're marginalized and stigmatized, and they show up to these clinics, the way people are treated, influences heavily influences, they're wanting to go back and access care.

01:27 Because if I'm mistreated, I'm very highly likely not to go back to a place and I have health insurance.

01:34 So thinking about that, and then thinking about the quality of care.

01:38 There's so much data to support that people of color don't have the same outcomes, because the quality is not the same.

01:45 And again, that goes beyond just marginalization because of the type of health insurance you have.

01:51 And when I say that I'm thinking about Medicaid and Medicare.

01:55 I have private insurance.

01:57 And sometimes people talk about empowering patients with knowledge.

02:01 Why am I a health care provider? And I still receive subpar care.

02:06 I've been on the receiving end of that so many times, and then you talk about empowering with education.

02:13 Well, I have the education as well.

02:15 And if you bring that out, sometimes the eagles of health care providers makes them treat you worse.

02:21 They ignored that you have this knowledge and still give you subpar care and try to -- I'm trying to think of a politically correct term to say, but I'm gonna say gaslight you into thinking that what you're experiencing is not what you think you're experiencing.

02:39 And it actually is.

02:40 And unfortunately, I just recently went through that again.

02:44 So it's very, very disheartening.

02:46 And if people don't realize that they do have to make anti-racism, anti-oppression, anti-discrimination, diversity, equity, inclusion, and belonging a priority, and then that's not going to change.

03:00 And it has to go beyond just words and commitments that are put out there.

03:05 That has to include disempowering people with the ability to gas light and ability to make excuses for why they treated people the way they did.

03:17 And the worst part of it is those people who don't have health insurance.

03:22 Then they don't get the care they need, they don't get the screenings they need, they don't get optimal treatment.

03:30 So obviously, they're going to have poor health outcomes.

03:33 So we need to stop making healthcare a business first and make it a service first.

03:40 When I came into this profession, it was a service first oriented and not profession.

03:46 And I saw healthcare change with my own two eyes over the last 27 years from and the detriment it caused when they went from service focus to service as a priority to money as a priority.

03:59 So that is a contradiction.

04:02 And so if we are in these C suites, or we have the ability to influence executives in healthcare systems, to think more about this being a service and prioritizing health outcomes and health equity, then it's going to continue to be a contradiction, and it's going to continue to stay in the same place it is.

04:22 And in this area, it was little to no change over the last several years.

04:27 And in my humble opinion, I think is because of what I just said.

04:31 People focus more on the dollars versus the equity piece of it.

04:35 And I'm still involved in conversations with people in these health systems and they just don't get it.

04:41 You want to save $1.98. This is a real situation.

04:46 If a test cost two cent, and the one that's going to give me the most optimal results costs $1.98, well, I still want to do the two cent tests because this person doesn't have insurance.

04:57 Well what happens is, there is also a cyclic effect on that because if you did the two cent test and they lay down the line, you still end up having to do the $1.98 test.

05:09 And then you have to do several other tests, because you were treating people with suboptimal medications, and you didn't do the screenings. You needed to do on the front end.

05:19 So now people are sicker, and now they're in ICU, or they're hospitalized for a longer period of time.

05:26 Whereas we could have done this on an outpatient basis if we spent the $2 versus the two cents.

05:31 So thinking about things from that perspective, and when I say, I'm in these groups, not only with executives, but with other health care providers, and I have to point those things out.

05:42 So I read in the literature from something in NIH, and this was from a few years ago, so it may be more.

05:49 But 320 something billion dollars are spent because of racism and health care.

05:57 And why is that? I just explained it, if we would just do what's optimal from the beginning, then we save so much money long term.

06:05 So the goal in this area is to increase access to comprehensive and high quality health care services.

06:12 So again, I mentioned that about the federal funding into these federally funded health care systems.

06:20 We can build all the buildings we want, and all the neighborhoods we want to put them in.

06:25 But the people who work in these clinics also have to have proper training and education, not just around the health care issues, and the customer service issues.

06:36 When we think about customer service, that includes how we treat people.

06:41 And it also includes making sure that everybody in those different systems, or adequately trained and aware of what cultural intelligence is, and the importance when I talked about of humanizing people beyond just being a human.

06:58 So individualizing that care, and making sure that people know that we're all going to always have a learning curve.

07:05 But there are certain things that every single healthcare professional and from everybody.

07:11 Let's talk about from the receptionist, because that's where the first impression happens.

07:15 So just taking all those cultural considerations into effect, and not thinking that you have to be competent.

07:23 Sometimes, it's one question, like, we can ask those things.

07:26 Is there something culturally, that you want me to include in your care that I need to know to make sure that I can have the greatest impact and provide that high quality care that you need that is specific to you? Imagine that.

07:41 Just that increase in someone's psychological safety, and there's controversy of that word.

07:47 But truly, that's so important to prioritize.

07:51 People need to be able to trust us in a few minutes.

07:54 Otherwise, that does determine whether or not people continue to access care.

07:59 So again, the building is not enough.

08:02 We need to have all people in those buildings, trained adequately in terms of culture, in terms of priorities and health priorities, and also having people to be accountable to that.

08:15 Because again, if we don't hold people accountable it's never going to work.

08:20 And that's a word that people have been afraid of lately.

08:24 It doesn't mean that you're gonna get fired.

08:26 I mean, there does need to be a process.

08:28 People do need the training.

08:29 You do need to know what the expectations are.

08:32 And there will be consequences if it's a repetitive behavior, because that shows that people aren't willing to change.

08:39 And the priority in those clinics and in the health care system, should be the patients, or clients, or whatever we want to turn them.

08:47 The humans who access care in all of those different spaces.