totally different story. Our company
provides supplemental insurance coverage to assist us, but I can’t afford
anything more on minimum wage.”
Eric Waddell, 49, is president
and CEO of Waddell Williams &
Associates, a private equity-funds
managing company in Celebration,
Fla. With an annual salary of more
than $500,000, Waddell, who is
black, travels to Chicago for all his
medical treatment, which he divides
between the hospitals of
Northwestern University and the
University of Chicago. “For me,” he
says, “I’ve always had great access. I
get a complete executive physical
every year. I feel great.”
David Kang, who emigrated
from Korea in the early 1980s and
became a U.S. citizen in 1996, is a
self-employed dry cleaner in St.
Louis, Mo., and paid for medical
expenses out of his pocket until he
recently was diagnosed with diabetes. “I’m fortunate that my family
of four never had a huge medical
emergency, except a couple trips to
the emergency room for a broken
arm and fever. Because of the costs,
we rarely went to the hospital for
checkups, but since being diagnosed
with diabetes, it has become a
necessity. I have medical insurance
now, but it would be disastrous to
have another hike on the already
high premiums we pay monthly,
which is about 10 percent of my
monthly take.”
Demetrius Jones is a 25-year-old
black man who works as a shipping
and receiving clerk in Edison, N.J.,
while his girlfriend takes care of
their new baby boy. Jones, who
earns $24,000 a year, believes that
it’s wealth and class that determine
the kind of care you receive. He
recalls a time when he went to the
emergency room with excruciating
pain but waited as others in less
critical condition were seen ahead of
him. To this day, Jones thinks it was
because he lacked insurance. “That
struck a chord with me. I always
thought first come, first serve, but I
found that out to be wrong.”
These are just a few of the personal accounts in the healthcare
landscape of the United States,
which has become a perforation
between the haves and the have-nots. With almost 21 percent of the
U.S. population ( 62 million people)
either uninsured or underinsured,
healthcare coverage has become a
national crisis. For years, the discussion surrounding the gap in health-
every turn (funding, access, treatment, mortality), there is a rapidly
increasing gap.
“At the root of the majority of
health disparities are social and economic inequities and the distribution
of resources and power in our society,” says Rep. Michael M. Honda, a
Democrat from California.
Class also can be determined by
geography. “No matter what your
stripe, if you live in a poor community, you’re affected,” says Joseph R.
Betancourt, director of The
Disparities Solutions Center at Mass
General Hospital.
Race/Median income 35%
Latino $32,997
30
Asian/PI $55,262
Black $29,645 25
White $47,777
20
15
10
5
0
Less than $5,000– $15,000– $35,000– $75,000– More than
$5,000 $14,999 $34,999 $74,999 $99,999 $100,000
Source: Income, Poverty and Health Insurance in the United States: 2003, U.S. Census Bureau (2004).
NO TES: Asian/PI refers to
Asians and Pacific
Islanders. Latino includes
Latinos of any race. Data
is not available for Native
American populations.
care has focused heavily on the
issues of racial inequality and cultural competency. Neglected is the
real issue—class.
Class Effect
Class is measured by assessing income, educational level and employment, all of which determine a person’s socioeconomic status (SES).
Read that sentence again, slowly,
and it suggests social stratification,
which if ignored long enough
becomes a caste system.
No social system in our country
conveys this more clearly than
healthcare. By observing the role of
class in healthcare, we see how at
All of these class-associated
components play a substantial role
in what kind of healthcare an individual can obtain, regardless of
skin color. “Right now, the health-care system depends on how much
you can spend. Increasingly, the
people more likely to get the best
care are people with money,” says
Dr. Alvin Poussaint, professor of
psychiatry at Harvard Medical
School and a staff member at Judge
Baker Children’s Center.
Ironically, the poorest Americans
are not those who are most dramatically impacted. They receive
Medicaid, federal health insurance,
which covers the basics. It is the
