The United States healthcare system is facing a reckoning. A set of interconnected social, demographic, medical, and economic forces are radically reshaping how healthcare works—and doesn’t work—in our society. Despite America’s reputation as a world leader in research, innovation, and treatment, health outcomes at the population level are getting worse even as costs soar. The reason for this is not necessarily that people are getting “sicker” or that they are getting “sick” in new ways. Many of the factors that drive high costs and poor outcomes could be managed effectively and efficiently. Instead, our fractured healthcare system often stands in the way of coordinated, comprehensive, human-centered care. Resolving these tensions will require grappling with the experiences and attitudes of the American public—as well as the systemic factors that shape their perceptions. Based on that understanding, community-based, mission-driven organizations can offer a new narrative of what healthcare can and should be.