White People with Money: Class, Free Markets & Race in Medicine

Medical ethics state that everyone be treated equally, but the pressures of the free market and individual prejudices often bend that ethic.

The medical students and physicians in training quickly noted the majority of patients are white and wealthy and nicknamed it the “Center for Caucasians and Donors"

Part of the problem is that medical facilities have to survive financially and not go bankrupt. This means even people who are well intentioned have to take financial reality into account. At the University of Chicago the newest hospital is called the Center for Care and Discovery or the CCD. Special rooms are set aside for people who make large charitable donations. The medical students and physicians in training quickly noted the majority of patients are white and wealthy and nicknamed it the “Center for Caucasians and Donors.” The local population from the south side of Chicago, which is overwhelmingly black, goes to the older hospital building. It’s a pretty obvious change when you walk from one building into the other. But it makes money and a lot of that money gets funneled back into the older hospital which operates at a loss.

Payment is lower through federal insurance than it is through private insurance, so some physicians will just refuse to see someone with Medicare or Medicaid.

Center for Care and Discovery

University of Chicago Medicine’s new Center for Care and Discovery (www.uchospitals.edu)

Sometimes it’s just outright dislike. Some medical professionals will refer to lower income patients as dirt balls or just say they are uncomfortable around poor or black people. It’s less common than 30 years ago, but it is still there.

I think there is a strong desire among most medical professionals to not treat according to class or ethnicity. It’s only a minority who are just so class conscious or ethnically biased that do it willingly, but they are there. And a few rotten apples can taint the whole bunch.

They get justification from the modern belief that the free market system is perfect with no negative side effects. I don’t quite understand this blind belief. Everyone accepts that life saving medications can have major side effects, that cars are useful but produce pollution and fatal accidents; but for some reason we are supposed to believe the free market has no downside. So if poor people can’t afford good care, it’s their fault.

Of the three big forces — class attitudes, racial attitudes, and free market pressures — I believe it is the free market pressures that have the biggest effect at creating unequal care and reinforcing class and racial attitudes. If people don’t have insurance or have low paying insurance then the hospital may not be able to pay the bills.

All of the other western democracies have seen the need to guaranteed 100% health insurance coverage through the central government to solve this problem. The net effect has been better outcomes at lower cost. Healthcare spending in the United States is twice a much per person as in Western European countries, but our net results are worse. Life expectancy is longer and infant mortality is lower in the Western European countries. The poorest people in Britain have a longer life expectancy than the wealthiest people in the United States. With Obamacare, coverage has increased from 80% to 90% of the population in the US.

No system is perfect, but I believe the more we move towards socialized medicine, the more fair it will become. This has been the experience of all the other industrialized Western countries. Even the conservatives in Britain like the national heath service.

1 Response

  1. splakeinthelake

    I heard socialized medicine leads to very long wait times and poor quality of care because of a lack of incentive for the medical professional to put in effort or time, is this true in your experience?

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