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Medicare for All Must Center Racial Equity

Passing Medicare for All is an Important First Step to Reducing Racial Inequities in Health Care

By Abi Velasco, Racial Equity Policy Associate

The health care system in the United States has a history of putting profits over people. As a result, insurance companies, Big Pharma, and corporate-run hospitals rake in exorbitant profits while many Americans struggle to access affordable healthcare and are left with staggering bills for their care. Medical debt in the United States totals approximately $140 billion.

This is exactly why Public Citizen has been in the long fight to enact “Medicare for All.” Medicare for All would replace our currently fragmented and profit-driven health care system with a single-payer, public system. Health care would be guaranteed and everyone in the U.S. would be able to finally get the health care they need, when they need it.

Passing Medicare for All would benefit all Americans, but in particular would lay the groundwork for a more equitable health care system for Black and Brown people who – for far too long – have been marginalized in our health care system.

The history of inequality in the health care system can be traced back to the beginnings of slavery more than 400 years ago. Since then, while progress has been made, much inequality remains. In particular, Black Americans are more likely to be uninsured, which contributes to worse health outcomes. Shockingly, when it comes to maternal mortality, Black women die at three to four times the rate of white mothers. And the ongoing COVID-19 health crisis has shown how the systemic inequality in the health care system contributed to Black and Brown people dying of COVID at higher rates than whites.

Public Citizen believes not only that Medicare for All is the right thing for the country, but the best way to begin removing systemic inequities in the health care system. However, organizations, including Public Citizen, that have been fighting for Medicare for All have historically failed to prioritize Black and Brown voices in their advocacy or meaningfully engaged with communities of color to understand how the current system has continued to fail them. That must be a priority moving forward. Without explicitly prioritizing racial justice, the Medicare for All movement risks further marginalizing Black and Brown people.

But the racial equity work has already begun. An influx of progressive activists have worked to ensure that Black and Brown voices are part of the conversation to make Medicare for All the law of the land. Through relationship building and amplifying Black and Brown voices and leadership, the push to bring quality health care to all in this country is gaining further momentum. Partnering with allied organizations led by people of color, in 2019, Public Citizen helped to mobilize a letter from civil rights organizations calling on Congress to support Medicare for All as a racial justice issue. In June 2020, Public Citizen hosted a webinar with healthcare leaders to discuss these changes in the Medicare for All movement. Moderated by Public Citizen’s Medicare for All campaign director Melinda St. Louis and Dr. Sanjeev Sriram from Social Security Works’ All Means All campaign, members of the Medicare for All coalition talked about the importance of centering racial justice in our Medicare for All movement work, including both the ways a Medicare for All system would reduce racial disparities in healthcare and its limitations in fully addressing racial inequity. In our ongoing efforts to build local coalitions in cities and towns across the country to win municipal resolutions in support of Medicare for All, we’ve made sure to highlight the voices and perspectives of Black and Brown local activists and elected leaders in our monthly webinars and activist trainings.

And the movement worked to ensure that Medicare for All would address the racial equity gap in health care. In March 2021, Representative Pramila Jayapal (D-W.A.) reintroduced the Medicare for All Act. If passed, this legislation would create an Office of Health Equity in the U.S. Department of Health and Human Services that would be tasked with increasing coordination and collaboration to increase access to health care, especially in underserved areas and for underserved populations.

While the Medicare for All Act is an important step in ensuring everyone in the U.S. is able to get health care when they need it, the movement recognizes that this is simply one step — getting everyone, especially Black and Brown communities, the health care they need goes beyond just being covered. Access to culturally competent and geographically close health care is yet another hurdle, but one that can’t be fully addressed until everyone is insured. Medicare for All is the starting point to better identifying where gaps and disparities exist. We are confident that one day Medicare for All will pass. And when that day happens, it will be a significant step in tackling the challenges of racial inequality in the health care system, and allow Black and Brown communities to thrive.