Featuring Dr. Tony Iton, Senior Vice President for Healthy Communities at The California Endowment: Why does the U.S. lack a universal, Medicare-for-All-type healthcare system like many other developed countries have? And what are the consequences? In this fifth and final episode of a podcast series with host Brenda Gazzar, Dr. Tony Iton discusses America’s long history of racism and both its impact on healthcare reform and on our fragmented response to the deadly coronavirus pandemic.
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RACISM, HEALTH CARE & CORONAVIRUS IN AMERICA
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Welcome to Code WACK, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host Brenda Gazzar. Today we’ll hear from a public health expert about the coronavirus pandemic and what forces may fuel America’s reluctance to adopt a single-payer healthcare system.
We have Dr. Tony Iton here with us. He’s the senior vice president for Healthy Communities at The California Endowment, a statewide health foundation. He previously served for 7 years as director of Alameda County’s Public Health Department. This is the fifth episode in a series with Dr. Iton about the deadly coronavirus.
Welcome back to Code WACK!, Dr. Iton.
Iton: Thank you.
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You’ve said that every developed country in the world has universal health care and paid sick leave except the United States. Why do you think that is?
Iton: Well, I think that there’s a long and unfortunately ugly history in this country of the inability to essentially create the social solidarity that’s needed to create universal policies. If the narrative basically says that undeserving people will get health care for free or undeserving people will just take time off of work and get paid, then there isn’t enough public will to get behind universal policies like universal health care or universal paid leave. And a lot of that has been driven by racism. It’s overwhelmingly racism. You don’t have to look very far in this country to see our history of apartheid and it’s overt racism. You see this throughout the history of legislative policy making in this country where Southern senators or various conservative senators and legislators have said that they don’t want to support policy that creates even the perception of equality across races. This is true in the New Deal. This has been true across a number of other policies. It used to be more overt now it’s full of dog whistles and you know this notion of crack babies and welfare moms and makers vs takers and the 47% and then you know this current president talking about some Americans being rapists and bringing drugs and bringing crime. That’s a narrative that doesn’t encourage people to see others as connected to them. Instead that narrative fosters people to see others as threats and then as a consequence ,you don’t get the you don’t get the sense of solidarity or shared fate that’s necessary to create universal policies. So that in a nutshell, American racism has precluded America from having Medicare for All.
I see. What do you think the worst case scenario is under our current healthcare system?
Iton: Well, I think we’re seeing the worst case scenario in many ways. It’s playing out right now. Louisiana expanded its Medicaid program, which is good because they’re right now a hot zone for COVID, but you’re going to see this in places like Alabama, in places like Arkansas, Mississippi, and other Southern states that have not expanded their Medicaid programs and so you’ve got huge swaths of the population that are uninsured. You also have divestment in health infrastructure in many of these places, rural hospitals that have closed clinics that aren’t adequately funded so you will see the worst case scenario playing out in the United States in 2020 in a number of these states. Even New York, which has a very generous Medicaid program and has made real investments in its public health system, is struggling to manage this outbreak.
Places like Mississippi and Alabama, they don’t have a prayer. The only prayer they have is that they’re not very dense and they probably don’t have the volume of sort of international travel and travel in general that you see in a place like New York or San Francisco but it will get there. It has gotten there. We’ve seen stories of that already and it will be devastating in those places.
Do you have a particular story in mind that illustrates why we need Medicare for All?
Iton: I think that there are hundreds of stories that make it painfully obvious. I personally don’t understand the argument against it. I can’t wrap any logic around an argument against universal healthcare. In fact, you know I think even in the American context we have pushed to these sort of designs that are basically universal. The VA (Veterans Affairs) system is a universal healthcare system for veterans. The Medicare system is a universal healthcare system for people over the age of 65 and people with chronic kidney disease. The Medicaid system to some extent is a universal healthcare system for children and mothers below a certain income level so it’s not like we don’t have the ability to design these systems. It’s that we spent so much time and effort trying to keep certain people out that we consider to be undeserving somehow that we’ve kind of cut off our noses to spite our face and that’s that’s the problem. We don’t really have any justification for that spitefulness anymore but the stories are all throughout the press of … people who are facing hospital bills in the tens of thousands of dollars, some of whom are insured by the way and and they have you know huge deductibles that they have to meet in the setting of a pandemic.
I can’t even begin to understand the other side of that argument that somehow this is a better design than universal health care.
Thank you so much, Dr. Iton! Find more Code WACK! episodes on ProgressiveVoices.com and on the PV app. You can also listen at HEAL dash C-A dot org. This project is powered by HEAL California, which uplifts the voices of those fighting for healthcare reform around the country. I’m Brenda Gazzar.
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