By James Besante, MS4
Common Dreams, Jan. 25, 2015
This past week the world celebrated the life of Dr. Martin Luther King Jr.
Marches of remembrance also served as painful reminders of unhealed wounds along the lines of race in America, particularly the failure to realize equal access to health care for all.
In 1966, while addressing the second convention of the Medical Committee for Human Rights, King declared, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
The true magnitude of race-based health inequality is staggering: In his seminal paper “What If We Were Equal,” former Surgeon General David Satcher calculated approximately 83,000 excess deaths per year among African Americans, also known as the “black-white mortality gap.”
Despite progress in civil rights, housing, education, and employment from 1960 to 2000, this gap has remained. Shockingly, it has widened for infants and African American men over the age of 35.
The King holiday was a sobering day of reflection, but it was also the crescendo to the very audible justice movement loosely organized under the banner Black Lives Matter.
Activists marched in cities across the nation to bring attention to numerous highly publicized incidents of police violence. More broadly, organizers sought to underline the subversive elements of racism still deeply etched in our nation’s subconscious, and no doubt represented in unequal health outcomes for African Americans.
As a nation, we do not provide universal access to even the most basic medical services. This is not likely to change anytime soon since the Congressional Budget Office estimates that 27 million people will remain uninsured after the full implementation of Obamacare.
The absence of universal health care coverage sets the U.S. apart from all other developed countries. It is the only member of the elite G7—a group of nations accounting for 66 percent of net global wealth—without universal health insurance for its citizens.
Dr. Satcher proposed national health insurance as the evidenced-based remedy to finally close the racial mortality gap and address persistent health injustice in America.
Polls show most Americans also support universal health care. In fact, the majority of physicians agree the private health insurance industry should be replaced with a streamlined, publicly accountable system, like “single-payer,” also known as “improved Medicare for all.”
What is single-payer? It simply means the government pays for health care costs without routing money through private insurers who manufacture paperwork, billing complexity and profits. This is how traditional Medicare insurance is able to operate with overhead costs of 2 percent, which is far more efficient than private health insurance plans, with overhead costs of 15 to 25 percent.
Harvard researchers recently calculated the administrative savings of single-payer’s simplified financing structure to be $375 billion annually, nearly 15 percent of total health spending. This would help to lower the sky-high cost of our current system, which is approaching 18 percent of the gross domestic product.
Single-payer would free patients from out-of-pocket expenses, like co-payments and deductibles—proven barriers to care that are administratively unwieldy and unnecessary for cost containment.
National health insurance would also give patients free choice of providers without the narrow networks that are commonly encountered by insured Americans.
The comprehensive, high-quality care that is equitably accessible in a single-payer national health program stands in stark contrast to our current market-based system in which health care is rationed based on an individual’s ability to pay.
The implications of ensuring a right to health care go well beyond medicine, because “health” is of fundamental importance for the exercise and enjoyment of all other civil, political and economic rights. Dr. King envisioned a world of justice for all. In spite of this, preventable or treatable illnesses continue to needlessly compromise the liberty and dignity of countless Americans.
A right to health care is therefore instrumental for effective citizenship and promotes active participation by the greatest number of citizens in a more robust democratic process.
Equality—whether in health care or any other sphere—is not a “dream deferred,” to quote Langston Hughes, but is attainable. We simply need the political will.
James Besante is a fourth-year medical student at the University of New Mexico School of Medicine and a board member of the Chicago-based Physicians for a National Health Program.
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