how to change the health care system in the US. Here are some of the ideas I have thought of:
Keep your first efforts local. What is happening in your immediate community? How is your practice or agency or organization managed? What are it's values? What is the quality of care being offered? How accessible is it for all community members?
As Social Workers we are especially skilled, hopefully, in helping people navigate the local service system. Where are the cracks in the system? We Social Workers have been taught how to do "case" and "class" advocacy which leads to the question of what are the skills and activities of advocacy at both the case and the class levels?
I have found that people increasingly are opting out of the commercial system and have gone without care or explored resources that are "off-grid." I, myself, practice what I preach and have become very skeptical about participating in what constiutes current practices which Cory Doctorow has called "enshitification."
Also, I notice that boycotts have occured by various unions of health care workers and in some cases institutions who have dropped off of panels and refused to cooperate with various health care insurers.
In the extreme, some resistance and objections to the current health system has become violent as in the case of Louis Mangione killed United Healthcare excutive Brian Thompson in December of 2024 in NYC.
I don't support violence or condone it but I do understand the dynamics contributing to such violent behavior. I favor "bypass" as a strategy because I don't think the current health care system can be changed. We have to create and implement alternative systems which we have had in the past through nonprofit organizations often staffed by religious organizations, and govenmental entities such as the VA and City and County hospitals paid for my tax and charitable dollars.
What ideas does anyone have about creating and implementing alternative nonprofit service health care systems?
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