when access + need ≠ spend
The language around healthcare for all always causes a stir in my soul. It’s the same ambivalence I feel whenever I walk into a doctors appointment with my mom’s Medicaid. Because empirically I know poor folks are discriminated against for trying to access care — and the care given to them in exchange is branded to say with certainty you are poor and because you are poor, you deserve the least.
Healthcare for all, nested in a capitalist oligarchy, only goes as far as we’d allow it to go — and I need not say, it indefinitely stagnates within the frame of capitalism. If we don’t cut the bs around why well-to-do folks are vehemently reactionary against it to begin with then we actively allow the violence of the healthcare system to mechanically reproduce itself with causalities being exceedingly Black, brown, and Indigenous. Folks in the U.S. with money have a clear understanding of healthcare as a neoliberal landscape that affords care on the basis of capital. In its inception it was segregated and its ostensible “progression” it believed itself benevolent in doling out alms. Everything from wait times, to referrals, to accessible services/operations, to general treatment (with or without dignity) is predicated upon the de facto and de jure politics of what’s written on a health card. Well-to-do folks want to keep their expensive private insurance because it grants them immediate access and is a material reminder of the inherent inequity of a healthcare landscape that was designed to bar out Black folks (and the vulnerable) from dignified entrance.
I don’t want to frame healthcare for all as the pivot for what I desire to see in the plundered community that I inhabit and the ones adjacent to me. What I need to see materialized is community care and healing stripped away from class markers that give appraisals; we need a dignified caring infrastructure. Here I want to be very very specific about what I mean by, “caring infrastructure.” So, I’ll define it as the aggregate of community (jobs, recreation, infrastructure, housing, food access), health-related, trauma-related, care-related (child chare, long term care, disability care) services equitably afforded to folks in proportion to their need. You know, such that mutual aid no longer is prided as king in a nation that has more than enough to usurp the demand that poor folks crowd fund to take care of medical bills that eclipse their mortgages.
Healthcare for all cannot be a discussion about entry into a system; it has to be discussion and action around access to the full spectrum of needs and services that are intimately connected to health. The healthcare system as is cannot be fully deconstructed without tending to the liminal harm that has become the traditional, albeit through insidiously unnatural means, cadence of the temporal and spatial landscapes of the Black, brown, and indigenous folks. And to reiterate, I need to not say that a divesting from capitalism is the only way to heal such a fractured system. And intuitively following, that a divesting from capitalism would hold in tandem a divesting from policing. What then can we guarantee of the health of our ailed communities if state sanctioned violence isn’t removed from the narrative of how we envisage healing?
I am of a sound mind enough to know that community healing has never once been bestowed to marginalized by the government they pay into. Had Ruby Duncan not disrupted the economic workhorse of Caesar’s Palace in Las Vegas, the city would have continued to turn a blind eye to the demands of the Welfare Rights Movement she sparked in the 60s. But it wasn’t the city that created a children’s medical clinic, jobs program, and other critical services — it was Duncan’s Operation Life. The city had a litmus test that allowed it the space to pivot towards changing its care infrastructure and it didn’t and that is the issue. Community resiliency was never designed to be a proxy of absolution for state abandonment of the vulnerable; give us the spend and we will materialize the infrastructures that honors us into fruition but do not believe that we will allow our labor to be filched and relegated.
So, if we’re going to be transparent, let’s say what we mean. No more giving poor folks crap insurance and acting as if the bureaucracy of “philanthropic” hospitals (like Penn) is good. At what threshold does philanthropy exist when we all have what we ought to be afforded? Because last time I checked, I did not sign on for zoning laws, urban renewal, and the plunder of Black and brown neighborhoods — those were unnatural occurrences willed into fruition by white delusion and capitalistic lust at the tradeoff of bodies for the maintenance of lifestyle. We don’t want your crap free screenings or your subsidized flu shots at open clinics. Keep that and give us the same spectrum of care that rich white folk in the Main Line get.
