When I think about the healthcare system here in the United States, and the addition of the Affordable Care Act that is slowly (slowly) taking shape, I am moved by the comments made by Dr. Steven Schroeder in “We Can Do Better-Improving the Health of the American People.” The most salient point refers to the lack of care for the poor and underinsured in this country, who make up a large portion of the labor market, but who are not represented in the political sphere. Here in the U.S., we are taking baby steps and this charge is again, not lead by the people, but by the politicians. Perhaps this is why it is taking so long to come to fruition? The working people have no unified voice, no leader, no one to rally them all to the cause. People who are not working have no voice at all.
Finding a leader who can unify the people in the current era has proven difficult. The Civil Rights Movement was a time of revolutionary change and action by the people, led by several different brave individuals who came to the forefront and are remembered as heroes, Martin Luther King, Jr. and Representative John Lewis to name two. While a major focus of this movement involved the rights of African Americans, civil rights encompassed other ethnic and social groups who were moved by the spirit of the time to protest and demand equal opportunity and freedom. A large focus of this cause was the eradication poverty, which separated the “haves” and “have nots,” a disparity that seems to be more pronounced in our current time. While we have achieved much in racial equality, the after-effects of discrimination continue to contribute to health disparities. As discussed in the article, those with lower socioeconomic status suffer more in terms of health. Who will step forward and champion the cause? Or have we reached a point where the class divide has prevented any chance for the working class to promote a leader from within ranks?
The working class, the poor, and the underinsured need a leader who can identify with their needs and promote the issues passionately and justly to the government. Perhaps this person will not come from that cohort, but rather will be some other inspired person of influence. Maybe as Dr. Schroeder advises, the voice of the people will come from physicians who care for the populations that need healthcare and reform the most. This person will have ideally been “in the trenches,” caring for communities and seeing the direct consequences of our lack of care for the less fortunate. We cannot hope to affect change in our most vulnerable population without unifying under one person with one mission: to make healthcare a human right.
- Schroeder, Steven A. We Can Do Better-Improving the Health of the American People. New England Journal of Medicine. 2007; 357:1221-1228.