Medicaid Isn't For the Weak

My dad was more than my father. He was the heartbeat of the community where I grew up.

He was a city bus driver in Seattle, kind of a Black Panther meets patron saint of the community. He was militant, yet gentle, tirelessly enduring and helping people with whatever they needed.

When you got on my dad’s bus, you knew you were being taken care of.

He knew everyone, which was really embarrassing as a child, by the way. And he never judged.

His sudden departure from my life was more than losing a loved one. It marked the end of an era, a huge turning point and shift in my life.

But his life also gave birth to something incredible, a movement, really. And that’s kind of what I’m here to talk to you about today.

The cost of systems change.

If you’re in healthcare, like I am, we talk about this all the time. Time, cost. Cost over time. Time over cost.

But the real cost of systems change is sometimes prompted by unexpected people, events, conditions, and, yes, time.

Five years ago, I started a nonprofit born out of my pain, my lived experience, and the reality that time is super short.

And it feels different when time goes from meaningful to meaningless.

1,826 days.

That’s a long time.

At the time of my dad’s passing, shockingly, I was knee-deep in my career as a hospital leader. I ran hospitals for a little over 13 years in Northern California.

So I was navigating the healthcare system daily. I knew that system inside and out, at least inside those four walls.

But it was my father’s death, and his life, that made me reexamine everything I thought I knew about time.

I remember the day I realized how many people relied on my dad to keep their time.

He was a timekeeper, right? Bus schedules are a little bit like clockwork, and they were in his control.

And there I was, a thousand miles away. I was a time broker.

I negotiated with clinicians about time, how much time they were spending with patients. I dealt with stacks of complaints about how much more time people needed.

I thought about wayfinding, how much time it takes to get from the emergency room to the cafeteria.

But in facing a system built around time, neither one of us truly understood a different kind of time journey.

You see, there is a journey that millions and millions of Americans are on every day, and their time is valued differently.

It’s not only about navigating the complexities of the healthcare system. It’s about the time that’s lost, the lives that are changed in those seconds, and the degradation of how we treat their time compared with our time.

Waiting for change to happen.

The time spent in line at the pharmacy, right? You get all the way to the front, and they tell you they don’t accept your insurance, even though you’re on the largest insurance program in the entire country.

We’re going to delve into this journey. We’re going to learn a little more about how time for some people is valued so differently than time for others, and the profound impact when systems change only over generations.

Medicaid is 58 years old. There have been generations of people devalued through this time.

A generational curse of time.

This journey is really pivotal for us, not only in unlocking human potential, but in creating a more compassionate meantime for all of us.

How many of us have said, “In the meantime,” right?

I say it all the time.

In the meantime.

But what if the meantime was really mean to you?

I’m going to have you take a journey with me. We’re going to get on my father’s bus.

And this time, when we’re on the bus, I’m sure many of you haven’t taken a bus in a while, but if you have, think about the people on that bus through their stories.

Their stories of resilience and hope and struggle.

Think about how these are the people whose time we devalue every day.

But I think we can change “mean,” right? We can make meantime, or “in the meantime,” meaningful time.

As we go about our days, it’s easy to overlook this. We’re all busy with our own lives and our own concerns.

But I want us to start pausing and thinking about the millions of people who spend hours, days, and years trying to access the care they deserve.

When we think about being mean, the system can be a bit like a bully.

It’s a system that prioritizes bureaucracy over compassion, paperwork over people, and inefficiency over empathy.

It’s a system that treats individuals as mere numbers, leaving them waiting endlessly and potentially feeling disrespected, disappointed, and disregarded.

But that’s a system.

We are people.

We can actually change this.

We can learn more about the 94 million people on Medicaid, 87 million of whom are adults, and understand how we value people’s time and the impact that time has on their lives.

This isn’t a Medicaid problem, just to be clear.

This is a humanity problem.

It’s a question of compassion and respect for everyone’s time, regardless of their circumstances.

So how do we move from being mean to being meaningful?

We have to address the systems that demand sacrifices from people who are already facing daunting and significant challenges.

We need to make things more efficient, not just for one or two of us, but for all of us.

And we need to remember that when we make people’s lives better, we make everyone’s lives better.

All right, I had you get on the bus with me before.

Now let’s think about how we transform everyone’s time.

Seeing people for who they are. Valuing people’s time. Streamlining those processes. Minimizing waiting. Maximizing the care people receive.

One thing that struck me backstage was hearing about all the incredible poets, doulas, and systems of care.

Not everyone receives that, or anything even close to it.

How can we change a system that values time differently and, in some cases, causes people to die?

All right, this isn’t a pipe dream, and I’m not here to depress you. I know I’m only the second speaker.

This is totally within our grasp.

We have the power to redefine how we approach time and how we approach other people’s time.

In our time transfer, I told you my dad was a timekeeper. I used to be a time broker.

I think all of us have the ability to transfer time and to do that in a meaningful way.

We can transform the systems we work and live in. We can be more compassionate ourselves.

And we can make sure there is a meantime that is cherished rather than lost.

1,826 days.

43,800 hours, as of last week.

That is the amount of time I have dedicated to my nonprofit organization, Health Tech for Medicaid.

And every ounce of that time has been worth it.

It has been worth it to rethink how we can fix our systems, our journeys, and our walks for more than ourselves, or the people we are directly caring for, our children, and our communities.

My time isn’t “me time.”

Your time isn’t “you time.”

It’s “us time.”

How can we redefine that?

Yes, in the past five years, I’ve been robbed of having my father’s time. But I’ve traded that for the most meaningful time, putting meaning behind the lives of people who have not always been valued.

Showing up for people.

Telling people I love them.

Saying yes when I didn’t think I had time.

Who has time to take five years out of their career and their life?

I did.

Taking that time to change the lives of 94 million people, valuing their time, and keeping their voices in rooms where they often would not be, that time is worth it.

So let’s think differently about time.

We say that time is money, right?

But I think we might want to redefine what that means.

Let’s think about more meaningful “us time.”

So this journey we’ve been on for the last, I don’t know, 14 minutes or so, as this clock is telling me, allows us to step into today thinking about time beyond ourselves.

Beyond our children, our parents, our patients, or our consumers.

It asks us to think about how our time can deeply bring more time to someone else.

Thank you.