We know that people would have done things differently if the lead poisoning in Flint had occurred in a white suburb. I would also pose this question: What would people be doing if 28% of white Americans were uninsured?
I think society would be treating this issue a bit more urgently. I think society would not be saying that universal health care plans like single payer will never happen, that it is pie in the sky, that it is not practical, that we need to be incremental and wait 20 years to see if things will change.
In terms of healthcare, some people talk about how there is only 10% (or 30 million people) uninsured, and express the vague hope that maybe one day we can cover everyone somehow, without actually saying how. What we don’t talk about is that those 30 million uninsured are disproportionately people of color.
In the first 3 months of 2015, 28.3% of Hispanic, 15.6% of non-Hispanic black, 8.7% of non-Hispanic white, and 7.2% of non-Hispanic Asian adults aged 18-64 lacked health insurance coverage.
Some people attack Bernie’s single payer plan for supposedly “forcing people to give up the insurance they have now.” But what we don’t talk about is that it is white people who have the highest rates of employer sponsored health insurance. The majority of people of color do not have employer sponsored health insurance.
Employer-Sponsored Coverage Rates for the Nonelderly by Race/Ethnicity:
White—63%; Black—45%; Hispanic—38%
When we talk about systemic racism, what we don’t talk about is the role that race has played in societal opposition to universal healthcare and other liberal government programs over decades.
The second paper, by the economists Alberto Alesina, Edward Glaeser, and Bruce Sacerdote, titled “Why Doesn’t the United States Have a European-style Welfare State?” Its authors — who are not, by the way, especially liberal — explored a number of hypotheses, but eventually concluded that race is central, because in America programs that help the needy are all too often seen as programs that help Those People: “Within the United States, race is the single most important predictor of support for welfare. America’s troubled race relations are clearly a major reason for the absence of an American welfare state.”
Now, that paper was published in 2001, and you might wonder if things have changed since then. Unfortunately, the answer is that they haven’t, as you can see by looking at how states are implementing — or refusing to implement — Obamacare.
...What do these states have in common? Mainly, a history of slaveholding: Only one former member of the Confederacy has expanded Medicaid (*update: now two former members), and while a few Northern states are also part of the movement, more than 80 percent of the population in Medicaid-refusing America lives in states that practiced slavery before the Civil War.
Obamacare has not resolved the racial disparities in health care. (And by the way, Obamacare is not actually Obama’s policy. Obama campaigned on and wanted universal health care, with a public option and Medicaid expansion to all states, but conservadems killed the public option and the SCOTUS killed the Medicaid expansion.)
In a new report "Breaking Barriers: Improving health insurance enrollment and access to health care,” author and researcher Gary Delgado provides plentiful evidence that the doors to quality health care are still closed to many people of color, families in rural communities, the poor, and those with language and cultural barriers.
I was recently on a telephone call with Antron McKay-West, the president and founder of Upgrade Mississippi. He was describing the frustration people in his tiny hometown on the Mississippi Delta experienced trying to sign up for health insurance under the Affordable Care Act.
Most families in the town still don't have Internet in their homes; cellphone reception is unreliable.
"I know people who were trying to sign up for health care coverage, but they don't have Internet at home, they don't have email addresses. When they tried to sign up by telephone, the assistants on the other end often told them to just go to the library and use the Internet there to sign up and check their email. In the neighborhood where I grew up, the library is 15 miles away," said McKay-West.
Expansion of Medicaid is critical to reducing the racial disparities in health care. Yet some people simply ignore the problem of the Medicaid gap and are comfortable leaving this problem to Republican governors.
A new study released Tuesday by the nonpartisan Urban Institute found that Obamacare will reduce the coverage gap between minorities and whites. But blacks won’t benefit as dramatically unless more states embrace the health care law’s Medicaid expansion, the study, billed as providing the first state-level projections of Obamacare’s impact by race and ethnicity, found.
Obamacare’s expansion of Medicaid is particularly effective at reducing the coverage gap between whites and racial minorities.
Unless more states expand Medicaid, the coverage gap between black and whites will fall just 1.5 percentage points by 2016.
Latinos would also stand to benefit if more states expanded Medicaid, with 38% currently living in non-expansion states. If Texas alone decided to expand Medicaid, Latino health coverage would increase by 11.3% by 2016, according to the study.
When we talk about systemic racism, we cannot ignore the racial disparities in health care. Economic inequality disproportionately hurts minorities, and thus we must treat economic justice as one facet of racial justice.
