The Spotlight Is On, and It Isn’t Pretty

 Long heralded as a “superpower nation”, the United States is a country unlike any other. With its powerful military presence and the world’s largest economy, there is no denying the global influence the U.S. holds. Despite these achievements, the U.S. is not immune to failure, and its Achilles’ heel involves what is most often regarded as a basic human right: healthcare. 

“Fragmented”, “costly”, and “poorly accessible” – these terms paint the picture of U.S. healthcare. Though every other highly developed country has instituted universal healthcare coverage, the U.S. stands alone in its decision to do without. This is not the only aspect which makes U.S. healthcare unique; it is also the surprisingly excessive cost of such a neglectful system. Compared to other high-income nations such as my home country, Canada, the U.S. spends more than double on health per capita. I suppose this would be an easier “pill to swallow” if we saw Americans benefiting from such exorbitant healthcare spending, but the data proves otherwise – out of the 36 countries within the OECD, the U.S. ranks 28th in life expectancy. That being said, what I find even more disturbing than these dismal health outcomes are the blatant and unavoidable health disparities among racial groups within the U.S.  Compared to their White counterparts, African Americans’ risk of developing heart failure, chronic kidney and/or liver disease, and dying from asthma or diabetes is at minimum two-fold higher. And despite the fact these disparities have been observed for decades, it has taken a devastating pandemic like COVID-19 to garner the attention and concern it truly deserves. 

According to the CDC, the death rate due to COVID is more than twice as high among Blacks as compared to Whites - the product of a life-time of health inequity. It’s like I always tell my friends and family back in Canada – U.S. healthcare is great, butonly if you have money. With nearly 20% of African Americans living in poverty, and no security net like a national health system in place, medical care becomes a “luxury,” not a basic need – even in times like a pandemic. The absence of universal healthcare has undoubtedly contributed to the high COVID mortality rate in the U.S. - nearly double that of Canada. While I appreciate the federal government’s attempt with the “Families First Coronavirus Response Act” to reduce the financial barriers in healthcare access, it’s been riddled with faults. Initially, it only waived the COVID testing fees, and didn’t include any treatment coverage, which can run up to $40,000. Bearing this in mind, I imagine many are questioning whether they should even be tested in the first place if they can’t afford the treatment, and I can’t say I blame them. Sadly, with such a broken health system in the U.S., we are foolish to have expected stronger public health efforts after the arrival of COVID. But the question remains: where do we go from here? 

Over the last few months, the U.S. has justifiably faced more scrutiny of its pandemic response than any other country. And while it’s easy to focus on the errors that have been made, I choose to direct my attention to the potential for change after such a catastrophic event. As a future physician, I want to practice within a national health system that provides quality healthcare irrespective of one’s ability to pay. I understand a change of this magnitude can’t be made overnight, but there are actions that can be taken in the interim, such as the preservation of the Affordable Care Act and nation-wide Medicaid expansion. With 11% of Blacks uninsured, these policies would be life changing. You see, from an early age, African Americans are at a cruel disadvantage. The persistence of residential racial segregation in many parts of the U.S. creates limited access to nutritious food, healthcare, and green space, but plenty of exposure to pollution, toxins and crime. Taken together, such adversities have set the foundation for African Americans’ poorer health. However, the real question is, will a pandemic be enough stop this vicious cycle?

COVID cannot be remembered as simply one of the lowest points in American history. Doing so would mean the millions of lives lost around the world were in vain. The spotlight it has shown on the gaping holes of the U.S. healthcare system is prompting discussion unlike anything we’ve ever experienced before. It’s time for a new, more equitable and accessible trail to be blazed.