The fight against universal health care in the U.S. has its roots in the peculiar institution

By Dorian Grayson

On the Monday in January 2015 commemorating the life of the Rev. Dr. Martin Luther King, Jr., Healthcare-Now emailed its subscribers a message titled “Reader’s Guide to Racial Equity in Healthcare.” The message started with the still necessary reminder that no biological basis for race exists, going on to point out that “[i]n the United States . . . segregationist politics in Congress blocked national healthcare for much of the 20th century – not, as is often claimed, the growth of employer-based insurance during WWII.” While this information is correct, nothing was said about the lingering effects of slavery on healthcare.

That night Fresh Air on National Public Radio (NPR) aired an interview with Eric Foner, history professor at Columbia University, about his new book Gateway to Freedom: The Hidden History of the Underground Railroad. Professor Foner pointed out that the U.S. Constitution itself has a Fugitive Slave clause, although vaguely worded. Even so, by 1850, several U.S. states, mostly in the south, not satisfied with this, had passed Fugitive Slave laws. The federal Fugitive Slave law of 1850 was intended to prevent the South from seceding but it had the opposite effect. According to Foner, while slaves or even free black people were brutally captured in some northern states to be sent back south into slavery, other states, like New York, refused to enforce the law vigorously. Still, at this time, NY was a very dangerous place for free black people as shown in the movie “12 Years a Slave,” based on an actual memoir. Southern states saw non-enforcement or lax enforcement of the Fugitive Slave Law as the North violating federal law and therefore, an example of northern untrustworthiness. This was one of the important factors leading to the U.S. Civil War.

Foner commented that the U.S. Constitution was deeply flawed from the beginning. When the Constitution was ratified, slaves were 20% of the population but not included in “We the People.” For Foner, this omission is “a flaw in the DNA” of this country, which demands a “com[ing] to terms with how deeply slavery is embedded in the country’s history.” Noticeably, the written “highlights” for this interview that you’ll find on the NPR website, omit this part of Foner’s interview. (See the seminal article “Structural Racism and American Democracy” published in 2001 by the late Columbia University Prof. Manning Marable, for more on race and omission in the history of black oppression in the US.)

I go to some length to relate these points, because it’s clear that the slow development of universal health care in the US stems from a cultural inability to honestly face the 500 years of slavery, mistreatment, torture, physical and mental abuse, theft, disrespect, and murder of America’s black denizens, forcibly brought to this   “land of the free and home of the brave.” The cause is not just the persistence of the form of ignorance we call racism, but in the historical fact of slavery itself as experienced in the U.S.

The majority of so-called informed people in the U.S., including medical providers and medical researchers, are found lacking when it comes to the illusion of race. They show their ignorance in their misguided and dangerous obsession with

finding racially focused genetic reasons for such complex ailments as cardio-vascular disease (CVD), high blood pressure, and diabetes. This obsession waned (somewhat) during the mapping of the human genome, but has roared back into mainstream medicine to the detriment of the health of all, and not just so-called “people of color.” Medical researchers still debate the merits of black “salt hypersensitivity,” using research conflating “non-white” with “black.” For these researchers “black” means persons with ancestors who experienced the Middle Passage. The black US population, however, is extremely diverse. More than a few came to the US after the American slave trade ended (officially outlawed in 1808) and many others have no African ancestors. Furthermore, as should be clear, not all “non-whites” are black!

Simultaneously, from time to time, Republican and several Democratic members of the U.S. Congress, seek to weaken or eliminate Social Security Disability, Social Security in general, Medicaid, and Medicare. If you take a careful look at the application forms and processes for SS Disability and Medicaid, you quickly come to the conclusion that the system’s focus is on rooting out any possibility that the person applying for such aid is not “faking it,” malingering, or lying so as to avoid working.

People receiving SS Disability do not “work” at a job. People on Medicare mostly do not “work” at a job. People receiving Medicaid are receiving funds from the government to pay for their health care or at least the premiums so that they do not become a public health hazard. All of these people are either not in the workforce mostly and/or are receiving funds without working for it at the time of receipt. This sticks in the craw of a culture of people who firmly believe that the main, if not only sole purpose of people living in the U.S., unless very wealthy, is to do wage work, and preferably hard physical labor, for the benefit of the capitalist system and capitalists.

U.S. style capitalism is built on slavery. We hear variously that the U.S. does not have universal single payer health care because it’s too expensive. If the US is so broke then how can it afford war after war, or massive tax breaks for the Waltons and Walmarts? (Read the books of the openly Republican David Cay Johnston on this point, such as Free Lunch.) If you call yourself a liberal and believe that the lack of universal health care “can’t be helped” or that universal healthcare failed thanks to the intense lobbying efforts of medical device makers and the pharmaceutical companies, then you are shying away from the reality: non-unionized working class and even lower middle class jobs in the U.S. operates a lot like slavery. Those in power want to expand this profitable slave labor economy, which free and equitably distributed healthcare would undermine.

Generally speaking, the perception of the wealthy class towards everyone else is that the latter are akin to slaves, that it’s OK for workers to have their wages stolen from them, their health stolen from them, that they are to be worked into an early grave, that even one’s health has to be embedded in capitalism through the intimate participation of for-profit corporations, as the health of enslaved Africans was embedded in the plantation system. This attitude is rooted in slavery.

To break this mindset, we need to fully face the lingering psychological and socio-cultural effects of slavery. A nation-wide Truth and Reconciliation-type process which includes seriously addressing the several long-standing calls for reparations, might be a start to changing the racist DNA of which Prof. Foner spoke. More of us need to be talking about this, day after day, rallying in the streets with relevant signs, songs and chants, use all the tools at hand including social media and old school lobbying, towards building a massive movement calling for a real end to slavery of the mind.


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