For African-Americans, expanding access to health care is literally a matter of life and death. A recent CNN/ESSECE magazine opinion poll cited that 57 percent of Blacks feel that it’s extremely important for President Obama and Congress to deal with our country’s health care issues—a statistic only outdone by the importance of the economy and unemployment. The absence of health reform, as President Obama says, threatens our national economy. A case in point are General Motors and Chrysler whose bankruptcies were caused in no small part by the costs of providing health insurance for their workers.

It’s true that African-Americans are less likely to exercise regularly. Even among those who can afford nutritious food, some of us have never met a dish with grease, starch or sugar we didn’t like. We tend to be disproportionately sicker than White Americans and die at consistently higher rates of most common ailments. But personal responsibility aside, absence of adequate health care is crucial. According to the National Center for Health Statistics, African Americans suffer from high blood pressure, and higher rates of stroke, asthma, arthritis and diabetes. Independently, we also have an alarming HIV/AIDs problem with increasing incidence among Black women.

African-Americans are also disproportionately the uninsured. We are the sick people in any city or inner suburban emergency room seeking treatment with no ability to pay for the care.

Insuring everyone will not just help President Obama keep a campaign promise but allow each of us to acknowledge that access to health care is a fundamental human right. For African-Americans, paying attention to the debate and insisting on real reform has got to be a major priority.
Real reform means including a public government funded insurance option in order to compete with private insurance to provide better service and keep costs down. This is a far cry from the most practical idea of a “single payer” government insurance plan which would be more cost-effective and cover all of the uninsured. Republicans denounce such a plan as socialist. Not to mention that a single payer would unfortunately have the disadvantage of cutting jobs at private insurers, such as tracking claims, some of which are held by Black women.

Nonetheless a public option of some sort is needed. Business, labor, the drug and health care providers, and insurers all want an infusion of government money. If President Obama stands firm that they can’t have it without a public option—like it or not—some type of public option will be fashioned. The battle will take place over the details—extent of coverage, how closely the public option must abide by the rules governing private insurance, and whether it will kick in only after private insurance is given a chance to cover everyone.

The most significant obstacle President Obama faces is a lack of grassroots pressure. He needs enough to counter the heavy lobbying financed by the health care industry. Physicians, drug manufacturers, private insurers and hospitals all have well-financed campaigns and ties to members of Congress. Up until now, the President has not been able to generate enough of a unified, national sentiment addressed to the same legislators. African-Americans have got to help provide the pressure necessary to move the agenda forward. Otherwise, given the likely October deadline for passage, we will not get the extensive reform our people so desperately need.

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Mary Frances Berry has been a Geraldine R. Segal Professor of American Social Thought and Professor of History since 1987. She served as the Assistant Secretary for Education in the U.S. Department of Health, Education, and Welfare (HEW). Her most recent book is “And Justice For All: The United States Commission on Civil Rights and the Continuing Struggle for Freedom in America.”