Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Southern states may block the government from delivering health care

Allen Perkins, MD
Policy
August 30, 2010
365 Shares
Share
Tweet
Share

I have lived on the Gulf Coast for all but 5 of my 50 years. I grew up in Baton Rouge, Louisiana and now live in Mobile Alabama.

I was educated in the public schools during the height of the desegregation battles and my experiences were colored by those battles in a number of ways. I ran track in high school and was in the racial minority on that team (as well as among the slowest). I have worked at South Alabama to increase minority representation in the medical school as well as the residency class. Although aware of race, I try to not let racial awareness influence my decisions in any way (and hopefully am successful most of the time).

I began thinking about race because of the events of the past week. The first was my trip to Uriah. I was asked to go and represent the Alabama Rural Health Association and speak to a group of black ministers (their word, not mine) on “ObamaCare.” As we drove to the church (go north past Little River, go over the bridge into the next county (no sign, turns out to be Monroe), take a left after the first two towns (churches, really) onto the dirt road) I couldn’t help but reflect on how difficult it was to make ends meet in this part of America. Although only 1 hour away from my home, it seemed like another country.

The ministers were acutely interested in what I had to say. I pulled up information regarding the benefits soon to be made available as a result of the passage of the Affordable Care Act and expressed my concern that state leaders may not avail themselves of these opportunities unless prodded. The ministers are very concerned about their congregants as well as their own health (which it turns out could use some help as well). The most interesting question I got was whether the reaction to “ObamaCare” was as much a function of President Obama’s race as it was his policies. Given that every President since Harry Truman has tried and failed I am more impressed by his abilities than disappointed by the reaction of some.

My second observation is a consequence of my visit to the PCPCC Stakeholders meeting in DC. Aside from the obvious contrast in settings, I remain concerned as I attend these meetings and see large corporations (Whirlpool, Boeing), government agencies (the VA, Tricare, Medicare) and large provider groups report success as they transform the process of care and see little of it in Mobile. I had a very interesting conversation about this with Allan Goroll, MD regarding reform and the South. He pointed out that the Community Health Center Movement which is vital to providing care to 20 million (soon to be 40 million) Americans got its start in Mound Bayou Mississippi and suggested that given enough interest and willing workers more surprising things have happened.

Third was an article in the New England Journal of Medicine about health care reform and Medicaid. In this article, the author reports that Medicaid has undergone a fundamental change. He reports that historically the program was seen as a poorly designed safety net, only to be used by the very poor. The not so very poor either had to find reduced healthcare or go without. As written into the Patient Affordabilty Act, Medicaid will act as a true safety net, functioning as a provider for those between jobs which provide insurance as well as a provider for those who are unable to get insurance through their jobs. In this way, Americans will be provided a coverage umbrella which will facilitate delivery of preventive and chronic disease care throughout the life span eliminating a rush to care which now occurs at age 65 (when the time for the most effective prevention has passed).

In an article by Greta de Jong entitled Staying in Place: Black Migration, the Civil Rights Movement, and the War on Poverty in the Rural South the politics of the South in the 1960s are cast in a different light. The farm worker was not needed, so one interpretation of the racial politics of that time identifies the lack of attempt to develop the resources for the community was a hope that the poor, uneducated black worker would move away if starved and barred from services such as health care. The story seen in this light is one of workers fighting to access services guaranteed by a federal government while local politicians fought against these efforts.

I remain concerned that the southern states  may once again try to block the federal government as they try to deliver services to the citizens (in this case health care). The NEJM article identifies seamless health care as important to our wellbeing as a society, regardless of how access is acquired. My conversation with Dr. Goroll reminded me that it was as a result of Southern community activists that we have a delivery infrastructure that can be used to deliver this care once implementation occurs. The black ministers reminded me of the importance of place, community, and being on the side of right. Let the games begin.

Allen Perkins is Professor and Chair, Department of Family Medicine, University of South Alabama.  He blogs at Training Family Doctors.

Submit a guest post and be heard.

Prev

Root beer bonds a chemotherapy patient with his oncologist

August 30, 2010 Kevin 4
…
Next

Whooping cough and pertussis tips you need to know

August 30, 2010 Kevin 5
…

Tagged as: Public Health & Policy

Post navigation

< Previous Post
Root beer bonds a chemotherapy patient with his oncologist
Next Post >
Whooping cough and pertussis tips you need to know

More by Allen Perkins, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Lessons I’ve learned from a colon cancer patient

    Allen Perkins, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Advice to prospective family medicine residents

    Allen Perkins, MD
  • a desk with keyboard and ipad with the kevinmd logo

    How the price of preventing a preterm pregnancy went up

    Allen Perkins, MD

More in Policy

  • Unveiling the global pandemic threat: insights into risk factors and urgent measures for prevention

    Ton La, Jr., MD, JD
  • Why the WHO’s pandemic accord is critical for global health care

    Elizabeth Métraux
  • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

    Robert Pearl, MD
  • Unveiling the intricate link between housing costs and health care

    Harvey Castro, MD, MBA
  • Uncovering the truth about racial health inequities in America: a book review

    John Paul Mikhaiel, MD
  • Why affirmative action is crucial for health equity and social justice in medicine

    Katrina Gipson, MD, MPH
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Unveiling the intricate link between housing costs and health care

      Harvey Castro, MD, MBA | Policy
    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
    • Fixing the system and prioritizing patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From medical student to intern: Discovering a deeper connection with patients

      Johnathan Yao, MD, MPH | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Unveiling the global pandemic threat: insights into risk factors and urgent measures for prevention

      Ton La, Jr., MD, JD | Policy
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 7 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Novel IDH1/2 Inhibitor Shows 'Dramatic Effect' in Low-Grade Glioma
  • Nivolumab-AVD Boosts PFS in Untreated Hodgkin Lymphoma
  • 'You Can't Yoga Your Way Out of This': What We Heard This Week
  • New Standard in Operable EGFR-Positive Lung Cancer
  • New Ovarian Cancer Drug Extends Survival in Resistant Disease

Meeting Coverage

  • Novel IDH1/2 Inhibitor Shows 'Dramatic Effect' in Low-Grade Glioma
  • Nivolumab-AVD Boosts PFS in Untreated Hodgkin Lymphoma
  • New Standard in Operable EGFR-Positive Lung Cancer
  • New Ovarian Cancer Drug Extends Survival in Resistant Disease
  • Neoadjuvant Chemo Flops Versus Upfront Surgery for Resectable Pancreatic Cancer
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Unveiling the intricate link between housing costs and health care

      Harvey Castro, MD, MBA | Policy
    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • Breaking free from restrictive covenants to combat burnout

      Raya E. Kheirbek, MD | Physician
    • Fixing the system and prioritizing patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From medical student to intern: Discovering a deeper connection with patients

      Johnathan Yao, MD, MPH | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Unveiling the global pandemic threat: insights into risk factors and urgent measures for prevention

      Ton La, Jr., MD, JD | Policy
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Southern states may block the government from delivering health care
7 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...