How Minnesota’s fight for racial justice can transform health care in America

Minnesotans are familiar with what happened on May 25, 2020. The police killing of George Floyd made Minneapolis the epicenter of a racial reckoning that spanned the globe. From Willmar, Minnesota, to London and Hong Kong, people gathered in the streets to point out the systemic racism that has plagued our state, country, and world for too long.

As a medical student, I took the Hippocratic Oath — to do no harm and do everything in my power to heal each patient I see. But the events on the night of May 25, 6 miles from where I took that oath at the University of Minnesota, reminded me of how we as a society hurt our minority communities over and over. From building I-94 through the historic black neighborhood of Rondo in the 1950s and 1960s, being ranked 50th in racial disparities in education rates, or having the second-worst racial income gap out of America’s 100 largest metro areas, Minnesota “Nice” has not applied to everyone. Additionally, these numbers were from before 2020 and fail to even mention the most current attack on communities of color: coronavirus.

Based on the Minnesota Department of Health’s Feb. 4 weekly COVID-19 report, the age-adjusted racial disparities are disheartening. Per 100,000 Minnesotans, a person of any non-white ethnicity is 2.6 to 5.2 times more likely to be hospitalized from coronavirus and 2.1 to 5.3 times more likely to die from it. Although all focus right now is on vaccination rollout and mitigating spread, we are neglecting to think about the long-term heart, lung, and systemic issues that may plague COVID-19 survivors for decades.

The Minnesota Health Plan

So what can we do to combat racial disparities in Minnesota? While no one policy can cover our inequities in housing, wage gaps, graduation rates, incarceration, and home ownership, we can take an important step for health care equity by pushing for and passing the Minnesota Health Plan (MHP). Proposed by state Sen. John Marty, the MHP would be a single, unified state health care program ensuring that all Minnesota residents would get the medical care they need. Under section 1332 of the Affordable Care Act, states are able to propose innovative alternatives to provide health care that is at least as affordable and comprehensive as the ACA. Through this waiver, the MHP could be yet another Minnesota medical innovation and lay the framework for how universal health care coverage would cover all Americans.

Contrary to belief, the MHP is not “socialized medicine.” The plan would cover all Minnesotans regardless of preexisting conditions or ability to pay but would not become government-controlled health care. Patients would be able to keep their same doctors, private sector health care providers would not be run by the government, and the MHP would act independently from the governor and state Legislature. Included in the MHP is coverage for dental, mental health services, optometry, chemical-dependency treatment, nursing home care, medical equipment, and home care services.

Cheaper than our current system

Marty’s book on the plan shows how it would be cheaper than our current system as well as deliver less charting — and more time — for our providers to actually provide the care they were trained to do. An argument against a unified state health plan may say that the MHP will cause “rationing” of services. While partially true (you may wait a couple extra weeks for an elective procedure), our current system is rationing health care services by excluding those who cannot afford or cannot access them. Additionally, the MHP is a major step forward in terms of health equity for all Minnesotans. For communities hardest hit by lower life expectancy or diseases such as diabetes, asthma, heart disease, or cancer, this plan would provide a safety net for care, while also serving as a jumping point into providing primary preventative care and stopping costly diseases before they occur or progress.

The MHP may be perceived as legislation that benefits the Twin Cities the most, but this is false. The most recent data available shows that the Minneapolis-St. Paul area has 5.7% uninsured, which ranks third in the state behind Central Minnesota (6.6%) and Southwest Minnesota (6.7%). This plan is just good policy — providing guaranteed health care for all while leaving medical decisions between providers and their patients, all while improving health equity and providing a framework to expand primary and preventive services.

It is far from perfect, but the MHP is the best way to deliver health care to the state of Minnesota. Passage would show a commitment to our communities of color that we are serious about change.

Justice Spriggs is a second-year medical student at the University of Minnesota. He graduated from St. Anthony Village High School in 2015 and from Hamline University in St. Paul in 2019. He and his wife live in Columbia Heights.

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