The cost of inclusion
By: Craig Dresang, CEO, YoloCares
For nearly 50 years, our organization has provided individualized end-of-life care and unparalleled support –without bias and without condition –to every person regardless of political affiliation, religion, gender, sexual orientation, socioeconomic status, physical or mental ability, background, personal ideology, or even citizenship. Period.
Moreover, the healthcare industry’s core ethical principles have long demanded justice, along with autonomy, beneficence, and nonmaleficence. Justice in healthcare ensures fairness, equity, and impartiality in the distribution of healthcare resources. History has shown that equity requires intentionality. Intentionality necessitates clearly stated goals and values.
Justice in healthcare should not be controversial. In fact, whenever and wherever injustice exists, there is a professional and moral obligation to call it out and address it. As Martin Luther King Jr. famously pointed out during the 1966 Medical Committee for Human Rights Convention in Chicago, “Of all the forms of inequality, injustice in health is the most shocking and inhumane.”
When it comes to politics, YoloCares has always remained apolitical. While the organization’s core values and beliefs could be manipulated into a political statement, they are not. Afterall, the agency’s patients, families, clients, 100+ staff members, 200 volunteers, advocates, and thousands of champions reflect the political landscape of America.
Every faith community under the sun would — and has — backed the agency’s core values of dignity, respect, compassion, and inclusion. From priests and rabbis to shamans and atheists, faith leaders and secular humanists recognize these core values as universal principles. They represent the agency’s moral code . . . a statement that each life matters. No matter what.
In the early days of 2025, the country was being primed for a collision of values. Powerful voices launched an attack on institutions that overtly foster diversity and inclusion. Suddenly, programs designed to bring people together, were being remade as wedges to divide whole groups of otherwise neighborly folks. Since hospice in America was an outgrowth of the Civil Rights Movement, the change in climate felt like an afront on traditionally held values in healthcare. Equity in care (and employment) has always been a central doctrine for end-of-life care providers. A history of the movement shows that early hospice providers were at the forefront of caring for the first waves of AIDS patients; those who have been marginalized, unhoused, uninsured; and immigrants who had little to no access to healthcare.
A year ago, there were a slew of executive orders intended to overturn the Federal government’s commitment to diversity, equity, inclusion and belonging (DEIB). Under pressure, many large corporations followed suit. IBM scraped its most meaningful diversity initiatives. An internal company memo referenced, “inherent tensions in practicing inclusion.” Farm equipment manufacturer John Deere said it would no longer support “cultural awareness” events. The nation’s largest newspaper publisher announced that it would stop publishing diversity data. It scrubbed its website to remove any reference about inclusion. The nation’s chief diversity officer was abruptly kicked out of a job, and the Department of Education banned every institution of learning (preschools to universities) from recognizing the value of diversity.
Meanwhile, at YoloCares, constituents from six counties were asking where the agency stood in this new environment. A fair question since more than a few of them were, and are, generous funders of DEIB initiatives . . . work that is in-keeping with the hospice movement’s founding spirit.
In response, the agency published an article during Black History Month, featuring the personal and professional journey of its black female board chair and former healthcare CEO, penned by its own openly gay chief executive officer. The candor of someone’s real-life experience was simply a bridge too far for a few individuals. A line was drawn in the sand and the idea of future funding evaporated like valley fog.
In the article, Jackie Clark, YoloCares board president, said, “The national move away from diversity, equity and inclusion (DEI) and affirmative action, is deeply troubling. Contrary to some common beliefs, there are no hiring quotas attached to affirmative action or DEI. Historically, Congress has, in a bipartisan fashion, created federal procurement programs to counter the effects of discrimination that have raised artificial barriers for businesses owned by disadvantaged individuals, including women and minorities.” Clark continued, “Affirmative Action simply gave me, and others, a seat at the interview table. It afforded me the opportunity to show what I could bring to a position. That’s it. The rest was on me.”
In every corner of American industry, and especially in healthcare, Clark said, “We should hire the best and the brightest, and understand that excellence is not confined to any one demographic.” Some interpreted those words as a political statement. They were not.
So, you can imagine my surprise — and deep disappointment — when a local six-figure funder/foundation dismissively withdrew future support because of the organization’s publicly stated commitment to diversity and inclusion. It happened during last year’s Black History Month. Ironic, really. One family member familiar with the situation said, “You should zip your lip, or loose support.” Her comment made me wonder why we were being bullied into a betrayal of our, and the healthcare industry’s, longstanding values.
Multiple studies, particularly from McKinsey & Company, demonstrate the significant value of diversity in the workplace. Companies with higher levels of gender and ethnic diversity tend to outperform their peers financially. In addition, companies with diverse teams show improved innovation, decision-making, and market capture abilities. Companies in the top quartile for diversity are more likely to have superior financial returns compared to those with lower diversity levels.
Valuing, and connecting with, fellow humans who are different from each other has been twisted into political theatre. Yet, it has always been a moral and spiritual challenge that demands us to answer: What kind of humans do we aspire to be?
From the beginning of time, survival depended on connection. Single-celled organisms evolved into new and more complex organisms. Life on Earth was simple. Cells existed, functioned and reproduced as free-living and isolated entities. But then, something remarkable happened. Different cells joined forces. They worked together instead of alone. This change, known as multicellularity, was a pivotal event in the history of life on Earth. Multicellularity – different cells connecting with each other – gave birth to an extraordinary diversity of organisms and structures, and an endless variety of plant and animal life. It was diversity beyond measure, and as a result, humans began to populate the earth. Here is the point: By Divine design, diversity did not weaken life. It fostered and strengthened it.
Imagine what our species, and society, would become if we could embrace, instead of fight, our most basic evolutionary calling to connect, understand, and advance into something even more remarkable. During last year’s Black History Month, Clark, said, “Diversity grows us as humans. It expands our learning and understanding of the world. It broadens our knowledge and perspectives. Instead of being fearful, we should embrace it.”
The idea of finding meaningful connection in a galaxy of diversity – and allowing those connected differences to evolve into something more spectacular – is not a man-made idea. It is how the universe is Divinely created, and what the earth’s inhabitants are expected to do. For YoloCares, the cost of inclusion has meant the loss of a few dollars and a friend or two. So clearly, living our values carries consequences. But abandoning our moral drivers would mean abandoning our founding spirit . . . a price YoloCares will never be willing to pay.
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You can read more about the connection between the Civil Rights Movement and the birth of hospice, and about YoloCares’ distinct approach to patient care, in my opening chapter for End of Life Ethics In A Changing World, published by the Hospice Foundation of America. For more information, or to purchase, go to:
https://hospicefoundation.org/hfa-product/end-of-life-ethics-in-a-changing-world/
or
www.hospicefoundation.org
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