The Racial Argument Against Healthcare Reform

2021.03.03 Segregation_2.0

Perhaps the most potent argument today against healthcare reform is racial. Let’s look at the argument, and see how it stands up.

The argument goes like this:

  • Non-whites are inferior to whites, not worthy of sharing in the “common good” reserved for whites.
  • Giving a societal benefit to non-whites subtracts an equal benefit from whites – be it housing, jobs, education, or healthcare coverage.
  • Therefore, cancel all public healthcare benefits (Medicaid expansion, public option Medicare, public marketplaces). This will allow for better healthcare to be given by the “free market” privately to (white) employed privileged citizens, who are not sickly, feeble-minded, or otherwise dependent. It will also lower total cost by jettisoning society’s burden to care for the unworthy.

A corollary to this argument is that if a public good is provided to non-whites, this diminishes its social, economic, and political value to whites. Giving non-whites the same benefit as whites lumps those whites together with the low-status non-whites, an affront to their privileged white social status. Accordingly, in order to preserve the prestige of a benefit, reserve it exclusively for whites (like the G.I. bill or federal mortgage subsidies), or cancel the benefit altogether (like cementing over public swimming pools rather than submit to desegregation).

Do these claims sound too exaggeratedly racist? Here are some direct quotes from President Trump that line up with them, if sometimes only in “code.”

  • “These aren’t people.  They’re animals” (statement made at a 2018 immigration roundtable and corroborated by the White House, reported by USA Today)
  • “Simply put, it’s a choice between a socialist nightmare and the American dream.” (Speech to Florida business forum, October 14, 2020, reported by the Tallahassee Democrat)
  • “the wonderful HealthCare package that some very talented people are now developing for me & the Republican Party. It will be on full display during the Election as a much better & less expensive alternative to ObamaCare…” (April 3, 2020, tweet, reported by Kaiser Health News)

The result is this argument against healthcare reform:  Better to keep the current fragmented system that cares for the privileged than to reform it to include the unworthy hordes, even though the system is corrupt, costly, unfair, and lethal.

Refuting the Racial Argument

But now two recent books tease out these racist arguments in great detail and expose them to clear-eyed scrutiny.

The first book is Heather Cox Richardson’s How the North South Won the Civil War. This 2020 work by a Boston College historian chronicles how white plutocrats extended the Southern political and economic hierarchical order into Western states after the Civil War. A new form of “plantation mentality” underpinned the economic exploitation of not only Blacks, but also of Hispanics, native Americans, Asians and women. And underlying it all was the Founders’ original “American paradox,” that the freedom and equality for “all (white) men” actually depended on racial, gender, and class inequality. Richardson traces the same paradox into today’s politics.

The second book is Heather McGhee’s just published work The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together. This think-tank analyst details case after case of cut-off-nose-to-spite-face politics that props up America’s racial hierarchy at the expense of the economy, the national interest, and even individual self-interest.

Let’s be clear. The racial arguments are false, as this blog has previously claimed.

  • All races, backgrounds, and cultures contribute to America. No race is inherently inferior or superior.  So said the most prominent doctor of the Colonial period, Benjamin Rush M.D., who signed the Declaration of Independence and became the father of American psychiatry. In this matter he argued against Thomas Jefferson’s counter claim that Blacks were inferior. More recently, eugenics and phrenology have been debunked as pseudo-science, and their use to justify slavery and segregation discredited. The United Nations has rejected race-based political and social theories.
  • The economy need not be zero-sum, especially in 21st century systems driven by automation, services, and information technology.  Likewise, public goods can benefit all; enjoyment by one group need not diminish their enjoyment by another group. This blog has argued that healthcare itself should be considered a public good.
  • Racial resentment is not a sound basis for public policy. Americans are become increasingly aware of the costs of sustaining an unjustifiable racial hierarchy – economic, social, and political. And since America understands itself to aspire to “life, liberty, and the pursuit of happiness” equally for all, racism is morally and philosophically untenable.

Let’s also be clear that maintaining a healthcare system primarily for the white and privileged perpetuates its exorbitant cost. The healthcare corporatists operate the system to their own financial advantage. They set up legal and political structures that shield the system from market forces. Excessive healthcare prices in the U.S. incur opportunity costs reflected in neglected infrastructure, environmental protection, education, and innovation. 

The corporatists also elude ethical responsibility and undermine civic solidarity.  Excluded uninsured non-whites live sicker and die younger. These healthcare inequities erode national cohesion and resilience.

There is a better way.

Take Action

Now, take action.


Heather Cox Richardson, How the North South Won the Civil War. New York: Oxford University Press, 2020.

Heather McGhee, The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together. New York: One World, 2021.

Image Credit

Title:  Segregation

By:  Standarddeviation


License:  Creative Commons Attribution-Share Alike 4.0 International license.

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