The De-Facto Segregation of Health Care

from the American Prospect:



The De-Facto Segregation of Health Care

Opponents of health care reform haven't shied away from invoking race. Why are advocates afraid to point out that people of color suffer the worst inequities of the current system?

Adam Serwer | August 21, 2009 | web only



Last week, over 8,000 people lined up to be treated by medical volunteers at the Forum stadium in Inglewood, California. It was a rare moment of visibility for the hidden faces of the health-care debate -- the 46 million Americans without health insurance, who have largely been obscured by the rage and fear expressed at town hall meetings and rallies. The majority are nonwhite and live in segregated neighborhoods without access to quality health care. It was the first time the organization, Remote Area Medical, had arranged this kind of an event in an urban area, the teeming crowds a reminder of the ongoing health-care crisis plaguing people of color. "This need has existed in this country for decades and decades," RAM founder Ed Brock told the Associated Press. "The people coming here are here because they are in pain."

They are in pain because of an inadequate health-care system exacerbated by the ongoing legacy of racial segregation, which limits access to quality care. "Segregation is still a profound problem in the United States," says Brian Smedley, a health-care expert with the Center for Joint Political and Economic Studies. "We've made a lot of progress in the past 50 years, in many U.S. cities, we have segregation levels that are not far below apartheid South Africa."

That ongoing de-facto segregation has a profound effect on the quality of care to which people of color -- insured or otherwise -- have access. While the health-care bills being debated in Congress would expand access to and quality of care for people of color, ultimately racial health disparities can't be eliminated without better distribution of health resources. That doesn't just mean more and better primary-care providers in minority neighborhoods; it also means environmentally safe living conditions, access to fresh and healthy foods, and safer and more exercise-friendly neighborhoods.

Racial disparities related to health care can be broken down into two categories: access and outcomes. Nonwhites are 52 percent of the uninsured population, the largest proportion of which is Hispanic, at 30 percent -- but those numbers don't tell the whole story about access. Even when people of color are covered, their access to quality care is diminished heavily by ongoing segregation and poverty; in nonwhite neighborhoods, it's simply harder to find a primary provider than it is in white neighborhoods. The facilities that exist are often of lower quality and lack the resources institutions located in primarily white areas have. ..........(more)

The complete piece is at: http://www.prospect.org/cs/articles?article=the_defacto_segregation_of_health_care

nt

Although they track together, I would say this is a CLASS problem and not a RACE problem. The greed of the medical/insurance complex guarantees that anyone to the south of white-collar professional is going to get poor service. The best way to deal with health insurance companies is to say "let me put you on speakerphone so my lawyer can join in the conversation". But to have a speakerphone and a lawyer in the room with you, you probably have a white-collar professional type job.
Conversely, if you are highly paid person of color, you'll have no problem getting treated as long as there is a lot of green in your pallete.

It is definitely a thinky disguised undercurrent. More homogenous societies do not hate their poor.

.... either through medicaid, medicare, work, charity, or 'show up at the ER and don't pay'.

However, many people are concerned about illegal aliens and the drain they currently represent and the potential for abuse of a more public and available system, though I don't see how the system could be more available than showing up at an ER which can't refuse you.

This opposition is much more sinister than racism, it's Cold War in nature and scale. I was listening to Jay Sekulow the other night on AM radio, and these people aren't using the actual term "Godless communists" but they are coming very close. The situation is being portrayed as the undoing of our economic system.

Am I missing the huge representation of blacks in the demand for single payer or public option? Are they to be found in this debate, other than Charlie Rangel and Maxine Waters?

The sort of people who worry about Euro-Americans becoming a minority in this country often have it at the backs of their minds that anything which keeps down the minority birthrate will delay that day of reckoning.

That is why so much outrage is directed against anything that promises to improve the health of minority families and the opportunities of minority children -- welfare, school lunches, public education, you name it.

It passes for the most part as opposition to taxation -- but you don't see anybody protesting the disproportionate amount of our tax dollars that go to provide amenities for the wealthy and to protect them and their property.

I read something a few days ago which pointed out that in all the developed countries which do have universal health care, the poor are thought of as just like anybody else only with less money. They are not minorities, and therefore they are considered worthy.

It is only in the United States that "poor" and "minority" go together -- at least in most peoples' minds -- and it is only the United States which lacks universal health care.