Thursday, November 15, 2007

Health Care, Justice, Profit and Racism

"The fact that we don't have universal healthcare is racist."

Vijay Prashad, Associate Professor of International Studies, Trinity College and author of Keeping Up With the Dow Joneses

"The fundamental issue is that we cannot continue to have a healthcare system with profit as its primary goal and expect it to help people become healthy."

Praxis News & Notes (Fall 2003)
The Praxis Project, Washington, DC

19 comments:

Cole M. French said...

Are these statements supposed to be food for thought? Because, they solve nothing...

Larry James said...

They are both "food for thought" and the ethical material for arriving at the solution you seem to say you'd like to hear about. One of the reasons we have no "solution" is because of the faulty assumptions we make about health care, its nature and our obligations toward one another in a moral society.

Confronting the racism back of the demographics of American public health reality ought to advance a thinking, moral culture to take whatever steps might be necessary to address the problems of created by race-linked/based disparities.

Admitting that our current system is more about market forces and P/L statements than about doing what it takes to improve overall public health outcomes should be a first step toward major and radical reform.

I put these quotes up to provoke thought with the assumption (unwarranted possibly--you decide)that the American people want what is right, decent and moral.

So, what are your thoughts, Cole?

chris said...

MY thoughts are why on earth are you quoting statements from a dedicated communist, especially if they are ridiculous

If you want to read something on economics from a real intellectual Indian, I suggest reading some of the writings of the late Dr. Romesh Diwan. Romesh and I were friends for years and I will always count him as one of my best friends. Just google his name.

Daniel Gray said...

chris -- labeling people for shock-value is not a very effective form of dialogue...

Since you obviously disagree with the value statements in these quotes, why don't you address those rather than pulling out the McCarthy Scare Card.

Anonymous said...

Chris, when you throw around the word "communist," what exactly do you mean? Are you saying Prashad is a Soviet Communist, or do you believe that people advocating socialist ideas vs. the status quo of unregulated capitalism are "communist" by your definition? Do you own an insurance company? Or, do you just sell the product? We aren't as dumb out here at you seem to imply with your comments.

Chris said...

Here is a quote from his biography.

"Vijay Prashad teaches in the Depts. of History at Cornell University and Syracuse University. He earned his PhD at the University of Chicago in 1994. Prashad is currently working on a project that responds to the ideas of Western Marxism: he is making theory out of the praxis of 'Eastern Communism'. Prashad is a member of the Young Communist League.

Larry James said...

Chris, let me help you out with this update on Dr. Prashad: Vijay Prashad is Professor and Director of International Studies at Trinity College, Hartford, Ct. His most recent books are The Darker Nations: A People's History of the Third World (New Press, November 2006) and (with Teo Ballve) Dispatches from Latin America: Experiments Against Neoliberalism (South End Press, October 2006). He is the author of ten other books, including two chosen by the Village Voice as books of the year (Karma of Brown Folk, 2000; Everybody Was Kung Fu Fighting, 2001). He is on the board of the Center for Third World Organizing (www.ctwo.org), United For a Fair Economy (www.faireconomy.org) and the National Priorities Project (www.nationalpriorities.org). He writes a monthly column for Frontline, India (www.frontline.in) and occasionally for Counterpunch (www.counterpunch.org).

That said about Prashad, what does his background have to do with what he said? Your comments attack the source rather than the substance of the opinion. Reminds me of some of Jesus' critics in the Gospel stories.

chris said...

Because what he says is not true--the fact that we do not have universal health care has nothing to do with race.

The profit motive is what makes our country great. In communist countries the motive is to have everyone equal--equally miserable. I wonder why Prashad chose not to move to a communist country if they are so great?

Larry James said...

My point is not to argue that the profit motive is always bad. The point here is that it doesn't work when applied to healthcare--health cannot be treated as a commodity to be bought and sold. If you compare the public health outcomes in nations with single payor systems, where health and health care are regarded as a human value open for all, you can see our system is broke. No one is arguing for communism here. And, yes, the data reveals that our system has racist outcomes. Another misconception: systemic racism results when we set up systems that by definition eliminate benefits for whole groups of people.

Larry James said...

Example of my point: the death rate from asthma among African
American children is four times higher that among Caucasian children...just a fact.

Ryan_267 said...

"The fact that we don't have universal healthcare is racist."

"The fundamental issue is that we cannot continue to have a healthcare system with profit as its primary goal and expect it to help people become healthy."

It seems to me that the current healthcare system in place in America is only racist by default. That is, it doesn't discriminate against racial minorities any more than it does against poor caucasians. It's just that a higher percentage of minorities are poor, due in part to racism in our society that has nothing to with the provision of health care directly.

I definitely agree with the second quote though. Markets are an oppropriate means of distribution of many goods and services. But coming to an understanding that they are not the right way to handle all services does not make someone an advocate of Soviet or Chinese style communism. There are some services such as health care that are just too important to leave to the market. I think health care is probably the best example since I believe access to health care ought to be recognized as a human right, not a commodity to be sold only to those who can afford it.

chris said...

One last comment from me. I think 50 years ago there was rampant racism but today it might even be a plus to be a minority. It's time to stop playing the race card.

Anonymous said...

Chris, ask a minority child with ashtma if she agrees with you.

Anonymous said...

I think we can all agree that the health care system is broken. Those with money have access and the majority, not just the minority are penalized because of it.

This is an access and poverty issue, not a racial issue.

Daniel Gray said...

I am a racist.

chris, the pluses of being a minority are far and few. I know you're thinking of affirmative action and how minorities often get jobs over equally-qualified if not better qualified white candidates. True this does happen, and there are people who are afraid of the whole "race" issue and target minority hirings out of fear of being labeled a racist. But these cases are far and few... the majority of minorities still face discrimination today in so many ways.

The problem is that today's racism is intertwined with education, socioeconomic status, and historical factors in a way that seems like racism is not an issue. Because of the extreme segregation and oppression faced by minority groups 40-50 years ago, it has created a chain reaction through time that has led to significantly high numbers of blacks who today or poor, uneducation, and have poor health.

No one is beating up blacks and burning crosses in their yard today. (Well, even that's not entirely true.) But the fact that we have significant minority populations missing out on the same opportunities most people have today is the problem. This disparity is a product of the past. And to do nothing to change that, is in effect racism.

Racism today is not primarily an active oppression of other people (hence, why we think it doesn't exist). But it does exist. Our racism today is in the reluctance to fix the problems caused by past racism.

As a white, as long as I refuse to acknowledge the disparity created by racism in the past, and as long as I do nothing to actively change the situation caused by that racism, I too am a racist.

Anonymous said...

I don’t totally agree or disagree with what any of you are saying other then based on my own personal experiences, the healthcare system is severely out of balance for most of us no matter what your skin color is.
I don’t feel it is wrong for those who have the means to pay to have access to better care. Yet I do feel the playing field is not level for the rest of us, the working middle class and impoverished. I am white, low income and have insurance yet a serious illness would still be devastating for me. That is wrong.
How can you make health care a racist issue when I see what my low income, elderly parents experience trying to get adequate health care for themselves? They get the same treatment or lack of treatment that everyone else does who is caught in our broken system and it has nothing to do with color.

Larry James said...

For the past year I've been involved with the Baylor Health Care System as a member of their health equity advisory board. The concerns of this group revolve around achieving equity in all treatment protocols throughout the system. The group is looking at research to discover points of inequity or injustice in the hospital system when it comes to treating different groups of the population. Gender, age, race and economic status are always factors under review. This very fine health care system, one of the very best in the nation, recognizes the challenges of equity and they consider race in their analysis every day. If they can see the connections to race in health disparities, even when controlling for socio-economic status, I think we'd be well advised to rethink our perspectives on the subject as well.

Ryan_267 said...

That's interesting Larry. I would have thought that race would not still be a factor when socioeconomic status was accounted for. If race is still a factor in provision of health care, that's very unfortunate indeed.

See you at the walkathon!

Justin said...

Wow. I don't know how I missed getting in on this ;)

I haven't researched the person quoted above, so I'm not one hundred percent sure that he is or isn't a soviet tyrannical style communist, but I don't think its out of line for someone to mention that when his ideas are being tossed around as truth. I mean, we've seen communism in action, and it isn't pretty. The motivation of Communists often starts out as one of trying to protect the greater good, but it nearly always ends in mass killings. Because in order to achieve the "fairness" that those that prescribe to communism desire, you must have total cooperation. And it has to come at the barrel of a gun.

If the country is racist, and racism is why we don't have universal coverage, why are we to believe that having the government take care of everything, leaving no choice for anyone, is going to fix the problem. If the people are racist, would not the government be racist as well... or if its not, is it not possible that racists could become bureaucrats involved in denying or allowing coverage? Then what do you do... when the government denies coverage and its illegal to go elsewhere for health care? Right now, Canadians who are more and more frequently running into this problem come to America and pay out of their own pocket (post tax dollars of course) to get the life saving procedures that they would have to wait months, even years for in Canada's single payer system.

The reason there are such long wait times is the same reason that doctors offices are filled to capacity now... and the same reason prices are out of control. There is no longer any incentive to find the cheapest and best doctor. Insurance and HMOs (as well as medicare) will pay up to a certain amount. And guess what doctors end up charging?

And tort suits have caused doctors to do unnecessary tests in order to protect themselves from legal dilemmas... this also increases the cost of health care.

Businesses normally raise prices to slow down demand. In this situation, that does not happen. Prices go up, but you and I and whoever does have insurance with a co pay pays 10-20 dollars per doctors visit, even though the actual cost to the insurance company is much higher. We don't see the increased cost, so we still go to the doctor every time we get a cold or a sore throat.

The system as we have it is broken, there is no doubt. Health care costs are spiraling out of control. But the answer of single payer system is the exact reason health care is so expensive. Sure, single payer's going to be "free" for a lot of people, but its not going to be free for everyone. In fact, a few people will end up paying health care cost for everyone. What happens when those people decide their done being greedy and making money?

The only sane answer to this problem is to get rid of massive employer sponsered health plans, and pass tort reform. Then you give major tax incentives to people who have coverage for emergencies... things that people really can't afford on their own. Employers can use extra money that previously went to growing health care costs to put in an HSA for each employee... allowing them to keep that money at the end of the year if it goes unused. This money is used to purchase meds, go to the doctor, etc. Then, you will have a true market system back in medicine, which will lower costs tremendously. Right now, we don't have a free market... and that's what's causing the problem.

And that's why when I go to the doctor and tell them I'm paying out of pocket, I get a discount. Because supply and demand doesn't control when insurance is involved.