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We can create a state system where all of us (even three-headed hydras) have quality care.

Health Care, Inc. in your state controls your health — by action and inaction. Heroes, rather than hydras, will heal us in our post-pandemic future.


This fifteen-part series introduces you to the heroic partners you and your community will require to survive and thrive during pandemics and economic disruptions. The articles also provide tips on avoiding the three-headed hydras of apathy, envy and fear, those people in positions of power who are fighting to keep a broken status quo.

The Business and Nonprofit Leaders of Health Care

The elephant in the room is the lack of a statewide health care system that can confront a pandemic. COVID-19 must be viewed as a test for each state. The next viral pandemic may be far more lethal. Ignore this warning at your peril. This is not some scene from Hercules: The Legendary Journey, where the hunky demigod “Herc” comforts Kassandra, cursed by the gods to be a prophet that no one will believe.

In times of chaos, suddenly everyone worries about their access to timely care. As the only developed country that has no system to provide all residents with health care, each state and county has patched together an imperfect collection of agencies to address health needs. Even with health insurance, the result can be co-pays that are too expensive and wait times that are exasperating, with vastly overworked providers being timed to dole out services in 15 minutes.

With a public health crisis like COVID-19, we woke up to the reality that we don’t have nearly enough hospitals, clinics, providers, masks, protective clothing, tests and medicine. Our first responders also lack the equipment needed to address a fast-moving viral threat. Then there was a private sector reaction when everyone was told, delay coming in for any health concern if you can. Health care providers were laid off in-a-global-and-unpredictable-pandemic.

We love opinions on care. Data we love more.

Everyone has had an opinion about health care and health disparities for many decades in the US. And, that’s great, but we prefer to use cold hard data when it comes to identifying what works and what does not when it comes to providing care, especially to our most vulnerable populations in the middle of a global pandemic. We are not invested in how it works or what role the private sector and public sector play. We just have one criteria: The state system must ensure that all residents have the timely care they need, regardless of their income level or geographic location. And this care needs to be put in place as soon as possible before the next public health crisis. And, to ensure funds are spent wisely, we need systems in place for measuring progress, user-friendliness and effectiveness.

More than 60 years ago, the countries of western Europe began instituting various forms of universal health care, single payer systems, and private/public solutions that guarantee everyone is covered by insurance to meet all medical needs. And, people in these countries rate these systems quite favorably. Yes, these systems are imperfect, but few would trade them for what exists in the United States — which is not actually a “system” but a patchwork of organizations that can heal illness and injury only if you have the cash. We implore everyone of all political stripes to get in a room and bring us a solution.

But we are getting ahead of ourselves. Let us take a step back to the county level.

Our health care “system” (an assortment of disconnected hospitals and clinics) — on every level, from national to local — is about as complicated as one can imagine. Each state operates rather like a country, with a unique way of setting standards, payments and hospital protocols for ER visitors and addressing the supply and demand of health care providers. Each state can quickly identify what percentage of their residents has health insurance provided by their employers, which are getting Medicaid, Medicare, VA or Tribal Health. Yet, this does not tell us if residents actually have easy or timely access to quality care. Issues like waiting lists, criteria that must be met and cash for co-pays and deductibles can be very difficult to measure and assess.

In some counties, coalitions are asking family members and community members if they have access to medical care. The results thus far indicate that many families struggle to access care in so-called normal times. In times of a public health crisis, the numbers might sky rocket in certain urban and rural communities.

From there we can help communities identify the players across various medical sectors — our GPs, behavioral health care leaders, school nurses, dentists and all the other medical specialists.

What’s needed in each county is a convening of all leaders of health-related organizations and businesses to share data on how difficult it is for parents and youth to access medical and dental care — and how to make easy and timely access our goal.

Meanwhile, back on the local level

What does this mean to folks working in the county? While a county won’t be developing its own system of single payer health care, it can ensure that there are enough providers and agencies to meet the needs of its residents. We will learn a lot about gaps in access to medical, dental and mental health care by surveying parents and youth. From there, we bring together all the players in Health Care, Inc and those working as health equity advocates to fix those gaps.

How do I identify and talk with leaders in health care?

This is admittedly a challenge. As you make your call to action when setting your sights to ensure that all county residents have access to health care, you will definitely attract the attention of those working in health care leadership. Most likely, health educators will be able to engage in dialogue. Hospital community outreach staff are another good place to start. Begin where you have connections, with the goal of eventually getting to leaders of both nonprofit and for-profit health organizations. The goal is to start a dialogue about meeting the health care needs of all county residents and their role in being ready for the next pandemic.

Bottom line

As we wait for some sort of statewide access-for-all solution to kick in, states and localities can ensure care through strategic investments in community and school health care clinics. Our immediate job is to advocate that all clinics and care facilities have the resources they need to address a public health challenge.

The future is what we make it. Join the evolution.

Please excuse any typos as I construct an article at 3am on only one cup of Joe. These stories are mine and mine alone. I do not represent any organization here. If one of my illustrations looks like a real human or three-headed hydra, that’s total coincidence. Words and images ©Dominic Cappello but share with everyone you know. Any questions? The future awaits:

A NY Times bestselling author, social justice activist, Oprah guest, co-author of Attack of the Three-Headed Hydras, 100% Community and Anna, Age Eight.

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