The Fight against Universal Health Care in U.S. is Rooted in that Peculiar Institution

On the Monday in January 2015 marked in the U.S. by many to commemorate the life of the Rev. Dr. Martin Luther King, Jr., the organization called Healthcare-Now in the U.S. 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, then went 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.” Their email said nothing about the lingering effects of slavery.

That night, the Fresh Air broadcast on National Public Radio (NPR) involved 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, already had their own Fugitive Slave laws. The very clearly expressed federal Fugitive Slave law of 1850 was intended to prevent the south from seceding but it had the opposite effect because, 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 NY did not enforce the Fugitive Slave law as forcefully or even at all. Still, at this time NYC was a very dangerous place for free black people as shown in the movie 12 Years a Slave, the story line of which was based on an actual memoir. Southern states saw this non-enforcement or lax enforcement of the Fugitive Slave Law as the north violating federal law and therefore, the north could not be trusted. 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 as at the time of the writing and ratification of the Constitution, slaves were 20% of the population but not included in “we the people,” that this omission is “a flaw in the DNA” of this country and remarked on the “need to come to terms with how deeply slavery is embedded in the history of the country.” Noticeably, in the written “highlights” for this interview that you’ll find on the NPR website make no mention of these parts of what Foner said. In connection with this omission, see the seminal article by the late Columbia University Prof. Manning Marable on “Structural Racism and American Democracy” published in 2001.

I go to some length to relate points made in this interview with Professor Foner, in combination with the email from Physicians for a National Health Program, because it’s very clear to me that the basis of the refusal of the U.S. to have universal health care for all can be found in the culture’s dismissal of truly dealing with its history of slavery and to honestly face the over 200 years of mistreatment, torture, physical and mental abuse, theft, disrespect, and murder by one group of residents towards another group of residents, whom the former forcibly brought to this “land of the free and home of the brave.” The cause is not just in 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 to this day with finding racially focused genetic reasons for such complex ailments as cardio-vascular disease (CVD), high blood pressure, and diabetes. This obsession waned somewhat around the time of the mapping of the human genome but has roared back into power to the detriment of the health of everyone in the U.S., not just so-called “people of color.” Medical researchers and physicians still can’t make up their minds whether to accept or reject the racist hypothesis of so-called salt hyper-sensitivity in people they ignorantly perceive, conditioned by the racist “one drop rule,” as being “not white” and therefore “black” and therefore with ancestors who had experienced the Middle Passage, even if those people had come to the U.S. directly from Africa well after the end of the legal transportation of enslaved peoples from that continent and/or truly do not have any known ancestors originating in Africa no matter how far back you go.

Simultaneously, from time to time, Republican and several Democratic members of the U.S. Congress, seek to weaken or even eliminate the Social Security Disability program, the Social Security program itself, as well as Medicaid and even Medicare. If you take a careful look at the application forms and processes for SS Disability and for Medicaid, you quickly come to the conclusion that the focus of the system is on rooting out any possibility that the person applying for such aid is not faking or malingering or lying so as to avoid getting back into the workforce sooner rather than later.

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 work very hard preferably doing physical labor, for the benefit of the capitalist system and capitalists.

U.S. style capitalism is built on slavery. We hear variously that why the U.S. does not have universal single payer health care is that it’s too expensive and the country can’t afford it (but can afford war after war and massive tax breaks for the Waltons and their Walmarts, for example. Read the books of the openly Republican David Cay Johnston on this point, such as Free Lunch), that, if you call yourself a liberal or a Democrat, that the lack of universal health care can’t be helped, that the medical device makers and the pharmaceutical companies lobbied Obama very hard or was it the very wealthy sickness care corporations (as if he could not resist and instead cleave to a moral imperative for universal health care), that this, that that, in essence a whole slew of excuses, shying away from the reality that non-unionized working class and even lower middle class jobs in the U.S. tend towards operating a lot like slavery. Those in power want to expand that system as we see from the almost complete decimation of unions in the U.S.

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. This attitude is rooted in slavery.

To break apart 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 that DNA of which Prof. Foner spoke. While the Black Lives Matter movement is a start, 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.

Cécile Lawrence, Ph.D., J.D., is a writer, college lecturer, activist, and hiker. Read other articles by Cécile.