It is impossible for any rational person to deny that our current healthcare system is dysfunctional and cruel. As a nation, we spend more than twice as much on health care as the people of almost every major country on earth while achieving worse outcomes. Even worse, Black Americans see only a fraction of those sub-par returns. In America today, Black babies are more than twice as likely to die in infancy than babies born to white mothers, and Black women are three or four times more likely to die from pregnancy-related complications than their white peers.
To change those unacceptable outcomes, it’s important to recognize that maternal health disparities don’t start at pregnancy. They start before mothers are even born.
According to The Center for Reproductive Rights the key drivers of the maternal mortality crisis are poverty, racism, and lack of health insurance. Tragically, women who are uninsured or enrolled in Medicaid report that they often receive no postnatal care, and inadequate prenatal care. They are also less likely to receive paid parental leave, during which they can adequately recover from the physical toll of pregnancy. Moreover, because women of color are more likely to live in poverty without health insurance, they’re more prone to risk factors for maternal death, like diabetes and heart disease.
In my view, any plan that targets Black maternal health that doesn’t include unequivocal support for a universal health care system that is free at the point of delivery is not good enough.
The Medicare for All Bill I’ve introduced will help prevent Black mothers from being discriminated against as they’re poised to give birth—left laboring in hallways because of their perceived inability to pay. It also means that large numbers of Black Americans who live in southern, Republican-controlled states like Mississippi will no longer have to suffer because local legislators rejected President Obama’s Medicaid expansion. Medicare for All will provide long-term home health care and community-based services for everyone.
We also have to address point-of-care discrimination due to provider bias and unequal resources for marginalized communities. That’s why Medicare for All requires us to address racial health disparities. It creates an Office of Primary Health to make sure that people living in underserved areas receive the high-quality health care that they need and that we adequately train doctors, nurses and medical providers to eliminate the unacceptable disparities in healthcare in urban and rural areas. And by substantially increasing funding for the National Health Service Corps as well as fully funding all Historically Black Colleges and Universities, which have a proud tradition of graduating a disproportionate share of Black doctors and nurses, we can facilitate the education of medical professionals and make sure that Black patients are treated with the respect and dignity that they deserve.
And let’s be clear: African-Americans are disadvantaged by an employer-based insurance system. In America today, Black employment rates remain disproportionately low due to well-documented employment discrimination, unequal public education and other systemic biases. While 65 percent of White families receive insurance through their employer, only 46 percent of Black families do, which in part explains why the uninsured rate for Black Americans is 11 percent—over 50 percent higher than that of White Americans.
Health care disparities expose the intersection of racism, classism and greed that is destroying the social fabric of America. Aetna—a company that just apologized for their role in the slave trade in 2000—now makes enormous profits by denying needed care, charging outrageously high premiums and deductibles and refusing to cover people they deem are too “expensive, all while providing a $500 million bonus to its CEO for merging with CVS in 2018.
While Black families receive subpar treatment for expensive care, the top 177 health care CEOs in America took home $2.6 billion in total compensation in 2018. While millions of Americans plead on the phone for insurers to pay for life-saving treatment, those same insurers spend millions on lobbyists to make sure that Members of Congress continue to protect the profits of the insurance industry over the lives of their constituents.
Further, there is something profoundly wrong in America today when Black children disproportionately go without dental care, while profitable companies like Amazon, owned by the wealthiest person in America, paid nothing in federal income taxes last year.
The dignity of life should start at birth and extend into retirement. Having high-quality dental, vision, hearing and long-term home health care should not be a privilege reserved for the rich. As a nation, it is time for us to go beyond “recognizing” or “acknowledging” health care disparities to advancing policies that will end them for good. And that is exactly what the Medicare for All legislation that I have introduced will accomplish.
The cruel indignity of not being able to afford health care is an experience that knows no color boundaries. But it is an experience disproportionately shouldered by Black and Brown women in this country and it is time for that to come to an end.
In the richest country in the history of the world, we can and we must guarantee health care as a human right and eliminate the outrageous health care disparities that exist in the United States of America. And working together, that is exactly what we will do.
Bernie Sanders is a Democratic candidate in the 2020 presidential election.