Health of Poor Americans Rests in Hands of Justices
President John F. Kennedy forced Gov. George Wallace to allow the first two
black students to attend the University of Alabama in Birmingham on June 11,
1963. At that time African Americans had twice the rate of unemployment, had a
life expectancy seven years shorter, were denied the right to a decent public
education, and earned only half as much.
Televised from the Oval Office, Kennedy said the National Guard was sent to
protect the students’ civil rights because, “They have a right to expect that
the law will be fair, that the Constitution will be colorblind.”
Nine Supreme Court Justices will decide this June on health legislation
affecting every American, but especially those that civil rights legislation
sought to redress nearly five decades ago.
Today, blacks compared with whites still have nearly twice the rate of
unemployment, have a life expectancy 3.6 years shorter, are almost half as
likely to graduate from college, and earn 60 percent as much. Yet we should not
indulge our cynicism that for minorities over the years – less employment,
poorer education and worse health – yield reluctantly to change.
Supreme Court decisions, and our state actions, affect New Mexicans. Over
40 percent of Native Americans are uninsured here, while Hispanics have twice
the rate of uninsured compared with whites (24 versus 12 percent).
It’s estimated that someone dies each day in New Mexico for lack of health
insurance, and 45,000 per year across the country. Glaring health disparities
persist in Native American, Hispanic and African American populations –
lower-quality health services, higher infant mortality and more chronic diseases
such as diabetes. Nothing reduces intractable health disparities faster than
insuring the uninsured.
As a nation, we pay twice what other developed countries pay per person for
health care. Yet our health outcomes are worse, far worse for the uninsured,
with a widening gap as demographics change. For the first time in history,
minorities comprised a majority of U.S. births (50.4 percent) in May. Hispanics
in states bordering Mexico comprise over half the Hispanic population of the
United States. With the presidential election nearing, candidates scurry to
court their vote.
New Mexico ranks in the bottom three states for percentage of the
population that is insured, and last in access to health care and prevention.
Within our grasp are the levers to lessen our uninsured more than any other
state, if we choose to pull the crank. For struggling families, for working poor
who can’t afford to buy insurance, it’s unconscionable to do nothing, or placate
the growing discontent with hollow half-measures.
What will the justices decide? If the Affordable Care Act (Obamacare) is
upheld, 150,000 uninsured New Mexicans whose household income is less than
$32,000 a year for a family of four will be covered by Medicaid starting in
January 2014. An equal number of uninsured would get help paying for health
insurance through a state or federal market exchange in the state. This will
create good jobs in our state, and dramatically improve health. That is unless
the Supreme Court throws it all out.
Like civil rights legislation 50 years ago, decisions will soon be made
whether each American can enjoy the privileges of a healthy citizenship, without
regard to race or color. These opportunities come as rarely as leaders with the
courage to turn the wheels of justice. As Theodore Roosevelt put it a century
ago, “No nation can be strong whose people are poor and sick.” Fifty years from
now Americans will wonder what took us so long, and why so many had to die,
waiting for us to act.
Dr. Dan Derksen is a family physician and a professor in the UNM Department
of Family & Community Medicine. and Senior Fellow at the Robert Wood Johnson
Foundation Center for Health Policy. He is the former director of the New Mexico
Office of Health Care Reform and past president of the New Mexico Medical
Society and N.M. Academy of Family Physicians.
Julianna
Koob~505.920.6002
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