“Health is a basic human right and it should not depend on how much you got in your wallet as to whether or not you get health services [...] Primary care instead of catastrophic care should become the focus on American medicine. We need an emphasis on preventive health-services. We need men and women who will specialize in giving, you might say, general services, family practice, to the people of America [...] We need community-based services and by that I mean distribution centers, [...] where health can be given to the people, where the people are, rather than making the people go someplace else to get it.”
Our Quote of the Week underlines the critical importance of making affordable health services accessible to everyone in the United States. Sargent Shriver’s observations about health care for all are particularly relevant now, as COVID-19 continues to ravage our communities, to put those with existing health conditions at greater risk of serious illness and death, and to keep health services out of reach of Americans who are uninsured or struggling economically.
Sargent Shriver’s 1974 Address Evaluating the War on Poverty to the American Public Health Association gives us some insights into his process as he constructed the programs of the War on Poverty. He admits that when he was designing programs, he looked at services that could support Americans through different phases of life and work, "[b]ut there was nothing specifically about health.” He continues: "[T]hank God we did have eyes and we did have ears, so we could see and we could listen to the poor who came into the Job Corps and into the Neighborhood Youth Corps, etc., and what did we find? We found out right away that for the customers, for the consumers, for the poor, health was a matter of primary importance.” To address this gap in the programs, he introduced Neighborhood Health Centers (which today operate as the National Association of Community Health Centers, NACHC). These centers provide medical services to individuals regardless of their economic or legal status.
During Sargent Shriver’s tenure as the Director of the Office of Economic Opportunity (OEO), he oversaw the creation of several Neighborhood Health Centers. You can read about a couple of them in this week’s speech, and you can also read his dedication at the 1967 opening of a health center in the Watts section of Los Angeles. Today, in addition to the NACHC, other individual agencies born of the War on Poverty, including Community Action and Head Start, continue to provide some health services to their communities.
It’s interesting to note the timing of this speech: Shriver shared his bold thinking on this issue in 1974, ten years after the start of the War on Poverty, but in anticipation of the efforts of his brother-in-law, Ted Kennedy, and of President Barack Obama, to make health insurance more accessible. To date, the culmination of work in this area was the passing of the Affordable Care Act (ACA) in 2010. However, there is certainly more that we can do to bring health care to all.
At the time of writing, the Build Back Better bill, which is at risk of dying in the US Senate, would see Medicaid expanded, reduce the cost of health insurance premiums for low-income Americans, provide paid medical leave, and cap drug prices for medications such as insulin, among other changes. We simply cannot afford to let an opportunity to improve health care and to expand our social safety net slip by. In fact, as we enter year three of a pandemic that has taken over 5.3 million people worldwide, over 800,000 in the US alone, we must call for nothing short of a revolution in the way we deliver health care to our communities. As Sargent Shriver reminds us: “We certainly can’t be a nation half healthy and half sick. We need leadership to change the topography, if you will, of the American medical system.”