Confronting Racism in Healthcare

On Tuesday, September 25, Healthcare is a Human Right Maryland hosted a special screening of the PBS documentary Power to Heal, which tells the story of how civil rights activists used the implementation of the Civil Rights Act of 1964 and Medicare to desegregate thousands of hospitals. The event was a success, selling out days in advance and generating much-needed discussion about race and healthcare in Baltimore City.

At a time when people in the United States feel pressured to look for exceptional political leaders to guide voters towards progressive change, Power to Heal reminds us that social movements provide the real leadership.  It’s important to take a moment to appreciate the magnitude of the victory that was won by the activists who worked together to push through the healthcare reforms of the civil rights era.  The success of their efforts should serve as an example for us to keep up the struggle for National Improved Medicare for All. 

Whose victory?

Dr. Karen Kruse Thomas, author of Deluxe Jim Crow: Civil Rights and American Health Policy, 1935-1954, specializes in the history of racial health disparities in the 20thcentury. She worked as a researcher and interviewer on the film and attended the screening as a panelist. Her opening remarks drew attention to the centrality of Black advocacy organizations in the formation of Medicare, a history that stretched back to well before Johnson entered office:

“All the major Black organizations lined up and testified in Congress on behalf of the Truman Health plan, which included national health insurance”. It was because of a shared interest in universal healthcare that Truman was the first president to address the NAACP. US involvement in World War II had already created an incentive to implement a national healthcare program.

At the same time that Truman was lobbying for a national insurance system, the British National Health Service was created. This year marked the 70thanniversary of the NHS and has brought much media attention to the role of Clement Atlee’s leadership as Prime Minister. But the momentum that created the NHS came from returning servicemen and a population devastated by war who demanded healthcare as a human right. Truman felt similar pressure, a tension that increased through the presidency of John F. Kennedy and into Johnson’s term.

“Healthcare was a unique part of the civil rights movement because there was white self-interest in healthcare when there wasn’t in anything else,” Dr. Thomas remarked. The mutual interest of both white and African American citizens in healthcare was the glue that brought the Johnson administration and grassroots activists together.

Black leadership in movements for health justice

If Power to Heal has a villain, it must be the American Medical Association, which first lobbied against Truman’s national health plan as “socialized medicine” and hired then-actor Ronald Reagan in 1961 to record an album attacking Medicare as a precursor to “a socialist dictatorship.” The AMA also supported hospital segregation and was a frequent target of protests during the civil rights era.

The National Medical Association, founded and run by Black doctors barred from the AMA, was a key advocate for Medicare. To this day, the NMA remains committed to a single payer program. This underscores one of the most important takeaways from the film: that we must take time to learn from the stories of the people who started this fight. We shouldn’t be surprised that the AMA still refuses to support single payer in spite of its current popularity among doctors.

Civil rights activists’ involvement in healthcare didn’t end in 1966. The influence of the community clinics created and run by the Black Panther Party, for example, is very much alive in the present. In Baltimore City, grassroots and peer-driven advocacy work towards harm reduction combine a historical perspective of the racialized origins and impact of the War on Drugs with the urgency of saving lives now.

Our second panelist at the event, Marvin “Doc” Cheatham, brought the discussion to the topic of health injustice in Baltimore. Cheatham is the former head of the Baltimore NAACP and now organizes with the Green Party. “Since 1975”, he told the audience, “minority health status has steadily eroded and there have been no significant improvements in the removal of barriers that are due to institutional racism”. Reports issued by Baltimore City and the Johns Hopkins Hospital in 2008, 2011 and 2017 “clearly documented significant and continued health disparities in many communities”.

Cheatham introduced a theme that was repeated during the panel discussion and in the audience comments that followed: community health goes beyond the need for good medical care. As an example, he cited food deserts—neighborhoods that lack easy access to fresh, nutritional food—as a significant barrier to improving health outcomes in Baltimore City. The problem of food deserts has gained increasing recognition, thanks to the work of grass-roots community activists.

Dr. Richard Bruno, our final speaker, is a family physician who lives and practices in Baltimore City. He reminded the audience of the lead paint epidemic affecting thousands of poor Black children in Baltimore, of asbestos in schools, of a city government that has not prioritized the lives of Black youth. Even now, Bruno said, a landlord can still get away with renting a property that is contaminated with lead paint.   

Moving into the discussion, audience members brought up a number of problems that single payer alone won’t fix. One attendee talked about the demonstrated impacts of the stress and trauma of living in a racist society on Black people in the US. Audience members also highlighted the need for more and better recreation facilities and services for city youth. All of these issues affect the health of city residents.

Michael Coleman of United Workers brought up housing injustice and the efforts to push the City to fund community land trusts. A year or two ago, I attended the launch for the campaign, where I watched Mayor Pugh promise to give funding to this project in front of a large public assembly – a promise that she neglected until pressure from the housing rights movement ensured her renewed support.

In regards to building a national health insurance system, the audience wanted to know more about ways to work for results now, in addition to pressuring legislators to sign on to HR-676. How can social work students, who know that they face high levels of burnout in the field, stay hopeful? Dr. Bruno answered that keeping conversations going about single payer and educating fellow healthcare providers is critical.

Medicare for All and Health Inequality

“Single payer healthcare has the potential to address poverty, inequality, discrimination and provide a more efficient and effective healthcare system for everyone. I can’t think of another reform that can do so many things at once,” Dr. Thomas remarked. She noted that this issue has the potential to bring together groups and interests that often diverge. Many people from different communities and political perspectives feel that they have been wronged by our current healthcare system.

Our movement must continue to show up for racial justice in housing, in education, in food and nutrition. Working together, we can be stronger than any powerholders who stand in the way.

Healthcare is a Human Right Maryland has copies of Power to Heal for in-home use and we are working with local groups across the state to arrange screenings of the film. If you would like to purchase a copy of the film or arrange a showing in your community, please contact me at [email protected]