“I Ain’t Woke; I Just Can’t Sleep!”: Social Justice In Medicine

The claim of rising diabetes test strips that is floating around Facebook is actually one for the Australia, not America. However, we still have plenty of issues that require vigilance. The election of 45 means that we are now engulfed in another restless battle. Republicans sweepingly demonized the Black voting block through these odd Jim Crowsian conversations about “real Americans” and “Take Back Our Country” and even “Back to the Good Ole Days.” The narrative of “Making America Great Again” only works when you define our current America as inferior.

It was “great” when Black folks were not seen joyful, dancing with Usher in the White House. It was definitely great before Michelle Obama showed off those beautifully sculpted arms and showed us we’re worthy of being healthy. Or, when we were so deep into a recession that you needed a second mortgage to get gas. Yup, that was greatness, right? Black women being viciously pushed by grown White men…Black students escorted out of a rally for simply being there…Photographers tackled for documenting the White thugs…Seeing Nazi salutes…folks being encouraged by their “leader” to “get them outta here” is not only dangerous but certainly illegal. Far from great.

Now, we are watching the diminution of citizenship along both racial and religious lines and I refuse to be silent. I ain’t woke; I just can’t sleep! See, there’s no joy in being “woke.” Your internal clock ticks through pain and despair that no one understands but fellow night drifters who still have to “work” in the morning. We can’t caffeinate our faith when our own brothers and sisters slept through the night. I’m tired. I’m tired of trumpeting Black excellence when being average trumps an election. I’m not woke; I just can’t sleep. So, I can certainly speak to the many defenseless civil liberties within 45’s crosshairs, but I’d like to address the threats to healthcare under the new administration.

The rocky passage of the Affordable Care Act (ACA) on March 21, 2010 brokered access to healthcare and quality enhancing metrics for all Americans. The ACA, not Obamacare because this politicizes the law for no reason, is a great start to the direction that ensures an equitable medical system.

Granted, the name implies “affordable” healthcare, even though costs really are not lowered. The law should have been named the “Access to Care Act.” With that said, 22 million new people now have access to healthcare according the Department of Health and Human Services. Preventative medical services for different types of cancers, depression and blood pressure were thrust to the center of a system that rewards disease over deterrence.

Patients’ voices actually matter under the ACA. Both insurance companies and provider payments are contingent upon patient satisfaction benchmarks and hospital readmissions for an illness. Finally, the ACA expanded equal protection against discrimination on the basis of sexual orientation. The legal protections also forced insurance companies to provide a reason for denial of any healthcare insurance claim within 30 days.

Why does this matter, you may ask? Well, imagine going to your favorite store and no matter what time you go only two of 28 registers are open! You know the lines will be long. You know customer service will be average at best but there’s always something that you need. Then imagine a new law tells this store that they can get 22 million new customers, but will only receive full price for their products if their customers are happy with their service. Next thing you know, ALL the registers are open! Blue shirts are swarming customers with the Chick-fil-A style “my pleasure to serve” smiles. Now imagine, the law changed while the regular and 22 million new customers were shopping. The new law basically says we do not care about that quality or equal protection stuff anymore. So, your favorite store closes down all but two registers and raises the prices of their products. Lines are longer and quality is worse.

In healthcare, we do NOT really pay for medical services because of the cost-sharing mechanisms of healthcare insurance. If insurance companies and providers profit regardless of how patients are treated, we return to the system that continues to uphold and normalize health and healthcare disparities that run rampant in our communities. If we remove those equal protection clauses, we make it harder to seek legal justice when misdeeds arise. If we repeal the ACA, we lose vital funding for research and workforce diversification. I’m simply saying that I ain’t woke; I just can’t sleep!

In the powerful documentary, “I Am Not Your Negro,” James Baldwin through the voice of Samuel L. Jackson said, “In America, I was free only in battle, never free to rest, and he who finds no way to rest cannot long survive the battle.”

Somehow the term “woke” translates to this voluntary burst of energy that allows one to attack racist institutions and ideals. Truthfully, I wanted to rest like my White friends. I wanted to ignore the racist jokes. I wanted non-Black people to know why OJ “getting off” and Rodney King’s beating being taped both made the perversion of justice real for me. Social justice in medicine is just as important as the cowering criminal justice system’s grip on our community.

I’m scared that we are going from “woke” to sleepwalking because justice is not coming. We’ve been sleep deprived. Sleep is a privilege of freedom. Fatigue is a consequence of oppression. Being woke doesn’t give us rest. I ain’t woke; I just can’t sleep!

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