A really important
CNN op-ed tries to expand the new national discussion on racial disparity in America to focus on a key issue: health care.
Racism mars the history of health care in America. For years, black patients were relegated to separate—and appallingly unequal—hospitals and wards. Many were simply denied medical attention, either "dumped" into the care of other facilities or turned away at the hospital door.
Fifty years ago this week, that started to change as Lyndon B. Johnson signed into law two programs—Medicaid and Medicare—that constituted real progress in the cause of health care justice. For one, these programs greatly expanded health care access for the elderly and the poor, of all races. Also, building on years of civil rights work and legal challenges, Medicare was wielded to finally end explicit hospital segregation; hospitals hoping to become certified for the program were required to comply with Title VI of the Civil Rights Act.
Yet despite this important achievement, racial justice in health remains an aspiration, not an achievement.
Obamacare has helped, as the authors acknowledge, but it's not been the silver bullet. That's in large part thanks to the Supreme Court and their decision that states could opt-out of taking Medicaid expansion under the law. But as the authors say "the program's intrinsic weaknesses render it insufficient for reaching the goal of health care equality." There are still vital issues of access to health care, both in terms of infrastructure—enough facilities and enough providers in poverty-stricken areas in particular—and treatments. For example, a study released last month "
revealed that state Medicaid programs are limiting coverage of sofosbuvir, a potentially lifesaving medication for those with Hepatitis C, a chronic condition disproportionately affecting minorities." Note that the company producing sofosbuvir, Gilead, set the
U.S. price for treatment at a ridiculous $84,000, at close to a 1,000-to-1 cost markup over production. Likewise, some health insurance plans—including some in Obamacare—put treatments for HIV/AIDS in the highest tier for drug copays, pricing them out of reach for many even with insurance.
In two neighborhoods in Baltimore, the infant mortality rate is higher than in the West Bank. There are 15 neighborhoods in that city where life expectancy is shorter than in North Korea. As a whole, the U.S. has the highest infant mortality rate among wealthy countries, but for many minority communities, we're competing with the second and third worlds.
No, healthcare reform in this country isn't done, not by a long shot. The growing discussion about racial inequality in our country needs to expand to include health care.