Racial justice town hall panelists talk race and the health care system

OLYMPIA –– Olympia held its third town hall of a four-meeting series centered on racial justice on Thursday night, with panelists focused on the healthcare system and the inequities that people of color often experience within it. 

Like the first two in the series, the meeting was mediated by Olympia’s Strategic Communications Director, Kellie Purce Braseth, and featured four panelists of color with diverse perspectives, academic backgrounds and professional experiences.

“The coronavirus epidemic is absolutely nothing new,” said Dr. Benjamin Danielson, a clinical professor of pediatrics at the University of Washington. “We’re at a time of the great revealer of weaknesses, challenges, and problems that have existed in our society for a long, long time. The pandemic of racism that goes back 400 years makes this pandemic miniscule in scale.”

One panelist characterized the disparities in the healthcare system as similar to a physical kind of pollution.

“Injustice of any type is like pollution. The pollution that we can see, we all will acknowledge shouldn’t be there and we’re very quick to acknowledge that it’s harmful to our health,” said Dr. Frederick Marland Chancellor, MD, who has extensive medical experience in Washington and California. “We clearly say ‘that’s not right,’ but what we’ve learned in environmental studies about pollution is that so much of it isn’t readily detectable by the human senses ... and nevertheless, it’s still doing us harm.”

A problem cited by the panelists is how white people are the focus of the healthcare system. 

“Through policy and through legislation, one of the number one things that we have to begin to work on is really decentering whiteness,” said Sheila Capestany, King County’s Strategic Advisor on Youth and Children. “Everything that we do centers around the experience of white people. And even our conceptualization of things like health disparities is all about how everyone is doing compared to white people.”

By involving all of our communities on the local level it can become possible to have the system reflect the people on a more realistic basis that avoids one-size-fits all solutions, Capestany added.

“Let’s take a look at all of our communities, and through community-led action, through what the communities are saying they need for themselves,” said Capestany, “Let’s see how we can implement those things in our policy and in our legislation.”

The ability to pay for medical care also emerged as a key topic Thursday night. One panelist brought light to the issue of the true cost of treatment for a simple, minor malady, saying it’s not it’s not just the cost of the medical care itself, but the effect is has on someone’s job and livelihood. 

“Under closer scrutiny, that cost actually is whatever that copay is,” said Chris Porter, a nurse practitioner. “If the child [stays] out of daycare or school for a day or two, if it’s a single parent, they’re taking those days off. If they don’t have time off or a way to cover that, that is income lost in the care of this child, so the actual, true cost of that ear infection can be hundreds of dollars.”

The often-unforeseen costs become difficult to pay for people without adequate health insurance, Porter added, a problem perpetuated by the current health care system being based on a person’s employment. Without a job, access to medical care is negligible –– most often affecting people of color.

“I was looking at the unemployment figures,” continued Porter, “The recent numbers for unemployment rates for white people are 10.1 percent, and for African-American or Black people it’s 23.2 percent, and for Latinos it’s looked at as 14.5 percent.”

According to Porter, about half of Americans that are insured get their insurance through employment. This relationship leads to concerns that half of U.S. workers do not have a reliable way to handle medical expenses.

Another factor brought up is how accumulated stress in daily life can affect one’s health.

“Whether it’s racial, whether it’s due to their sexual orientation [that] becomes a persistent cause of stress, we know very very well that stress is a negative risk factor in terms of health,” explained Chancellor, “so if people are not only experiencing intermittent situational stress but stress across their lives, that’s going to create negative health outcomes.”

Of course, it is common for a patient to be prescribed medication to attempt to mitigate the symptoms of high levels of stress, Chancellor added.

“[There’s] inequity that they are facing in their lives that they can’t just counsel away,” continued Chancellor, “or take medication and have that go away. Taking Prozac doesn’t change the fact that you’re unemployed, or you’re housing insecure.”

According to Braseth, one of the most commonly asked questions by audience members was what people can do on the individual level to help move the healthcare system in the direction of increased equity. The first suggestion regarded Health Maintenance Organizations, or HMOs.

“What can a member of an HMO do?” asked Chancellor. “To help specifically with regard to helping to decrease racial inequalities and racial injustice, the best I can say is feel free to speak up, to ask leadership the questions.”

As a nation, the panelists suggested that the fundamental way the health care system is structured needs to be reworked.

“We have to move away from health insurance coverage that’s employer-based,” Porter said. “It comes with a huge financial burden.”