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Why health care reform matters

Commentator Melissa Harris-Perry

Kai Ryssdal: There's going to be a whole slew of health care stories in the news next week. Wednesday will be one year since President Obama signed the reform package into law. Since then there have been lawsuits challenging its constitutionality. Federal judges in Florida and Virginia have struck parts of it down. States have applied for and gotten exemptions from certain of its requirements. Truth is, the law passed, but arguments over health care reform continue.

Commentator Melissa Harris-Perry says the debate is still missing one critical element.


Melissa Harris-Perry: The fights are about budgets, government authority, and ideology. Surprisingly absent from the rhetoric and positioning is any serious conversation about the actual state of American health.

Just listening to the politics, one might easily conclude that most Americans enjoy good health, reasonable access to care, and multiple options for high-quality treatment of illness and injury. That's not the case.

From infancy to old age, African Americans have worse health outcomes than non-Hispanic whites. Consider these statistics: Black infants are twice as likely as white babies to die before their first birthday. African American women have lower breast cancer rates, but are more likely than their white counterparts to die of the disease. Black Americans suffer from diabetes and asthma at nearly twice the rate of other Americans. These and other disparities remain even after accounting for economic status. In other words, health disparities are truly an American racial problem, not just an issue of poverty.

Researchers have considered many different reasons for these disparities. The causes are complex and include: biological factors, environmental inequities, and differential access to care caused by persistent residential segregation. None are easily solved because all are rooted in century-old systems of racial injustice that include the residual effects of American slavery, the recent practice of segregated medical care, and persistent inattention to communities of color.

The solutions are not simple, but addressing these disparities must be a central aspect of our health care debate. We cannot afford to lose the contributions of our fellow Americans simply because they are caught in a system that severely limits their opportunities for health and well-being.


Ryssdal: Melissa Harris-Perry is a professor of politics and African American studies at Princeton. Take a second to share your thoughts -- click on this contact link.

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My wife and two children and I live in the state of Illinois. Our current health insurance plan is a Choice Plan that is provided by "Wise Medical Insurance" . The plan itself is a consumer driven health care plan.

Four things. First, federal judges have struck down the law in its entirety, not just parts of it. Second, of *course* arguments over it "continue"; the President and the Democratic majorities in Congress rammed it through with at most minimal debate beforehand, and without even giving legislators time to *read* them before the votes. Third, while this sort of data is important background for future decisions, such problems are independent of the issues of budgeting and government authority. If the federal government doesn't have the authority or the money to pay for health care, then anything about health care conditions is irrelevant to whether the federal government should pay for health care. We have to start with first principles; the debate will keep going on and on until those are settled. And fourth, unless you want to bring equality by making the better health care worse, as is happening in countries with single-payer single-provider systems, the solutions to these problems are irrelevant to the debate; instead, we need to find their causes---lack of access to health care, poverty, or not taking advantage of resources that already exist?---and then find real and working solutions to those problems, which will in almost every case be utterly independent of government.

I am suprised (or maybe not considering the source)that no mention of teenage pregnacy, single mother families, diet, cultural attitudes towards education and other factors were not mentioned. I am troubled by the consistant insinuations that it is always somebody else's fault. Non-hispanic whites or any other race for that matter have no control over black teenage pregnacy or divorce rates and life style choices. These factors greatly impact the statistics. This commentary was neither balanced or fair but smacks of a political agenda.

Ms. Harris-Perry is right on the mark for all the talk about a post racial america and how things have gotten better, why aren't African Americans even close to closing the health care gap? How heathy you are is a true measure of your value to a society. I guess all people are not created equal when it comes to health outcomes. The color of your skin still determines how long and how well you live.

The prevalence of obesity for African Americans is 51 percent higher than for white Americans, according to new findings from the Centers for Disease Control and Prevention.

Was this considered in the study?

While I enjoyed this segment and Melissa Harris-Perry's analysis and commentary about the disparities in health with regard to race, I thought the lead-in was misleading. When she says, "Surprisingly absent from the rhetoric and positioning is any serious conversation about the actual state of American health" I was expecting some discussion of how Americans actually take care of themselves. As a yoga instructor who mostly works with seniors, I see first-hand the results of taking care of one's body well throughout life and conversely the results of over-eating, not exercising, and dealing with stress in unhealthy ways. Why not be more straight forward about the nature of this valuable article? And perhaps in a future segment, you might be interested in reporting on how our personal choices affect the cost of healthcare. For example, I read recently that 75% of chronic health conditions are attributable to lifestyle choices. I do not find this surprising, but I do feel it is unfortunate both in financial terms and in personal quality of life.

Thank you so much for detailing the view which African Americans have on Health Care.

Professor Harris is exactly on the money.

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