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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsNo. You can't just jury this away. Any American single payer system will be racist
I'll take as many hides as this requires, because if you don't get this, you aren't helping.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3983362/
That's an article about racial disparities in kidney failure survival rates in the US. Everyone with kidney failure in the US is put on Medicare. Medicare does not solve the problem: the problem is that Americans are racist as fuck.
Any American social healthcare plan that actually comes into existence will have as its first mission reassuring white voters. And that means they will deny black and brown patients the same opportunities white patients have.
This isn't a theory; this is what we have seen happen with Medicare. The system is not the problem. The people are.
We pretty much have word-for-word the Dutch healthcare system. The difference is that the Dutch jurisdictions are not actively sabotaging their system, and our jurisdictions are. That will remain true.
We cannot have universal healthcare in the US until we end racism. It is not possible.
FBaggins
(26,728 posts)You haven't even provided a thesis claiming that theoretical single-payer system would be more racist than the existing system.
I'm not a fan of single-payer... but this isn't a valid reason to oppose it.
WhiskeyGrinder
(22,326 posts)Why doesn't the United States have universal health care? The answer has everything to do with race.
The smallpox virus hopscotched across the post-Civil War South, invading the makeshift camps where many thousands of newly freed African-Americans had taken refuge but leaving surrounding white communities comparatively unscathed. This pattern of affliction was no mystery: In the late 1860s, doctors had yet to discover viruses, but they knew that poor nutrition made people more susceptible to illness and that poor sanitation contributed to the spread of disease. They also knew that quarantine and vaccination could stop an outbreak in its tracks; they had used those very tools to prevent a smallpox outbreak from ravaging the Union Army.
Smallpox was not the only health disparity facing the newly emancipated, who at the close of the Civil War faced a considerably higher mortality rate than that of whites. Despite their urgent pleas for assistance, white leaders were deeply ambivalent about intervening. They worried about black epidemics spilling into their own communities and wanted the formerly enslaved to be healthy enough to return to plantation work. But they also feared that free and healthy African-Americans would upend the racial hierarchy, the historian Jim Downs writes in his 2012 book, Sick From Freedom.
Federal policy, he notes, reflected white ambivalence at every turn. Congress established the medical division of the Freedmens Bureau the nations first federal health care program to address the health crisis, but officials deployed just 120 or so doctors across the war-torn South, then ignored those doctors pleas for personnel and equipment. They erected more than 40 hospitals but prematurely shuttered most of them.
White legislators argued that free assistance of any kind would breed dependence and that when it came to black infirmity, hard labor was a better salve than white medicine. As the death toll rose, they developed a new theory: Blacks were so ill suited to freedom that the entire race was going extinct. No charitable black scheme can wash out the color of the Negro, change his inferior nature or save him from his inevitable fate, an Ohio congressman said.
All of our institutions are built on white supremacy. We must dismantle it before we can move forward.
pnwmom
(108,976 posts)is diabetes, and most of the people who develop kidney failure developed diabetes LONG before they went on Medicare. And many of these people had no insurance or inadequate insurance before they went on Medicare.
It makes no sense to blame Medicare on the problem that developed long before.
And the expansion of Medicaid -- which is single payer -- has already improved the health outcomes of the people on it.
https://www.washingtonpost.com/health/i-would-be-dead-or-i-would-be-financially-ruined/2019/09/29/e697149c-c80e-11e9-be05-f76ac4ec618c_story.html?fbclid=IwAR2G5GkOX1nnR1jjxBxJ7YSxGyVrZyb1oyD6Nwh6WcbXrPsxzAIM_aT06HQ
DETROIT Poor people in Michigan with asthma and diabetes were admitted to the hospital less often after they joined Medicaid under the Affordable Care Act. More than 25,000 Ohio smokers got help through the states Medicaid expansion that led them to quit. And around the country, patients with advanced kidney disease who went on dialysis were more likely to be alive a year later if they lived in a Medicaid-expansion state.
Such findings are part of an emerging mosaic of evidence that, nearly a decade after it became one of the most polarizing health-care laws in U.S. history, the ACA is making some Americans healthier and less likely to die.
SNIP
It is difficult to prove conclusively that the law has made a difference in peoples health, but some strong evidence has emerged in the past few years. Compared with similar people who have stable coverage through their jobs, previously uninsured people who bought ACA health plans with federal subsidies had a big jump in detection of high blood pressure and in the number of prescriptions they had filled, according to a 2018 study in the journal Health Affairs.
TheRealNorth
(9,478 posts)brush
(53,764 posts)can't let that stop us from deploying improved services. As we have done for centuries we've learned, some more successfully than others, to work around racism as we go about our lives.
It would be the same with single payer health care.
Recursion
(56,582 posts)I don't want them. I don't want to benefit from them. I don't want to pay for them. I don't want to give Mitch McConnell the power to decide if sickle cell is a "real" disease or not.
brush
(53,764 posts)going anywhere. Moscow Mitch won't be working in your health care office. Be smart and learn to work around it like we've always had to do while trying to eliminate racism and rid the system of the racists.
TidalWave46
(2,061 posts)You make one point that is excellent and follow it up with a point that is truly ignorant. Racial disparity within healthcare is real. In your other op, you literally said that is a reason we cannot do single payer. That is just nonsense and completely ignorant. There are other words that could be used but I don't want a hide. Your thought experiment is so foolish it isn't worth discussion. It should be hidden.
Recursion
(56,582 posts)That's the barest way of stating the issue. And I'm happy to stand by it.
TidalWave46
(2,061 posts)You are conflating two things that should not be conflated.
Why achieve 100% insurance coverage for people of color when there is disparity services in place? Do you see how mind-numbingly foolish that is? Why make sure someone has a general primary physician? Why make sure every person of color has affordable access to cholesterol meds? Why make sure people of color can have access to affordable blood tests twice a year? Why make sure people of color won't go into insurmountable debt because of a necessary surgery?
Your thought experiment is frightening.
Talk about the disparity in services provided among races. Talk about how that won't disappear with single payer. Both of those aspects are as real as could be. Don't then follow it up with how we shouldn't move on single payer because of it. That is a level of dumb that cannot be entertained for obvious reasons.
To be fair, you have changed your wording for this op. This op is much less foolish that the other one.
edhopper
(33,570 posts)any part in a Single Payer system?
Recursion
(56,582 posts)If we give them power they will use it.
Act_of_Reparation
(9,116 posts)Yeah, ok. BRB while I end racism.
muriel_volestrangler
(101,307 posts)So your link disagrees with you. What is your case?
Recursion
(56,582 posts)Medicare is a single-payer system.
muriel_volestrangler
(101,307 posts)Then you can consider whether to self-delete your OP:
The problems with minority care are before they get onto single payer systems. After they're on Medicare or the Veterans Administration, the treatment is equal.
Your OP has got it completely wrong.
Midnightwalk
(3,131 posts)Theres a lot to digest there so apologies if I get some wrong.
The abstract says minorities tend to have worse progression of disease but have better outcomes once on dialysis.
The authors seem to think universal healthcare is a way to improve outcomes for minorities and in general.
In addition, the promotion of universal forms of health care and/or more structured medical care systems7 may be vital prospects to advance our knowledge. These approaches can ensure that all persons can receive timely quality care.
Also
I am not trying to argue there isnt way too much racism in America and in the healthcare system in particular. There is. Im just questioning your conclusion that single payer would make it worse. The article seems to argue that universal healthcare would help.
Mosby
(16,299 posts)It says that long term outcomes for kidney disease seem to vary based on socioeconomic status, race, and education, and these variables are interrelated.
Educated people are more healthy and live longer:
The health disparities are a lot more about knowledge and behavior but are influenced by poverty, family makeup and the legacy of slavery.
I think single payer/universal HC should mitigate these issues, not make them worse.
ETA those numbers (.71, .77, .62) are correlation coefficients where 1 is a perfect correlation. r = .7 for example is considered extremely high.
http://sites.utexas.edu/sos/guided/inferential/numeric/bivariate/cor/
ismnotwasm
(41,976 posts)Imma certified Med surg RN who also does in-patient dialysis. Racial disparities are very apparent in real time.
I think we can work toward Universal health care while simultaneously work toward racial justice.
Medicare for all is not going to work for a variety of reasons.
My last shift, our ICUs were 9 nurses down, and they were begging us to dialyize patients almost ready for floor care. Our dialysis list was also out of control. We work very long shift to provide care. Management hates the overtime we work.
We are short clinics. We are short providers. We are short nurses. We are short healthcare workers all across the county. Medicare chronically under reimburses healthcare services. Chronic Kidney disease is the only condition full covered (the history of why is interesting)
So while I agree in part, I also want to see forward momentum on universal healthcare.
ecstatic
(32,685 posts)And is the delay of detection due to not having any insurance, or not having regular checkups, or not going to the doctor at the first sign of an illness?
The reason I ask is because of this line:
I don't have time to read the entire article right now, but it sounds like they're saying that once the disease is detected, minorities recover even better than their white peers.
I'm not advocating for single payer, I'm just saying that this article doesn't appear to support your OP.
ismnotwasm
(41,976 posts)The average life span on HD is five years.
Im not going to get into this, but our healthcare system is part and parcel of institutional racism, as is all American systems.
That doesnt mean we cant move forward with universal healthcare, it means there isnt a simple fix.
Recursion
(56,582 posts)Single payer would be great, and it would still leave us with a ton of work to do. Just like we have now. But we could also make our current system work, if we fixed the same problems.