--Jeffrey O. G. Ogbar, Director, Institute for African American Studies, University of Connecticut and author of Black Power: Radical Politics and African American Identity (The Johns Hopkins University Press), 2004 and Hip-Hop Revolution: The Culture and Politics of Rap (University Press of Kansas), 2007.
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Blacks are more likely to be uninsured than nonblacks. In 2004, 19.7 percent of black Americans did not have health insurance, according to the Census Bureau. It was 15.7 percent for all Americans in 2004. For Americans generally, the percent without health insurance has been rising.
The growing number of uninsured is only one of several critical problems facing the American health care system. The New York Times highlighted another problem in its series of articles on diabetes in January of last year: the American health care system does far too little in terms of preventive care.
Consider treatment for diabetes. Blacks are more likely than nonblacks to be diabetic. Diabetes is the fourth leading cause of death among blacks. The New York Times ("In the Treatment of Diabetes, Success Often Does Not Pay" by Ian Urbina, January 11, 2006) illustrated how dysfunctional the American health care system is. Effective diabetes treatment centers were closed down because they did not make money, and they did not make money because they provided good preventative medicine. Urbina writes:
[The diabetes treatment centers] were victims of the byzantine world of American health care, in which the real profit is made not by controlling chronic diseases like diabetes but by treating their many complications.The United States spends a greater proportion of its wealth on health care than any other county, but Americans have rather little to show for it. In international comparisons, American health care ranks highly for treating some specific diseases, but overall the American system tends to fall near or at the bottom of developed Western nations (see the World Health Organization's 2000 ranking).
Insurers, for example, will often refuse to pay $150 for a diabetic to see a podiatrist, who can help prevent foot ailments associated with the disease. Nearly all of them, though, cover amputations, which typically cost more than $30,000.
Patients have trouble securing a reimbursement for a $75 visit to the nutritionist who counsels them on controlling their diabetes. Insurers do not balk, however, at paying $315 for a single session of dialysis, which treats one of the disease's serious complications.
Beyond the Public-Private Debate: An Examination of Quality, Access and Cost in the Health-Care Systems of Eight Countries (Vancouver, BC: Western Sky Communications, Ltd., 2001) by Cynthia Ramsay, a health economist, produced the following overall rankings after a detailed analysis of eight health care systems:
- United Kingdom
- United States
- South Africa
In December of 2005, the New York Times had another important article on the American health care system. Eduardo Porter (in "Health Care for All, Just a (Big) Step Away," December 18, 2005), explained that, from a purely economic standpoint, the U.S. could fairly easily shift to a universal health care system that would provide health insurance for everyone.
What Porter argued was that the federal government provides about $130 billion to businesses in tax breaks to encourage them to provide health insurance to their employees. If the federal government collected these taxes and added a little more revenue, it could provide health care for all. The 20 percent of blacks without health care would be much better off under this system.
Randolph K. Quaye (African Americans’ Health Care Practices, Perspectives, and Needs (Lanham, MD: University Press of America, Inc., 2005), 50-51) comes to this conclusion after assessing the American health care system and the needs of black Americans:
Countries that have provided universal health care coverage for all their citizens have realized the massive health care cost savings associated with such a policy. As we in the United States struggle to contain health care costs, it is time to recognize that tax incentives for health care coverage only to big corporations will in the long run not be in the best interests of this country. As has been demonstrated, the loss of manufacturing jobs overseas and the high cost of prescription drugs in the face of a potentially bankrupt Medicaid and Medicare systems will in the end frustrate the aspirations of younger and older Americans. The time to act is now, and act we must.Health care for all!
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--Algernon Austin, Ph.D.
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