Rhea Boyd, MD @RheaBoydMD A pediatrician and hopeful participant in democracy. Trying to do the right thing by the children of the world, one day at a time. youtu.be/xBUEsDtBfiQ Jul. 11, 2019 2 min read

Can we talk about @PeteButtigieg's "Douglass Plan" Black twitter?

As presented here, it seems to advance a "talented tenth" notion of racial uplift that while persuasive can be a problematic misreading of how racial inequality works in America.

Here's my take. Short thread:

1. America cannot *buy* its way out of the impact of racism. Period.

And this point might be controversial, but not even by investing in laudable institutions, like Black businesses or Black colleges.

2. To address the impact of racism, America has to eliminate and redress past and present forms of systematic discrimination and exclusion by race.

That requires robust anti-segregation measures and processes to criminalize and penalize forms of discrimination and exclusion.

3. Simple investments in Title I schools as proposed by @PeteButtigieg (which by itself is great), does nothing to mandate and federally enforce school desegregation, the major driver of racial inequality in school funding and resources, teacher support, and student achievement.

4. The reason to "diversify" the teacher workforce is not because Black teachers magically teach Black students better but because the lack of non-white teachers evidence systematic processes of racial discrimination + exclusion that negatively impact Black teachers and students.

5. The same is true in healthcare. Black professionals are not "underrepresented" they are excluded and when included, it is within systems that preference, normalize and reward whiteness. Bias training does nothing to address whiteness and its powerful impacts in healthcare.

6. Arguably the greatest (and most horrific) account of what America's racism has stolen from Black and Blacker peoples, is measured in health indices. It is the mothers, babies, fathers, friends, neighbors stolen by early death, unjust disease, or unpredictable racial terror.

7. Yet "Health" only receives 3 bullets in @PeteButtigieg's "Douglass Plan" the most robust of which is an expansion of ACO's they call Equity Zones. ACO's have been shown to perform *worse* on quality metrics when they serve more "racial minorities."  https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2016.0626 

8. I appreciate the plan's intent to decriminalize poverty and drug use, abolish the death penalty, end for-profit prisons, and extend Medicaid to those incarcerated. These reforms are critical for Black Americans ensnared in the racism of the criminal justice system.

9. But we have to question how racial inequality works in America and which investments and reforms actually hold individuals, systems, and institutions accountable for racial discrimination and exclusion in America and its multitude of impacts.

10/End This will require a broad restructuring of every single institution in America. Because capital, mobility, and health in this country are predicated upon the racial dominance of whites and subjugation of all others. Ending that would be worthy of Frederick Douglass' name.

You can follow @RheaBoydMD.


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