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Will Health Care Reform Help the Racial Legacy of Health Disparities?

Thursday, February 10, 2011



Kimberly Seals Allers

With people of color representing 50 percent of the uninsured in America, the new Affordable Health Care Act stands to represent the biggest social movement to impact our communities since civil rights.

But will it solve the health disparity issues that continue to plagues African Americans?

Recently, I attended the Families USA conference in Washington, D.C., where among other distinguished speakers, the 44th President of the United States, Barack Obama, spoke live addressing the conference attendees.

The president eloquently spoke of the benefits of the act, which has already dismantled that pesky "pre-existing condition" clause, which forced millions of Americans to be uninsurable by deep-pocketed insurance companies and caused thousands of others to die because of it. He was candid about the flaws in the law and reiterated his willingness to make changes in some areas.

As a self-employed mother of two who has struggled with my own health insurance issues, I listened intently to the debate that preceded the current law. And the still unfolding drama since it became law---and I just couldn't figure out why there was so much vehement dialogue against health care reform.

Was it really debatable that our system needed a major overhaul?

Having lived in London, England, and having experienced their medical care for myself and my children, I couldn't really understand what was the real problem with a universal health care system. Or with creating more options and lower costs. Not the political excuses and grandstanding, but the real issues. Especially since most of the most vocal objectors have some of the best health coverage this country has to offer. Lucky them.

The answer came to me at the conference in a dynamic panel discussion led by an extremely passionate woman--Gail Christopher, vice president for health at the W.K. Kellogg Foundation. (Full disclosure: The Black Maternal Health Project is funded by the Kellogg Foundation)

After sharing her personal story of arriving at a hospital to deliver a baby only to be left in the corner because someone just assumed she was a black woman on Medicaid, she said something so simple, yet true: "Where you stand is often based on where you sit."

It took all my strength not to jump out of my seat with an uncharacteristic, "You said it, sister!!"

I clapped instead.

But where most detractors "sit" is at the table of the haves with little concern for the have-nots and a lot of selective amnesia.

They've forgotten that this country got its haves by raping, killing and stealing from the people of color they found when they got here. They forget that their history of racism and segregation, left blacks concentrated in communities with severe health risks and without access to any remedies. They choose to ignore the cumulative impact of this racial legacy and the scores of women and vulnerable children it disproportionately impacts.

They forget about environmental racism, doctor deserts, food deserts and other gaping holes that have created and maintained a systemic inequity in access to health care.

An inequity and legacy that plays out every day in high maternal mortality and infant mortality rates and poor birth outcomes in black women across all socioeconomic levels, among others.

And multiple studies have already proven that people of color receive inferior care regardless of their insurance status or socioeconomic status. (I was happy to learn that the health care law has over 75 provisions to address equity issues, including more community based health care services.)

This is an important step in the right direction.

And so, unfortunately, like so many other issues in this country, it really comes down to race. Racial tensions in this country are getting worse, not better.

Everybody knows the true wealth of a nation is the health of its people. Yet, in this country any concept of a publicly supported health care system has a stigma of helping poor people. And by poor, they think lazy. So what if your children suffer? This stigma needs to be removed.

Politicians have pulled off a near-Reagan like maneuver duping Americans into believing who really benefits from the new health care act.

Every one benefits.

But the same patriotic, Federalist Papers-reading countrymen who "want their country back" should take a fast forward real look at the country they hold so dear. By 2042 it is estimated that one in four people will be a person of color. You can take the health care reform issue to the Supreme Court if you'd like, masking your political agenda in a baseless legal challenge. But we're all in this together, with our futures inextricably linked. And we are a constituency not to be ignored.

Because unfortunately for you, my memory is not like your memory.

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