If you know anything about UHCAN Ohio, you may be puzzled about the seemingly odd assortment of work we do. ACA implementation makes sense, but why are we engaged in a dental access campaign, a report on community health workers, building the voice of Medicare/Medicaid beneficiaries in a new managed care model? There’s a method to our seeming madness.

Even with the achievement of the Affordable Care Act, there is still much to be done. We still have too many people without insurance, and others with insurance but unaffordable out-of-pocket costs. We have people with chronic conditions and disabilities, including mental illness and addiction, who do not receive the right services at the right time and place. Too many people end up in the hospital and nursing homes because they don’t have the care they need to stay healthy and at home. Health care spending is growing too fast for individuals and the economy. And 30% of that spending either provides no value or actual harm. Because the problems are so complex, we need to have a multi-layered approach to solutions.

In its earlier years, UHCAN Ohio, understandably, focused largely on fighting for coverage and access to affordable care for uninsured and under-insured people – expanding Medicaid coverage for working parents, strengthening hospitals’ “charity care” policies, and immigrant access to interpreters and health care, to name a few

In 2008 Governor Strickland’s administration convened a multi-stakeholder “State Coverage Initiative.” UHCAN Ohio was at the table, along with Ohio Consumers for Health Coverage. From the start, participants raised the need to address skyrocketing health care costs, waste in the system, uneven quality of care received, and racial/ethnic health disparities. Otherwise the rising cost of health care would make coverage expansions impossible to sustain, Both the Strickland and Kasich administrations, in different ways, organized initiatives to develop strategies to reform how we deliver and pay for health care.. UHCAN Ohio, aware that system change could be very good – or very bad – for consumers, organized consumer participation all along the way. After all, shouldn’t consumers have a voice in reshaping the system?

The goal of health reform is often defined as the “triple aim:” Better care, better health, and lower costs for everyone. We recognize that “better health” means investing more in prevention and health improvement. Furthermore, much of what determines a person’s health – especially for people of color and people with low incomes – occurs outside the medical system, such as where you live and work, access to nutritious food, and time to exercise. Plus, profound racial and ethnic health disparities, the legacy of historic discrimination in employment, housing and criminal justice, won’t go away without deliberate policy decisions.

Here are some core understandings that UHCAN Ohio has about its work.

• We know UHCAN Ohio will never be able to do everything without many partners. We build coalitions uniting organizations that combine their various strengths for greater power. And we know how to organize effective campaigns, with policy, media, grassroots and other key components.

• Consumers often receive fragmented, unnecessary and avoidable treatment that does more harm than good. That’s why we are building the voice of organized consumers in state and private efforts to improve how consumers experience health care.

• You can’t be healthy if you have poor oral health. Oral health care IS health care, and solving the dental access problem in Ohio is one of the most important challenges facing Ohioans.

• It’s not fair that communities of color suffer from higher rates of diabetes, asthma, infant mortality, cancer and stroke. Eliminating racial and ethnic disparities in health care and health is achievable, but only with passage of policies designed to achieve equity. And those policies won’t happen without a strong consumer voice.

• The best doctor’s office can’t improve health if people are living and working in unsafe, polluted unhealthy communities with financial and other stressors. People need access to and support for healthy eating, exercise, and addiction-free lives. People living in affected communities need to be engaged in designing and building healthier communities.

• Organized consumers must have a significant voice in health care decision-making in order to reshape the health care system to provide better care, better health, and lower costs.

• Real consumer engagement, with representation across diverse communities, requires investments in under-represented communities, including communities of color, ethnic communities, persons with disabilities, and those left out because they lack resources, transportation and education.

There’s a lot wrong with our present health care coverage, quality and cost. That’s why we have to tackle change from several angles at once – and demand a seat at the table for the users of the system. In future newsletters, you will see articles exploring how we are tackling the various parts and how you can get involved in reshaping health care.