Institutional Racism (real estate, insurance, mortgages)

[Pitts10yrs]

I guess I would be addressing this question to people of ethnicity (namely AA people of the city), or/and also people who come from a low SEC (social economic class). I am interested if anyone has experienced, or has any awareness to the above topic. I am especially interested if this has happened while staying at any of our many hospitals.

The reason is that I have been following the treatment of a young man and it readily appears he has recieved sub-standard care. Though looking back over his record, there are many holes in, I can not isolate any wrong doing by anyone specifically, but yet I have seen similar people with the same problems treated with better care, and given more alternatives. When I questioned this, I was told matter-a-factly, it no only happens often but is whats called "institutional racism".

Please feel free to respond or educate me....I am interested in knowing how this operates.

[Tallysmom]

Originally Posted by Pitts10yrs

I guess I would be addressing this question to people of ethnicity (namely AA people of the city), or/and also people who come from a low SEC (social economic class). I am interested if anyone has experienced, or has any awareness to the above topic. I am especially interested if this has happened while staying at any of our many hospitals.

The reason is that I have been following the treatment of a young man and it readily appears he has recieved sub-standard care. Though looking back over his record, there are many holes in, I can not isolate any wrong doing by anyone specifically, but yet I have seen similar people with the same problems treated with better care, and given more alternatives. When I questioned this, I was told matter-a-factly, it no only happens often but is whats called "institutional racism".

Please feel free to respond or educate me....I am interested in knowing how this operates.

It's not like institutional racism has a book of directives you can refer to -- but honestly, money is a factor. When you have money, you have access to better care at better hospitals. You have insurance.

In February, my husband had a hell of a scare. He had chest pains and a massive headache. He had them while moving large full dumpsters out. He came home -- didn't tell me about the pain -- and told me the next morning that he was STILL having them. I made him call the doctor.

the doctor called back ten minutes later and asked what hospital we wanted to go to.

Fifteen minutes later, we pulled up to Eden, and he walked into the ER, while I found a parking place and walked in.

You know all the things you hear about emergency rooms? He was sitting in the waiting room, already had talked to a nurse, they did BP check, and two minutes later he was escorted in to the er and given a bed and hooked up to monitors. I filled the paperwork, no money exchanged hands. I was told I'd get a bill.

The staff was efficient and cheerful and bustling around, busy as bees. It was the best experience of the worst day in my life. (by the way -- Hubby is fine, even though they don't know what it was -- all they know is it WASN'T his heart or a stroke.)

I went out to make a call, I came back in and the receptionist remembered me and let me back in, but that's when I saw the sign. This hospital doesn't take Medi-Cal. If you do not have private insurance or can't pay cash money, you aren't treated there.

NOW -- a friend is working at our local county hospital ER. It's everything you've seen bad about ER's. She says the bulk of what she sees is GSWs -- that's gun shot wounds. She sees 4-7 daily. Not to mention other people come in to cadge drugs, because they have the flu and they have no access to doctors, can't speak English, may be having a heart attack, are homeless and crazy and acting out --- all this ends up at her ER.

The staff is overwhelmed. I know my friend is an incredibly caring person, and she talks about her co-workers as being the same for the most part.. but do people fall through the cracks? Yes. Are they misdiagnosed? Yes. (heck -- my husband was misdiagnosed, and his care was primo!)

But is it racism? At it's most elemental sense, it is. And it isn't. I think it's more a poverty thing, but our poverty has a racial edge to it. In many ways, these lives are written from the day they are born. They are born into poverty, warehoused in bad neighborhoods, sent to bad schools and expected to fail -- so why are we surprised when they do?

And that's institutional racism. It's stacking the deck against a class of people, and expecting them to "achieve" out of it. That does happen. But it doesn't happen often enough.

Oh yeah -- just got my bill for the ER visit. 100 bucks. Total cost near 9 grand..... that's good insurance....

[zip95]

Medical professionals are human so I'm sure cases of racism exist. That said, in the relationship between you and the hospital, you're writing the check. And as a general rule of thumb it's much more difficult to act stupid when your wanting the check and vulnerable to lawsuits. Moreover, the top local hospitals have tons of minority doctors, nurses, and staff, and I'd guess at least a quarter of the patients are minority. So I wouldn't expect local hospitals to be a cauldron of racism. However, I would expect no-insurance-ism to be rampant. Note: this is all in general and not relevant to any specific case.

Some general comments...

In the modern world people have identified institutionalized racism in areas like real estate or mortgages (agents directing minorities to specific neighborhoods or specific loans). Although to me, his seems more sociological than institutional.

Edit: I just read Tallysmom's post and I think she describes the situation more succinctly than me.

[By~Tor]

I can only speak to this as a citizen, and surely not as one who knows anything about the medical profession in relation to the rest of society, but I'll offer my opinions, anyway....

I believe that doctors & nurses, just like anyone else, would tend to respond towards anyone on a professional level, in the same manner they would anyone else... but on a "personal" level, if someone appears to act in a "thuggish" or gang-related way, the tendency to shy away from them during their stay might be apparent... and that said, if they aren't receiving the level of care or attention that would be ordinarily perceived as "average", then one should look at both the potential for racist belief structure in the minds of the providers as WELL AS the persona of the patient, themselves...

Of course, just because someone is black, that wouldn't necessarily mean they are a gang member or a thug, anymore than being white would make someone a Klansman or other racist xenophobe.... but with everyone "Perception IS Reality", and I'd assume medical staff are no exception....

Just my thoughts, and I hope the patient gets all the right care, and has a speedy recovery.

[Katarina Witt]

OK, I'll take a stab (no pun intended) at this one. When I was a student nurse at good old Pitt, we were taught to be non-judgemental towards our patients. That is, if Osama bin Laden showed up in our ER, clinic or hosptial floor, we were to treat him as we would anyone else (actually, we hadn't heard of Osama back then, the example was more likely Fidel Castro!). We had many philosophical discussions about this over coffee and in the dorm rooms, as college students like to do. One student said you'd have to be an angel to be totally non-judgemental. She meant that religiously. Point is, it has to be taught. You don't just throw away your biases when you put on the white uniform.

I now work in a doctor's office. I have also raised two children, almost to adulthood. I have seen, from both sides of the fence, that patients are treated somewhat differently with different insurances. I am referring to medically different. I have been told, "if you had better insurance, we'd do X, but since you don't, we'll do Y". Would the outcome have been different? Who knows? Many tests are ordered to verify the diagnosis, not as some think, for the docs to cover their butts in case of a lawsuit. Thankfully, when my daughter was diagnosed with cancer, we had good insurance that would pay for every test the dr. ordered.

I would say in our office, we strive to treat everyone equally. We have a very multi-cultural clientele, for some reason. When we can't understand what someone is talking about over the phone because they barely speak English, we'll bring them in for an appointment, to be on the safe side. When people can't afford immunizations, we send them to the health department, even giving them the HD's phone # so they don't have to look it up.

There have been some studies about institutional racism, but I don't know if they've looked at insurance status as one reason some people don't get "Cadillac" care. And as tallysmom pointed out, a misdiagnosis is always possible, even with great insurance.