As a primary care physician, I see racial disparities across every aspect of health care. Eliminating those disparities is a major priority to me. And Senator Bernie Sanders is the presidential candidate who best understands and is best prepared to fight those disparities.
The examples of racial inequality in health care abound. African Americans have the highest prevalence of hypertension in the world. We are three times more likely, on average, to have end-stage kidney disease requiring dialysis. Black women are slightly less likely to get breast cancer, but more likely to die from it. Black men have higher mortalities from even low-grade prostate cancers. Black children are six times more likely to suffer asthma-related deaths. These are realities I see and fight every day in my family medicine practice.
Lack of health-care coverage is a huge contributor to health disparities. In fact, black doctors have been advocating for universal coverage for people of color since we were freed slaves. The Affordable Care Act (ACA) did lessen some coverage gaps, but black people are still more likely than whites to be uninsured. Not only does this affect our physical health, it affects our financial wealth, leaving both older and younger black families in more medical debt.
Sanders’s Medicare for All (M4A) proposal is an improved form of Medicare that eliminates out-of-pocket costs at the point of care. It covers primary and preventative services, prescription drugs and medical devices, mental health and substance abuse treatments, laboratory and diagnostic services, reproductive and maternity care, dental health, audiology, vision services, and long-term care for seniors.
It caps prescription costs at only $200 per year. Eliminating out-of-pocket costs is crucial to ending health disparities, as African Americans are 1.5 times more likely than whites to report difficulty affording health-care costs. M4A alone could decrease poverty by 20 percent.
Sanders’s M4A bill contains explicit language that bans providers from discriminating against patients based on race, color, gender, and pregnancy. It allows for the development of an Office of Primary Health Care, which will provide training for providers at every level to address health disparities and perform a comprehensive evaluation of disparities to submit an action plan to Congress. It allows our nation to address not only the shockingly high black maternal mortality rate, but all health disparities across the country.
And not only would Sanders’s plan address racial disparities in health outcomes; it would also address inequities in who becomes a doctor to treat those disparities. Recent research shows that physicians of color are more likely to treat underserved populations, but black communities are still 67 percent more likely than majority-white communities to lack a primary care physician. M4A addresses this physician shortage by increasing funding for medical residency programs, expanding the National Health Service Corps loan repayment program, and increasing funding for historically black colleges and universities.
Sanders’s plan to cancel all student debt will disproportionately help black students and physicians who experience a greater student loan debt burden. Based on current student debt numbers, this policy alone would cut the racial wealth gap for young Americans from 12:1 to 5:1.
Without facing exorbitant student loan debt, physicians will be free to practice in underserved communities. By making public colleges and universities free, future black doctors will graduate with less overall debt, which makes them more likely to choose primary care. Black patients have plenty of reasons to be distrustful of the medical community; evidence shows that when black patients have a doctor who looks like them, they have better health outcomes.
In addition to insuring all people, eliminating costs as a deterrent, and increasing the field of black doctors, Bernie Sanders understands that we must also address social determinants of health in the black community.
Eliminating health disparities requires policies that will reverse decades of discrimination beyond just the health system alone. Sanders’s Racial Justice and Justice and Safety for All plans combat policies that promote toxic stress in black communities, a phenomenon that contributes to increased maternal and infant mortality for black women. These plans are designed to end voter disenfranchisement, abolish the death penalty, eliminate cash bail, promote law enforcement accountability, and eliminate private prisons.
Racial bias in housing contributes to poor health; Sanders addresses this in his Housing for All plan. This plan is designed to eliminate homelessness — an epidemic that hits African Americans especially hard, as we are 13 percent of the US population but 40 percent of the homeless population. Black families saw their wealth decrease by 40 percent due to the 2009 housing crisis; Sanders’s plan will create a commission to provide reparations for these families in the form of down payment assistance, mortgage relief, or rental assistance.
Black communities are disproportionately affected by climate change. Bernie’s Green New Deal plan will rectify these disparities, addressing environmental injustices that worsen health in black communities. It allows for a $40 billion Climate Justice Resilience Fund to help these communities recover from and prepare for the impacts of climate change. In addition, he is the only candidate calling to ban all fracking, a process that creates cancer-causing chemicals most likely to be disposed of in neighborhoods of the poor and people of color.
A Bernie Sanders presidency will lessen health disparities by making health care a human right through Medicare for All. And because we know poverty and inequality are leading indicators of poor health, Sanders’s anti-poverty policy proposals — his support for the Fight for $15’s demand for a $15 minimum wage; his Income Inequality Tax Plan; his promise to provide universal, year-round free school lunch; his Workplace Democracy Act to strengthen the labor movement; and much more — will do more to combat health disparities than those of any other candidate of our time.
Nobody claims that Medicare for All alone will eliminate all health inequalities. But it can play a crucial role in lessening them. A recent editorial by Jeneen Interlandi underscored this, explaining that “One hundred and fifty years after the freed people of the South first petitioned the government for basic medical care, the United States remains the only high-income country in the world where such care is not guaranteed to every citizen.”
Any candidate who fails to provide health insurance for everyone falls short in addressing health disparities for African Americans.