POC for M4A? Not necessarily. Here's some reasons why.

Note: Photo of John Conyers used at the request of the thread author. Thread reposted with permission.

About a week and a half ago, a die-hard Bernie Sanders supportern named David Klion posted something I found pretty offensive. I already wrote about that.

However, in the wake of that back & forth, a Twitter follower of mine, a woman of color who goes by the handle @Kamalaallday, posted an angry rant which I felt lent a lot of insight as to why many in the black community aren't nearly as keen on "Medicare for All" as envisioned by Sanders and other M4All activists as you might expect.

I already knew about some of her complaints and concerns below, but not all of it. Instead of putting words in her mouth, I'm just gonna let her speak for herself.

I've embedded the first tweet directly, but have converted the rest of the thread into bullets and reworked the structure (putting half-sentences together and adding paragraph breaks, etc.) for easier readability, but have otherwise left her entire thread as is. I strongly advise that folks read it all...food for thought:

Charles my main concern with M4A is them slashing provider payments and having to see my providers close up opening me up to medical racism. I’m afraid we will get stuck with more busted down community health centers & Ill get assigned a random PCP like I did on medicaid. I want

— #Dear white feminists: I am not the one (@Kamalaallday) January 5, 2020

  • And everything will have to go through that person. I want to keep my insurance. My kids and I have doctors I trust, good dental insurance & vision. I have a 20 copay and 35 for specialists. My husbands employer HSA covers copays. We get reimbursement checks...
  • I liked Medicaid once I switched our PCPs but I hated dealing with the renewal for that and my food stamps. My workers always lost my paperwork, didn’t return my calls & when they did were awful to deal with. They switched me at least three times a year. I don’t want to deal with that again if I don’t have to. I hated having to go to my PCP for referrals 4 everything to. They would call and hound me for that referral paper before I even had my appointments.
  • I’m most afraid of losing my providers though if provider payments are slashed. I’m terrified of medical racism bc it’s killing us.

Another Twitter follower--a white female doctor who ideally supports M4All decided to chime in, but...well, it didn't go over well at all:

  • I’m sorry Ill wait until a Black doctor in my community shares your same optimism. I don’t trust white doctors as far as I can throw you all and that’s not very far so I’ll wait until a doctor in my community who depends on private insurance to stay afloat tells me that.
  • And show me where I said Medicare paid out the same amount but that won’t matter once they slash payments to providers like mine.
  • And no medical racism is not going to be solved by M4A. Do you even know how silly you sound? You sound like Bernie saying our maternal mortality rate will be solved by M4A bc it’s a class issue. No, it’s not. Beyonce is how rich? Serena is how rich? This is serious to me.
  • It’s the number one killer of Black women and babies and Im not going to be patronized by a white doctor from Virginia. They did. Study & White residents think our skin is thicker and so they are less likely to treat our pain properly. I’m not going to be forced into seeing white providers who think they’re white saviors in busted down community health centers once provider payments are slashed and private insurance is all but gone & we end up with the bad end of the deal. LIKE WE ALWAYS DO.
  • My job is to find funding for ppl to go to treatment & if you think disparities like the ones I see every dam* day are going to be magically fixed my M4A this conversation isn’t even worth having. Besides I was talking to Charles who lives twenty minutes away from me & understands what it looks like across 8 Mile. Not to you.

For the record: 8 Mile Road is the dividing line between the city of Detroit and the suburbs surrounding it (thus the Eminem movie "8 Mile").

  • He lives very close and understands exactly what I mean. Black mothers are twice as likely to have CPS called on them when they deliver in the suburbs as white mothers are. M4A isn’t going to magically fix that racism. They are literally talking about slashing payments & that will force us away from doctors we trust. Once their private practices can no longer stay afloat we will be the ones corralled into busted up health centers that don’t have the same resources. I brought up my worker bc I don’t want to ever have to deal w/ that again.
  • You think they won’t require referrals for specialists? They will and Black mothers like me who live paycheck to paycheck will have to take more time off work to go see a PCP at a community health center with long wait times (once ours close down) just to get to the doctor we need to see.
  • Ever been to A DHS office in my community? Yeah there’s a stark difference between ours and the ones In white communities. The wait can be half a dam* day even with a appointment.
  • It’s like the opiate epidemic. They did nothing for us but when white kids got addicted all the provisions were made to get them help. We were told it would benefit us too. All it’s done is inconvenience Black ppl. There’s still no viable option for treatment in our community & now the Black folks they warehoused in methadone clinics are losing their take home privileges bc white kids got into their parents methadone and overdosed.
  • Now they have to go back to their lives completely revolving around the clinic & addicted white kids are a priority. This “color blind” it will help everybody & “solve discrimination” is bulls*it. We’ve seen it time and time again and for you to patronize me like this and repeat the same ignorant Bernie Sanders talking points is exactly why I don’t listen to white doctors unless I know you.
  • You are a danger to our community if you think M4A will solve discrimination instead is exacerbating already existing disparities. I trust Charles bc I know where he lives and I know his work. I know he knows exactly what I’m talking about which is why I approached him. The lift all boats thing is exactly what trickle down economics promised us, the ND promised us, the opiate “Crisis” (it was only a crisis when White kids got addicted) Measures promised us, etc.
  • Until there is a consensus of Black doctors in my community who say “yes we can stay open even if they slash provider payments” I’m not going to be duped into believing the “raise all boats nonsense” again.
  • I also don’t appreciate you acting like I don’t understand the difference between Medicaid & Medicare. Had four read what I actually said the only reason I brought it up was to share what my experience was dealing w/ referrals & DHS offices to determine my eligibility and whether or not I had a deductible ( I didn’t). Yes, they will demand referrals & yes we will still have 2 deal with DHS to determine whether or not we have to pay anything & I’m telling you in my community that’s not a walk in the park. It’s a major inconvenience.