The Power to Heal: Civil Rights, Medicare, and the Struggle to Transform America's Health Care System

by David Barton Smith

In less than four months, beginning with a staff of five, an obscure office buried deep within the federal bureaucracy transformed the nation's hospitals from our most racially and economically segregated institutions into our most integrated. These powerful private institutions, which had for a half century selectively served people on the basis of race and wealth, began equally caring for all on the basis of need.

The book draws the reader into the struggles of the unsung heroes of the transformation, black medical leaders whose stubborn courage helped shape the larger civil rights movement. They demanded an end to federal subsidization of discrimination in the form of Medicare payments to hospitals that embraced the "separate but equal" creed that shaped American life during the Jim Crow era. Faced with this pressure, the Kennedy and Johnson Administrations tried to play a cautious chess game, but that game led to perhaps the biggest gamble in the history of domestic policy. Leaders secretly recruited volunteer federal employees to serve as inspectors, and an invisible army of hospital workers and civil rights activists to work as agents, making it impossible for hospitals to get Medicare dollars with mere paper compliance. These triumphs did not come without casualties, yet the story offers lessons and hope for realizing this transformational dream.

This book is the recipient of the Norman L. and Roselea J. Goldberg Prize from Vanderbilt University Press for the best book in the area of medicine.

256 pages, Paperback

First published July 1, 2016

Reviews

[Zora · Rating 4 out of 5]

This was a great read on how Medicare was the gift of the civil rights movement. Integrating hospitals across the country by requiring the integration of their patients if they wanted to receive federal funding. Without this condition tied to federal funding would a systematic change to the health system have occurred. As a result of hospitals desegregating their patients other health care providers/agencies and namely doctors were forced to desegregate their services.
This was a great read on how the civil rights movement impacted healthcare, particularly since the task of desegregating hospitals across the country required civil servants and civil rights activists (sometimes individuals served both these roles simultaneously) to join forces in creating this systemic change. These change agents implementing desegregating hospitals across the country were courageous and frequently faced death threats seeking to thwart them from their task. If anyone is interested in learning how Medicare came to be and it's impact on the healthcare system this is the book to read. Particularly, how it changed disparities in health and health care are a result of minorities being forced to live (circumstances of economic & social factors) in lower income areas (residential segregation) which have fewer resources than areas where Whites choose to live.