Book on Poor African-American Family and Race Posing a Problem for Health Care

¶ … Mama Might Be Better off Dead

For the past several decades, health care reform has been on the top of the political lip service agenda. Presidential candidates debate heatedly over which types of Medicare or Medicaid reforms should be instated and purport to want "universal health care." They call out for assistance to low-income families and claim that no American citizen should go without health care services. Yet through all their platitudes one thing remains painfully clear: they really just don't care. Not only has little been done to ensure that every American, regardless of race, receives the best health care services available but the situation seems to be getting worse as the income disparity gap widens with every successive year. In her 1993 book Mama Might be Better Off Dead, Laurie Kaye Abraham illustrates the impact of America's failing health care system by focusing on one family. The Banes' are poor, and they happen to be African-American: what will turn out to be two strikes against them in their pursuit of adequate -- not even exceptional -- health care. Abraham offers in intimate view of the Banes' lives, four generations of men and women who suffer from various ailments and who have found it nearly impossible to receive medical attention to meet their needs. By showing the effects of what Abraham calls the "healthcare nonsystem" on one family alone, Mama Might be Better off Dead emerges as a powerful reminder of one of the hugest domestic political issues of recent American history. In fact, Mama Might be Better off Dead alludes to the notion that health care shouldn't even come under the general political rubric but has rather become more of a human rights issue. The eerie title of Abraham's book shows how in many cases the American health care system only responds to the rich or to the nearly dead.

Jackie Banes essentially became the caretaker of four generations of family members: her grandmother Cora Jackson, her father Tommy Markham, her husband Robert and her three children. While the tales of these individuals are heart-wrenching, the object of Abraham's book is not to draw tears but to inspire change and prompt readers to think strongly about how they vote. The first chapter of the book, entitled "Where crowded humanity suffers and sickens": The Banes Family and Their Neighborhood," traces and explains Robert Banes' kidney failure. Since he was twenty-seven years old and his kidneys failed, Robert Banes has needed kidney dialysis three times a week. With considerable detail, Abraham details some of the experiences and medical procedures that Robert must endure and describes how closely race and illness are linked. On page 20, the author states, "Though genetic differences still are occasionally cited in medical literature in order to explain disproportionate disease among blacks, nearly all health experts put most of the blame on poverty," (20). Abraham continues, "The starkest contrast in longevity is between white and black men," (20). Part of the purpose of Mama Might be Better off Dead is to expose the insidious connections between race, poverty, and health. Throughout the book, Abraham uses stories, incidents, and examples like that of Robert Banes to demonstrate how deep the currents of prejudice and privilege run in American society.

Robert's story is one of the most poignant in the book, which is why the author again focuses on his dialysis and his run-ins with the health care bureaucracy in Chicago, a city boasting some of the best medical facilities in the nation. Robert had trouble finding clinics that would treat him because he couldn't afford it. Basically the system creates a frustrating catch-22 in which the poor can't afford proper health care, which exacerbates their illnesses, which makes them unable to work. Therefore, Abraham shows that poverty begets illness and illness likewise begets poverty. The conundrum is not only disheartening when it affects individuals like Robert Banes; it is also chilling and overwhelming in its scope.

The story of the elder Mrs. Jackson is slightly different from that of her son-in-law, but both were victims of the deplorable American health care system. For clear and understandable financial reasons Mrs. Jackson lied about her working status to acquire Medicare insurance. Even with her troubled and underhanded dealings she was unable to receive the assistance she needed in her ailing condition. Abraham explains, "Even with Medicare and sporadic Medicaid coverage, Mrs. Jackson's access to medical care was far below the standard most middle-class Americans expect," (56-57). Mrs. Jackson's story is particularly poignant because it illustrates how convoluted the governmental health care system is and how it entraps individuals into catch-22 situations.

Laurie Kaye Abraham dedicates three entire chapters to the tale of Mrs. Jackson: her personal struggle with her aging body and diminishing health, her interpersonal and spiritual struggle dealing with the impotence of being poor and the sense of being a second-class citizen. Her inability to acquire or afford health care underscores the importance of books like this to bring to light the problems with health care in the United States.