Social injustice in the name of racism has marred the history of the American health care system. For quite some time, black patients were segregated and isolated into appallingly unequal wards and hospitals. Still others were denied medical attention and turned away from hospitals. On July 30, 1965, Lyndon Baines Johnson, the 36th president of the United States signed two programs; Medicaid and Medicare into law and this marked a turning point in the health care justice system. Before I continue I just have this side rant real quick. I had to move the weekend and it totally blew except for the fact that we were smart enough to hire a professional to move our grand piano in bucks county. Talk about injustice! I digress and back onto the issues with health care.
The signed programs expanded to a greater extent health care access for the poor and the elderly of all races. They also ended the rampant cases of explicit hospital segregation. In order for hospitals to be certified under the program, they were required to meet the standards as stipulated in Title VI of the Civil Rights Act. However, in spite of this crucial achievement and the gains realized out of it, racial justice in the health care system still remains an aspiration.
Following the death of Freddie Gray, the 25 year old who died in hospital out of spinal injuries on April 19, 2015 after being taken into police custody on April 12, 2015, the debate on race and the criminal justice system was debated once again and the entire nation was reminded of the existing and disturbing racial inequalities in the health care system. For instance, there were glaring differences in life expectancy in some of the segregated neighborhoods of Baltimore with figures as high as two decades. Across America, black males in 2010 recorded a life expectancy which was close to 5 years lower than that of white males. Black women on the other hand had life expectancy levels which were 3 years lower than their white female counterparts.
Health Care System Disparities
Health care access also witnessed persistent disparities. In a report released in 2013, Hispanics and blacks have remarkably higher uninsured rates compared to whites. Unfortunately, the Affordable Care Act which is seeking to address the existing inequalities won’t be able to remedy the deeply rooted social and racial injustices in the health care system.
The Affordable Care Act targets the expansion of Medicaid to all people with earnings below 138% of the poverty level as defined by the federal government. This Act hopes to expand Medicaid eligibility nationwide although the U.S. Supreme Court gave states through its ruling an option to opt out of the program if they so wish. Currently, 19 states are in the process of doing so.
Limited Access to Treatment
Some of the intrinsic weaknesses that prevent Acts and programs in the United States from reaching their goal of enhancing health care inequality came out following an audit of the California’s Medicaid managed care system in March, 2015. Inadequate doctor networks to attend to the program participants in California and the limited access to certain treatments are some of the main problems. For instance, a study done in March 2015 showed the limited coverage state Medicaid programs had on sofosbuvir, a lifesaving medication for patients suffering from hepatitis C. According to the investigators, the restrictions which apparently are not based on any professional or official clinical guidelines amount to human rights violations because patients were prevented from obtaining the much needed health care.
High Out of Pocket Expenses
Contrary to earlier claims that the health care inequality is only a problem with Medicaid, a recent study noted that some of the Obamacare plans have some sort of discrimination on the basis of drug affordability for particular illnesses such as HIV/AIDS. Medications for certain conditions are categorized in the highest co-payment tier meaning patients suffering from those ailments are priced out. The victims who bear the brunt of a commoditized health care system are the people of color. The high out of pocket costs deter many patients from seeking treatment. These challenges mostly affect minority families thus leaving them out in the cold.
The Way Forward
As we continue to confront structural racism and social injustices in the United States, there should also be an equal measure of attention to the health care system that continues to fail lots of people. Economic and racial inequalities are interwoven intimately making the United States to have a record number of billionaires while at the same time having infant mortality rates that are higher in places like West Baltimore. The key to improving the health care system in America is to jointly consider all the other factors including social injustice that are connected with roll out of medical care programs.