Somewhere between AI taking over our meeting agendas, drug commercials becoming small cinematic universes, and the general chaos of being alive in 2026, we seem to have misplaced a pretty important conversation.

Healthcare

More specifically: who actually gets to have it.

Universal healthcare used to be one of those phrases guaranteed to turn a perfectly normal conversation into a cable-news panel. Say it at dinner and suddenly everybody has charts.

But maybe we have made the conversation more complicated than the question.

What would it look like to build a country where people could reasonably expect access to healthcare?

Not perfect healthcare. Not unlimited healthcare. Not healthcare delivered by robots wearing Patagonia vests.

Just healthcare.

Because despite enormous advances in medicine, biotechnology, data science, precision medicine, AI, and therapeutics, access remains stubbornly uneven. KFF estimates that more than 27 million people in the United States were uninsured in 2024, while employer-sponsored insurance remains the primary source of coverage for working-age Americans. And even employment does not guarantee access: many uninsured workers simply do not have affordable coverage available through their jobs.

That tension should matter to anyone working in health.

We are building some of the most sophisticated healthcare technologies in human history while millions of people still struggle with one of the least sophisticated questions imaginable:

Can I afford to see somebody?

There is something really absurd about that.

I'm not pretending there is one simple policy answer. There are legitimate debates about financing, implementation, public and private roles, workforce capacity, reimbursement, innovation, and what “universal” should even mean.

But organizations do not have to wait for Washington to settle the argument or for administrations to change before preparing for what broader access could require.

In fact, they probably shouldn’t.

If you work in higher education, life sciences, biotechnology, healthcare, philanthropy, community development or really anywhere touching human health; there are a few things worth building now.

Start thinking in populations, not just customers.

Healthcare organizations are very good at thinking about the people already inside the system. Population health asks a harder question: who never made it through the door?

That changes how we think about data, partnerships, prevention, workforce development, research, and investment.

Build equity into the architecture.

Health equity cannot remain the initiative that appears on slide 47 after the “real strategy.”

It should influence how studies are designed, where programs operate, whose data are collected, which communities participate, how products are launched, and how success is measured.

Equity is STILL a design principle.

Invest in navigation, not just innovation.

We love innovation. Innovation markets beautifully.

Navigation does not.

But the world's greatest therapy offering is not particularly revolutionary to the person who cannot find it, afford it, trust it, understand it, or get to the place where it is delivered.

The future of healthcare will require better bridges between discovery and actual human beings.

Treat community infrastructure as health infrastructure.

Community organizations, trusted messengers, schools, faith institutions, libraries, local leaders, and neighborhood networks are often described as “partners.”

That language undersells them.

They are part of the infrastructure through which health information moves, trust develops, behavior changes, and care becomes possible.

Design for access before access becomes mandatory.

Maybe America eventually adopts some version of universal coverage. Maybe it doesn’t. Maybe the answer looks completely different from the models we debate today.

But organizations making 10-, 15-, and 20-year investments should at least be asking themselves:

What would we build differently if access to healthcare were treated as the expectation rather than the exception?

That is not really a political question.

It is a strategic one.

And perhaps that is where the conversation becomes more interesting.

Because the future of health will certainly involve better technology, better medicines, better data, and better science.

But none of those things matter very much if people cannot reach them.

The future of health is human.

— Micah