“Is health care a right or a privilege?” Dr. Emma Simmons asked as she addressed the audience during a Center for Healthy Communities (CHC) community workshop on June 29.
Attendees remained quiet as they contemplated the question.
A few people spoke up, explaining that health care should be a right, but in America, it’s a privilege to have access to health care.
“Health care is a fundamental human right,” Dr. Simmons asserted. Dr. Simmons is a Health Sciences Clinical Professor at the University of California, Riverside, senior associate dean of student affairs and the Salma Haider Endowed Chair for the Thomas Haider Program at the UC Riverside School of Medicine.
While community members nodded in agreement, the reality in the U.S. is health care is not treated as a fundamental right. According to a 2023 report published by the Commonwealth Fund, a private and independent research organization, the U.S. is the only high-income country where a large portion of the population lacks any form of health insurance.
In 2021, U.S. health care spending reached $4.3 trillion — $12,914 per person, according to the National Health Expenditure, which monitors total health care spending. Despite spending the most on health care among high-income nations, the U.S. is the only one of these countries that does not offer universal health and has the worst health outcomes.
The U.S. has the highest maternal mortality rate across high-income countries, with Black birthing people having a higher rate — 2.6 times higher — than White and Hispanic populations, according to a 2021 report from the U.S. Centers for Disease Control and Prevention (CDC).
In a country where access to health care is not a fundamental right and underrepresented communities experience the health inequities, Black and brown people are forced to become advocates for themselves and others in order to access equitable health care.
The CHC community workshops have fostered a safe space for community members to ask medical professionals questions, hear from the perspective of providers and gain knowledge on what actions to take while interacting with health care institutions.
As the three-part community workshop series comes to an end — for now — these workshops set out to inform the public about the findings from CHCF’s “Listening to Black Californians” survey and equip the community with tools for addressing the shortcomings of the health care system.
Creating partnerships and being involved in your care
Dr. Simmons’s presentation focused on addressing how disparities exist across gender, race, ethnicity and a host of other factors. While she acknowledged the lack of equity in the health care system, Dr. Simmons discussed how individuals can take action in particular instances. The presentation sparked a conversation on how patients and providers need to recognize one another’s role in health care and realize that their relationship is a partnership — “not a dictatorship,” Dr. Simmons said.
“What do we do when physicians don’t listen to us? How do we get them to listen?” Community member Grace Nyanzwii asked. Nyanzwii explained how physicians had constantly ignored her friend and downplayed her symptoms. After several consultations, her friend was diagnosed with lymphoma, a type of cancer that impacts the lymphatic system.
Dr. Simmons took Nyanzwii’s question and asked the audience. Attendees shouted responses like “get a second opinion” and “file a complaint.” Dr. Simmons agreed. She explained that part of taking action is asking questions about what providers say and knowing the right questions to ask.
Developing a relationship with your provider is one of the most important things a patient can do to become more involved in their care, according to Dr. Adwoa Osei, director of UC PRIME. For doctors who are juggling dozens of patients and patients who feel unheard, Dr. Osei believes that communication is key, but the “art of communication” is lost.
“This person took an oath to do you a service,” Dr. Osei emphasized. Providers are overworked and appointments with patients often feel rushed, but Dr. Osei reminded the audience that providers are human too, and need empathy just as patients do. There are things patients can do to support physicians with providing the service that they want, such as addressing doctors with simple pleasantries as a courtesy and having a prepared list of questions regarding what the visit is about. Fostering a relationship with a provider helps create a partnership that will prioritize the patient’s health needs.
The importance of advocacy
Throughout the CHC’s community workshop series, one theme has been clear regarding the changing landscape of health care in the U.S.: Patients have to act as advocates on behalf of themselves and their loved ones as they navigate the health care system. There was once a time where patients took doctors at their word, but those days are long gone.
As inequality reveals itself to be embedded into every facet of health care institutions, advocacy has become an essential tool utilized by patients to demand adequate care. With the health care system constantly transforming in the wake of the pandemic’s exposure of institutional racism and inequitable care, patients are forced to be their own advocates in order to achieve the best health outcomes.
“We only have one life, one body,” CHC Communications Director Michelle Burroughs said. “We have to be active in our health journey.”
After the community workshops conclude, Burroughs often reminds the audience that “no one is going to save us.” With those words, she encourages the audience to participate in the workshops by asking questions, sharing their experiences and gathering all the information they can to take back to their families and communities.
While the community workshop series has concluded in Riverside, Burroughs and her team hopes to host a similar community series in San Bernardino, to further share the information across the Inland Empire.
This article is published as part of the Commonwealth Health Equity Reporting Fellowship.