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As aspiring doctors, we see the racial toll of poor health insurance
By Scott Goldberg
Chicago Sun-Times, December 23, 2014
On December 10, medical students at more than 70 schools across the country held “white coat die-ins” in response to the lack of indictments in the police killings of Michael Brown in Ferguson, Mo., and Eric Garner in New York.
Here in Chicago, I and more than 100 students from Rosalind Franklin University, Northwestern, Rush, the University of Chicago, and University of Illinois at Chicago lay down together in protest on the campus of UIC. It was a moving experience.
Why did we do this? Like many Americans, we are angered by the repression and injustice that affects communities of color. Yet we are not outside observers to these systematic injustices.
Every day, we see the toll inequality has on the lives and health of our African Americans, Latinos, and other nonwhite patients. If we do not speak out on behalf of our patients, then we are not living up to the standards set by our profession.
In an important journal article from 2005, former Surgeon General Dr. David Satcher and co-authors demonstrated that while overall survival for both African American and white populations has improved over the last 40 years, there has been little improvement in the mortality gap between blacks and whites. In fact, this “death gap” worsened for black infants and black men age 35 and older.
What this means is that in 2002, blacks suffered 40.5 percent more deaths — 83,570 excess deaths — than would be expected if they had experienced the mortality rate of whites. This is a shocking statistic for a country with the greatest wealth and resources ever seen in human history.
While there a number of reasons why this racial disparity exists, the lack of universal health insurance coverage is an obvious one. Importantly, it’s a fixable problem.
Every other industrialized country in the world has some form of public health insurance. Many countries, like Canada, have a single-payer system whereby the government funds the private delivery of health care. In Canada, everyone is guaranteed care, medical outcomes are as good if not better than in the U.S., and yet per capita health spending is about two-thirds what we spend.
Our own extremely popular Medicare program, whose 50th anniversary will be observed in the new year, resembles a single-payer system in many ways. For those who qualify, Medicare provides ready and equitable access to care, free choice of doctor and hospital, and a minimum of wasteful paperwork.
As long as private health insurance companies remain in our health care system, there were will be steep financial barriers to people of color and all people with lower to middle incomes getting access to medically necessary, life-saving care. A Medicare-for-All system, without co-pays or deductibles, would eliminate these barriers, save money and improve health.
Regrettably, the Affordable Care Act does not come close to removing these barriers to care. Nearly 31 million people will remain uninsured even after full implementation of the law, and millions more will have skimpy health insurance policies that will leave them vulnerable to financial distress in the event of illness.
As a medical student and future physician, I believe access to high-quality health care is a right of all people and should be provided as a public service rather than bought and sold as a commodity. Until this becomes a reality, the death gap between blacks and whites will continue to afflict us.
This state of affairs is unacceptable. As Dr. Martin Luther King Jr. once remarked, “Of all the forms of inequality, injustice in health is the most shocking and inhuman.” We shouldn’t settle for it. We need an improved Medicare for All.
Scott Goldberg is a third-year medical student at the University of Chicago Pritzker School of Medicine.