On April 14, 2000, the Maine Health Access Foundation was incorporated as a private foundation. Today, twenty years later, our work is put into clearer context as we examine it through the lens of the largest pandemic in a century.
As Maine’s only health focused philanthropy, we were incorporated “to foster improved access to health care and improved quality of health care to medically uninsured and medically underserved persons within the state of Maine, and to serve other unmet health care needs within the state of Maine, particularly with regard to medically uninsured and underserved populations.” We work in accordance with that mission, adjusting our strategies as both the external context has evolved and our own learning and understanding about what “fosters” access to care have changed and expanded.
The people who were medically uninsured and underserved before the COVID-19 pandemic still are, and many more have joined them. The rapidity of spread of the virus among the groups with the greatest barriers to health and health care is alarming, and we are only beginning to see the toll it is taking. Race and class, differences between the “haves and have-nots,” widespread ageism, and the insufficiently acknowledged implicit and explicit rationing of services in the United States health system have been brought into stark focus.
And with the COVID-19 pandemic we must ask a hard question: What, if anything, will we learn through this experience about how our health system needs to be reshaped?
We know that access relies on insurance coverage and ready availability of services. We know that health care includes physical health as well as behavioral health and oral health. We know that coverage and services are insufficient when other elements that foster access are missing, including readily available translation services, care management, culturally competent providers, transportation, and strong social support. We know that health care itself comprises just a small fraction of what actually creates health, and that without attention to the other, mostly social, factors access to care is not enough to address the underlying unmet social needs. Our reliance on health care to fix the issues created by inattention to how our society is organized and functions results in tragic breakdowns when we face a crisis like COVID-19.
Will the experience of a global pandemic change these things? We do not know.
We do know, though, that MeHAF will continue to focus its work on fostering access and improving health. Right now, that focus is concentrated on making sure that Maine’s fragile health and behavioral health systems can respond to the current threat posed by COVID-19 so that as many Maine people as possible survive.
MeHAF is ready, today, tomorrow, and in its next twenty years, to continue to foster access. We hope that it will be in an environment that has moved toward a more equitable view of health and health care. As we are learning in ways that are personal and painful, such an approach is the only way that can help all of us.