hen Bernie Sanders suspended
his campaign to be the first socialist in the White House, Americans, including Democrat “moderates,” were hoping talk of single-payer health care would be put on the back burner, at least until after the election. Guess again. The case for socialized medicine is being ramped up in a subtler way: COVID-19 is a disease of racism, the argument goes, and the only way to fix it is more government health care.
It is hard to avoid media reports of how COVID-19 has impacted African Americans more than the rest of the population. Indeed, in some communities, black Americans are dying from the virus at a much higher proportion than the rest of the population. Instead of exploring the role preexisting conditions or genetic factors might play (there are diseases that impact some races more than others), some reports gravitate to “institutional racism.”
Even if there is acknowledgement in these stories that things like hypertension, obesity, diabetes, and heart disease can make infection more lethal, they generally discuss not unmanaged health conditions but “structural inequities” that black Americans face very day: “dead-end” service jobs, crime, poor schools, “food deserts,” “recreation deserts,” high-density housing, exposure to crowds, and fumes from smelly mass transit — the list goes on. Many people would agree these conditions exist and do make life miserable for the people who endure them.
So why has it taken COVID-19 for politicians and the Left to suddenly acknowledge them?
But rarely does anyone question why the people of Detroit can’t afford their water or how, in the name of climate change, the federal government can give up to a $7,500 tax credit to buy an electric car but nothing to urban dwellers with corroded pipes. The water and sewage rates in Detroit are double those of Phoenix. The price for Detroit water has been so high, in fact, that it forced the city of Flint in 2015 to switch to an alternative source, the Flint River, which turned out to be too corrosive for the city’s old, decaying pipes.
Now we face the coronavirus crisis, and, like the water problem in Flint, racism gets the blame. “Higher rates of infection and death among minorities demonstrate the racial character of inequality in American,” writes Jamelle Bouie in the New York Times
. Even Magic Johnson
, the basketball star who has survived 29 years after testing positive for HIV, has joined the chorus: “We don’t have access to health care, quality health care. So many of us are uninsured. That creates a problem, just like with HIV and AIDs.”
Opinion leaders should be asking why the government’s program for the disabled and needy is failing. African Americans may be disproportionately impacted by the virus, but they are also disproportionately covered
by Medicaid. In Louisiana, 52 percent of African Americans are covered by Medicaid. Media reports
never mention this when they report the “shocking” disparity that African Americans make up 33 percent of the population but 70 percent of coronavirus deaths in the state.
African Americans have insurance coverage. What they don’t have is accessible, affordable, and quality primary care. The conditions associated with COVID-19 death, like hypertension, diabetes, and obesity, can be successfully managed with adequate care and lifestyle changes. Medicaid fails to do this. Enrollees find it nearly impossible to get timely and worthwhile appointments in Medicaid networks. More often, they wait until they get sick and show up at an emergency room. In fact, since Congress expanded Medicaid under the Affordable Care Act, ER use for enrollees has been on the rise
The managed care companies the states hire to run Medicaid collect their fees regardless of health outcomes. Medicaid providers and states can also get access to “supplemental payments” from the federal government, which have nearly nothing to do with direct patient care. The Trump administration is trying to clamp down on this practice, but it is another reason we should not believe that more government health care is the solution.
A better solution would be to give cash directly to African Americans so they can buy direct primary care (DPC) in the private market for as low as $80 a month. Americans in all income brackets are discovering this consumer-driven model and loving it. They get more and better care, which can protect them from dangerous viruses. States are already exploring DPC for Medicaid
Medicaid cost taxpayers $597 billion in 2018
, 16 percent of national health-care spending. Instead of blaming “institutional racism” for COVID-19 “disproportionately impacting African Americans,” the nation should stop throwing money at Medicaid and support health-care plans that actually take care of people.