Our current health system came of age when racial segregation and many other forms of discrimination based on such things as gender identity and sexual orientation, disability, and other factors were sanctioned by custom and law. Widely practiced discrimination bred structured health disparities for racial groups and other populations whom the society decided to disadvantage. The U.S. health care system has dismantled the outward manifestation of segregated care so that race is no longer the explicit discriminator. However, the legacy system continues to bolster discriminatory practices and has replaced the language of segregation with new discriminators.
Piecemeal solutions are no longer an option. It is time for a complete transformation of the health care system to promote unbiased structures and processes to advance equitable access to quality health care for all. This includes addressing all societal, structural, financial, and policy determinations that are products of – and reinforce – this historical bias. The NHC is committed to elevating the patient voice and reframing conversations to elevate managing the health, financial, and other risks patients face over managing financial liability to the health system.