Throughout U.S. history, people of color have endured a health care system that perpetuates racial disparities. Hospitals across America were segregated by race and, not surprisingly, black patients received inferior care, or no care at all. With the passage of the 1964 Civil Rights Act, Medicare, enacted a year later in 1965, refused to provide payments to institutions that discriminated on the basis of race. Within a matter of months, thousands of hospitals took down their “Whites Only” and “Colored Only” signs. Black patients were able to access care, some for the first time in their lives.
While Medicare ended legal health segregation, today, there is still inequality in both health coverage and outcomes between whites and people of color. Black Americans are more likely than whites to be uninsured, to spend a higher percentage of their family income on health care, have significantly lower life expectancies and often receive lower-quality health services. During the COVID-19 pandemic, minority communities are less likely to have testing sites, protective medical supplies and have been refused tests even when symptomatic.
It’s time to address these unequal power dynamics and substantially reform health care.
Single-payer Medicare for All would provide equal coverage for all medically necessary care, without financial barriers. Studies of patients in the VA and Medicare systems show that with universal and comprehensive health coverage, racial health disparities shrink and even disappear. We can replicate this success by adopting single-payer. Racial justice is tightly intertwined with health care justice.