I recently visited the doctor. It was my first doctor’s appointment in I’m-ashamed-to-admit years. The visit wasn’t spurred by a sudden onset of illness or even a newfound desire to protect my health; it was more of a necessity—required by my new insurance provider to continue (read: begin) my health coverage.

See, I am a struggling, debt-crippled law student. I also happen to live and attend school in a state that—thanks to the Affordable Care Act—expanded their Medicaid programs to include folks like me. So, while I was sad to see our nation’s first black president leave office, I get to reflect on his legacy every time I whip out my newly-minted insurance card (I see you, B.O.!).

I'm probably more amped about health insurance than a twenty-something should be. I open mail from my provider while humming the chorus to Young Jeezy’s “My President.” My roommates probably rolled their eyes when I got excited about a request to submit a preliminary health assessment. Nonetheless, I quickly arranged an appointment and did a little jig for my favorite first family.

That excitement faded on a sunny, Friday afternoon as I crossed the threshold from the dim waiting area to the harshly-lit examining room of my assigned primary care physician’s private practice.

The doctor, a spry, middle-aged fellow with a wide smile and a crew cut, entered into the room with an affable “hello” and began to read over documents provided by the equally pleasant woman managing his office. That’s when it happened:

“You know I always find it interesting when Medicaid recipients come in with their smartphones.”

Dr. Crew Cut sliced through my TGIF-joy with what he thought was a well-intentioned comment critiquing abuse of government services. I was shocked still and stunned silent by the doctor’s suspiciously timed remark.

I felt an ambush of vulnerability. I was suddenly acutely aware of my presence in the room: a young black man—a Medicaid recipient—with my history and records laid bare before a Boomer-era white man entrusted with my health and well-being. I couldn’t help but feel the sting of race.

To anyone that has followed racial politics over the last half-century, that doctor’s comment was as loaded and charged as the iPhone that I held in my hands. But, eschewing thoughts of malevolent intent or outright racism, I queried the doctor for more information (I played along). “I’m not sure I understand,” I chimed in and Dr. Crew Cut was swift with his retort:

“I come from a family of conservatives and we think that we shouldn’t be paying for the healthcare of people who can shell out money for smartphones. It’s all about choices.”

Ouch! I felt guilty (too guilty to even come up with a clapback). Am I a free-rider?

As I questioned this, I couldn’t help but wonder how my doctor viewed me. Every question or remark now felt like a casual degradation. I was afraid that I was confirming much of the public discourse surrounding blacks in this country. My grandparents’ struggle with high blood pressure was now the confirmation of a trope. Those distorted images and narratives evoked feelings of shame and social misrecognition and I was spared only because I don’t have any relatives diagnosed with diabetes (fingers crossed).

It’s all about choices.

That’s the narrative that dominates a segment of American politics today—but for their choices, we would not have to subsidize them. Coded in that framing is an appeal that typifies Ian Haney Lopez’s account of “dog-whistling.” It is the masterful use of language to reframe racial and racist politics. The personal pronouns serve as marked designations, showing not only contrasts between groups but establishing fault lines that shape political behavior.

For some of us, the dog-whistles ring clear. They were evident when the South fought for “states’ rights,” when Nixon declared a “War on Drugs,” and when Ronald Reagan first introduced his Cadillac-driving “welfare queen.” Collecting food stamps, Social Security, and veterans’ benefits, the latter stereotype is thoroughly raced – conjuring an image of a lazy black woman thriving on the charity of the federal government and this nation’s hardworking taxpayers.

The dog-whistles ring clear to others, too; signaling but not deploying naked racial appeals. The whistle is blown when discussing everything from housing to crime to education. This country has, in many ways, moved beyond outright racial politics, but these veiled approaches still frame popular conceptions of race and class.

Dr. Crew Cut harbors the views of many Americans. In fact, his comment mirrors the sentiment of a current Republican politician (though the appeals do cross party lines). House Oversight Committee Chairman Jason Chaffetz, discussing the failed Republican healthcare bill on CNN, recently remarked:

“Americans have choices, and they've got to make a choice. So rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on that, maybe they should invest in their own health care.”

The Republican politician’s comments highlight the political tradition of dog-whistling and its deployment at the national scale. It is a clear derivation and consequence of Reagan’s effective use of dog-whistles. The smartphone-toting Medicaid recipient joins the “welfare queen” and the “strapping young buck” in buying T-bone steaks with food stamps and pilfering from the federal government. These narratives and characters channel race and have been used for political gain to sway American voters all while destroying policies that help average Americans.

The Affordable Care Act (can we officially rename it Obamacare?) provided ALL Americans with better health security, but my doctor couldn’t see that past the glare of my iPhone screen. His political views in many ways seemed to blind him to the human present in his office.

But I guess this is about my choices: I faced the risk of sickness, dealt with the tax penalty, and finally stumbled through the poorly-designed Healthcare.gov site all because my phone bill should have been my insurance premium. That doctor doesn't know my story and perhaps chooses to ignore those of millions of other Americans now insured thanks to the expanded coverage.

I was boiling inside, but I remained calm as he moved to measure and record my blood pressure—it was low. Take that, Dr. Crew Cut.

dmathis

Writing since April 2017 · 1 story contributed