More Than Campaign Promises: Health Reform and Health Equity

By Daniel E. Dawes and Erika Brown Pringle

Attorney Daniel E. Dawes is the executive director of health policy and external affairs at Morehouse School of Medicine and a lecturer within Morehouse's Satcher Health Leadership Institute and Department of Community Health and Preventive Medicine. He founded and chaired the National Working Group on Health Disparities and Health Reform and is the cofounder of the Health Equity Leadership and Exchange Network (HELEN). His book, 150 Years of ObamaCare is available now. Dawes' op-ed, "Would a Republican President Dare to Dismantle Obamacare?" can be read on History News Network.

Erika Brown Pringle is a business and policy researcher, writer and analyst. She has worked extensively in government regulatory and public policy sectors specializing in legislative reporting and analysis, regulatory compliance, policy review and program development. She currently serves as the managing director of KMR Consultants, LLC where she is responsible for business development, operations, and strategic planning. Prior to KMR she served as an administrator with the state of Florida Department of Business and Professional Regulation.

The 2016 Campaign season has been eventful to say the least. One strong theme has emerged from the campaign rhetoric and political punditry: Americans are skeptical about American politics and policies. It was no surprise, as I wrote 150 Years of ObamaCare, that many held strong views on the Affordable Care Act (ACA) or “ObamaCare.” The law is highly controversial; to some an abomination, others a boon, and a work in progress for several.  However, two points struck me as I researched and discussed the book with others. First, that the sense of skepticism that surrounds our political process had so tainted public perceptions of health reform policies that often the true beneficiaries - the vulnerable among us - were often forgotten in the heated discourse. Second, many are unaware that the ACA was the result of the converging of separate advocacy campaigns around mental health, minority health, and universal health under one umbrella. Collectively, these diverse and independent groups fought during ObamaCare negotiations for health equity in order to craft a more comprehensive and inclusive strategy to address a problem that had challenged lawmakers for decades; fifteen decades to be exact!


A Health Policy for the People

Lack of trust in our political process pervades our society and it is often hard for some to believe that any policy could be grounded in the spirit of goodwill. ObamaCare is often mischaracterized as a law designed simply to fulfill the desires of a “socialist” president. Little do these detractors know that the work of health reform began long before President Barack Obama took office in 2008. The ACA was the result of the diligence of generations of health equity advocates since the 1800s.  In 2008, champions of health equity were very concerned that approximately 50 million Americans at the time were uninsured and nearly 45,000 died annually as a result of their uninsured status. Health reformers knew all too well that people with mental illnesses died 25 years earlier on average compared to the general population and that minority children were chronically misdiagnosed, undiagnosed or under-diagnosed for behavioral health issues. Few can deny that our health system was broken, yet many forget health reform is not simply a sound bite on the lips of presidential hopefuls. There are real faces attached to these statistics; a mother, an uncle, a child, a friend.


Coming Together: Understanding the Great Achievement

While conducting research for the book it also became clear that so many do not understand the great feat of humanitarian and organizational collaboration ObamaCare represents. Even as I spoke to proponents of the law I was amazed by the lack of knowledge surrounding the history of health reform. Falsely criticized as a partisan “government takeover” law, the ACA, in fact, brought together health equity advocates who had been waging separate, uncoordinated campaigns for over 150 years. For arguably the first time in U.S. history organizations representing the health and welfare interests of women, children, older adults, minorities, the LGBT community and those with disabilities joined forces, forming the National Working Group on Health Disparities and Health Reform. This diverse group worked to cooperatively develop and implement a master plan for health reform. Organizations that for years had made it their priority to give voice to the disenfranchised coalesced with one loud voice to advocate for and empower so many of the most vulnerable among us. Simply stated, this law was written by people who care about the health and well-being of other people.


We should be reminded how important it is to separate the work of advocacy from the pomp and circumstance of political campaigns. For generations, struggling individuals and families needed and sought out health reform. This law was the successful culmination of 150 years of attempts to bring about a more accessible, equitable and person-centered health system. While imperfect, the ACA was a remarkable accomplishment and has been an undeniable success. Today, 20 million new people have gained health coverage since the law was enacted – the lowest uninsured rate in U.S. history, rising costs have been contained, and health care quality is improving. It is time for these facts to rise above the partisan discourse so that we can come together and build upon those successes and ensure that the benefits of the ACA reach all among us.