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In today’s America, racial disparities in income and wealth play a massive role in the experiences of communities of color. Our broken health care system — with its high prices, lack of access and often inadequate care — makes these challenges even worse, by creating new racial health disparities.
The effects are lethal. African Americans have higher rates of diabetes, hypertension and heart disease than other groups, and Black children have a 500% higher death rate from asthma compared with white children. Infant mortality is higher and maternal mortality is too.
There are a few reasons for this. One of them is our racist health care system. While Medicare for All won’t single-handedly eliminate racism among health professionals, it will shrink racial disparities in care significantly, many of which are the result of lack of access to quality care. For example:
1. People of color are more likely than white counterparts to be uninsured. We are 42% of the nonelderly U.S. population, but over half of the total nonelderly uninsured population. Black people have significantly higher uninsured rates (11%) compared to white people (8%).
2. Black Americans are more likely to live in a state that hasn’t expanded Medicaid, including South Carolina. 214,000 more South Carolinians would have insurance if they expanded Medicaid, and this population is disproportionately Black.
3. While most non-elderly Americans get insurance through their employer, Black Americans are more likely to be unemployed or underemployed (not full time) — meaning we are less likely to have employer-sponsored insurance. (Our broken employer-sponsored system therefore disproportionately penalizes people of color — who are already being penalized by the labor market — it’s a double disadvantage.) African Americans are twice as likely to lose insurance in a given year compared to whites.
Implementing Medicare for All will mean that everyone is covered, with no additional, sky-high bills and no requests for health coverage will be denied.
Although access alone isn’t enough, it is responsible for a big chunk of the disparities. Half of maternal deaths in our country are preventable. While there are many reasons why Black mothers and mothers-to-be experience poor treatment and care, a lack of quality health access is a significant factor. Hospital quality can account for nearly 50% of the racial disparity in maternal illness.
Black Americans are also more likely to be on Medicaid — which is not accepted at many hospitals and doctors’ offices. Black patients and low-income women are more likely than others to be treated at under-resourced hospitals, increasing the chances they may experience complications during and after childbirth.
Of course, we all know that expanding “access” is not enough if the care is still not something we can use. We must now take the step to ensure we all have the financial and structural ability to actually use the healthcare we have access to.
Black Americans pay disproportionately more for health care because our average income and asset levels are lower than other demographic groups. On average, Black Americans have less income and far fewer assets than white Americans and are therefore less able to weather unexpected medical expenses, and are hit much harder by high-deductible plans like those offered under the Affordable Care Act.
As a result, Black Americans are more likely to have medical debt. Nearly one in three Black Americans, age 18 to 64, has past-due medical bills. Black uninsured populations face burdensome out-of-pocket medical expenses when seeking care, which often means they are forced to delay preventative care and get treated as a last resort — the most expensive form of treatment.
For all these reasons, it is vital that African Americans mobilize behind fixing our broken healthcare system. Medicare for All will mean no more high premiums, deductibles or surprise bills for people with insurance. And it will mean those without insurance will finally get full coverage. In all cases, we will get the highest quality care with no soul-crushing bills.
Obamacare was a great first step and addressed many of the problems we faced in 2010. Now, a decade later, it’s time to keep pushing forward. Our lives depend on it.
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Kerri Evelyn Harris is Movement Director for Medicare for All NOW!
