Caste and Healthcare in America

“Race, in the United States, is the visible agent of the unseen force of caste. Caste is the bones, race the skin.”

In her 2020 book Caste: The Origins of Our Discontents, Pulitzer Prize-winning journalist and author Isabel Wilkerson explores the evidence for a caste system in the United States, and how it has defined our past and shapes our present.

“Caste is insidious and therefore powerful because it is not hatred; it is not necessarily personal. It is the worn grooves of comforting routines and unthinking expectations, patterns of a social order that have been in place for so long that it looks like the natural order of things.”

In the chapter “The Price We Pay for a Caste System,” she explores what this system costs us as a society and as individuals, including in healthcare.

She notes that most of America’s peer nations have some form of free or low-cost healthcare coverage for all residents; that America falls woefully behind other wealthy nations in indicators of health and quality of life; and links this situation to caste:

“A caste system builds rivalry and distrust and lack of empathy toward one’s fellows. The result is that the United States, for all its wealth and innovation, lags in major indicators of quality of life  among the leading countries in the world.”

How universal healthcare supports racial equity and justice

In “The Case for Change” on our website, Maine AllCare board member Dr. Caryl Heaton lays out how racial inequities in healthcare play out in the present–and how universal healthcare would help to alleviate them:

“Health insurance, physician quality and physician access would no longer be tied to employment or socioeconomic level. Reimbursement for health services would be consistent for all patients and would improve access in underserved communities.”

Maine News

Troy Jackson and healthcare on Maine Challenge

Maine Senate President Troy Jackson appeared recently on Maine Challenge, in conversation with Betsy Sweet. They discussed how the pandemic has further highlighted the critical importance of universal healthcare, and the role of states in pressing forward with healthcare reform.

Jackson says that he hopes that a silver lining of the pandemic could be Mainers getting more involved with state government. He hopes that Maine people will keep “making the legislators, myself included, feel very uncomfortable that we don’t support something that the people of Maine want.”

Brooklin passes healthcare resolution

On January 19, the town of Brooklin joined Bangor, Blue Hill, Brunswick, Orono, and Penobscot in passing a resolution in support of healthcare for all Maine residents.

Would you like to get a resolution passed in your town or city?

Contact us to learn more and get started. We’re here to help!

Call to Action

Your help needed to get universal healthcare on the ballot in Maine!

Maine Healthcare Action was formed in late 2020 by Maine AllCare with the express purpose of getting a Resolve on the ballot in 2022 that will direct the Maine Legislature to create a publicly funded universal healthcare system for the state.

Signature-gathering in support of this effort will be starting soon, and your help is needed.  Learn more and sign up to volunteer on the MHCA website.

Get a Maine AllCare bumper sticker!

Contact us to request one and we’ll put it in the mail to you.


Voices of Maine

A physician perspective on health equity

In a commentary in West End News on January 29, Dr. Oren Gersten, a family physician practicing in South Portland, explores how issues of equity in healthcare play out on multiple fronts.

“In the United States we have entrusted our health care and public health to large private institutions that have failed to keep us healthy and treat us equitably.”

Read more letters to the editor on our website

Write a letter to the editor in support of universal healthcare. Check out this guidance on how to write an effective letter–and why they are so important. Please send us a link if your letter is published.

PNHP Resources

Maine AllCare is a chapter of Physicians for a National Healthcare Program (PNHP)

PNHP has active chapters in states around the country and offers many resources in support of universal healthcare. These include resources to learn more about racial inequity in healthcare, and what we can do about it:

Further Reading

Addressing the caste system in US healthcare in the era of COVID-19

International Journal of Equity and Health (October 2020)

Social Determinants of Health

New England Journal of Medicine–Catalyst (December 2017)

Advancing Health Equity by Addressing the Social Determinants of Health in Family Medicine

American Academy of Family Physicians (April 2019)

Learn More and Get Involved

Check out our website to learn more about health care reform for Maine, who we are, the work we do, and how you can get involved.

Maine All Care chapters usually meet monthly, around the state, and our meetings are open to all.Chapters are meeting via Zoom due to the pandemic.

Make a donation to support Maine AllCare’s work–any amount makes a difference! Make a one-time gift, or set up a monthly donation.

Follow Maine AllCare on Facebook and Twitter and share posts and events.

And please spread the word!

Thank You for Your Support

Maine AllCare promotes the establishment of publicly funded healthcare coverage for all Maine residents. This system must be efficient, financially sound, politically sustainable and must provide benefits fairly distributed to all. Maine AllCare advocates that healthcare, a basic necessity, be treated as a public good, since it is fundamental to our well-being as individuals and as a democratic nation.

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