“The American Medical Association has never been a friend to us [African Americans],” explained the late Chicago physician Dr. Donald L. Chatman. Referring to the history of racial inequality in healthcare, Dr. Chatman revealed the difficulty of forcing the historically white-lead medical establishment in the United States to provide African Americans with equal access to healthcare. A chapter of this history of racial inequality in healthcare and its opposition is the subject of the recent PBS documentary, entitled Power to Heal: Medicare and the Civil Rights Revolution (narrated by activist and actor Danny Glover). Produced by Dr. Barbara Berney (City University of New York School of Public Health) and directed by Charles Burnett (The Glass Shield) and Daniel Loewenthal, Power to Heal examines the passage of the Civil Rights Act and Medicare in the early 1960s. While the film often focuses on famous events and traditional high political actors, it also includes a vital counter-narrative of how Black physicians and activists pushed for healthcare reform in the United States.
As racial health disparities continue to plague the United States and amidst contemporary calls for expanding Medicare coverage to all Americans, Power to Heal examines how civil rights activists were able to partially reform the racist and capitalist foundations of the healthcare system. The documentary discusses well-known figures and events in the history of the civil rights era, such as Martin Luther King Jr., John F. Kennedy Jr., and Freedom Summer. Yet, it also focuses on actors that will be new to many who are not experts on the intersection of the history of medicine and the Black Freedom Struggle, including activist/medical professionals such as Nurse Dorothy Ferebe and Dr. George Simkins, as well as the more well-known National Medical Association, formed as a Black professional organization in the late nineteenth century. Based on the monograph of the same title by David Barton Smith, Power to Heal represents a vital contribution to the public history of both healthcare and the Civil Rights Movement, revealing the white medical profession’s historical complicity with and contributions to white supremacy, and it highlights the courageous activists and medical professionals who opposed this system.
The narrative that the documentary adopts will be highly familiar to most historians, even if the inclusion of medical issues breathes new life into this often-repeated timeline. The documentary begins in the period immediately following the end of World War II, relating how the Black men coming home from the war were disturbed by the continued racism of American society, even as they had risked their lives overseas to protect the country. The South, the documentary relates, had a healthcare system defined by segregation that produced deeply unequal health outcomes. Through interviews with victims of and opponents to this system, the film unearths stories of towns without hospital wards that would admit Black patients and the fatalities that resulted from this lack of facilities.
The Civil Rights Movement, the documentary argues, created an opportunity to challenge these structures of medical white supremacy, and the high volume of middle-class Black physicians within the movement brought medical issues to the forefront. As with the prominence of lawyers in the Civil Rights Movement, Black doctors played a powerful role in traditional civil rights activism, a position that largely has been under-examined up to this point. As with other high political histories of the Civil Rights Movement, the assassination of John F. Kennedy, the passage of the Civil Rights Act of 1964, and the inauguration of Lyndon B. Johnson play integral roles in the film’s narrative of hospital desegregation.
The last third of the documentary focuses on the period leading up to Medicare’s implementation in July 1965, with volunteer government compliance inspectors in a race against time to force the South’s white hospitals to desegregate. Hospitals that failed to desegregate would not receive federal funding through Medicare, which provided affordable healthcare to the country’s elderly. This is the culmination of the film’s story, with the volunteers succeeding and over 90 percent of hospitals nationwide and 70 percent in the South desegregated by the end of July 1965.
The documentary concludes with a powerful call to action, reminding viewers of the progress made by desegregating hospitals, while also pushing for further action towards universal access to healthcare. As Glover narrates over the credits, “While hospital desegregation was a significant advance, it did not erase racial discrimination from our healthcare system. The amazing work and life-saving policies recounted here are not irreversible. Today, far from over, drawing on the strength of those who came before, the struggle continues.”
In addition to the film’s more targeted narrative of the desegregation of southern hospitals, it also hints at a history that has been given less attention: the formative role of African Americans in forcing the American medical system to be more equal and accessible along economic — as well as racial — lines. While the documentary never makes such an explicit claim, it lies beneath much of the surface of the story. Throughout the documentary, it is the American Medical Association — founded in 1847 by a white-controlled medical profession that actively excluded African Americans — that stood in the way of progressive reforms. During much of this period, the AMA allowed local chapters to exclude African Americans, and they opposed the expansion of the public healthcare system. As depicted in the film, they only supported Medicare upon being publicly strong-armed by President Johnson. The National Medical Association, in contrast, supported Medicare from the beginning. Hinted at then is an important stream in African American intellectual history: a long-standing belief and advocacy for a more egalitarian healthcare system. As much as telling an essential and less-known story of the national government and desegregation to a popular audience, it is this underlying history that makes this documentary so powerful.
On the other hand, the documentary would be stronger if this intellectual history were more overt, and if the documentary briefly discussed other approaches to healthcare activism in African American history. While desegregating white medical spaces has been essential to making American healthcare more equal, it has been far from the only effective approach to improving African Americans’ access to quality healthcare. Just as important as desegregation, scholars such as Vanessa Northington Gamble and Alondra Nelson have emphasized the role of healthcare institution-building among African American doctors and activists. This history of Black medical institutions spanned from the Black hospital movement of the early twentieth century to the creation of free community clinics by the Black Panther Party in the 1970s. While extended commentary on these histories is beyond the scope of a one-hour documentary, greater reflection on the diversity of approaches to eliminating inequality from US healthcare would reflect how continuing the fight against racial health inequality must be taken on several fronts. The larger history of African Americans and the medical profession reveals that ending inequality cannot be reserved to just reforming institutions with white supremacist origins.
Despite this oversight, Power to Heal remains an exciting and welcome contribution to the study of race and health in US history, and it is certain to have an impact on both lay and professional audiences. The film’s accessible style, inclusion of interviews with historians, physicians, and activists, and its concise and targeted narrative, make it a useful tool to a variety of educators and activists. As “Medicare for all” becomes a rallying cry among many Americans, Power to Heal highlights the germinal contribution of African American medical professionals and activists to combatting inequality and envisioning a more equal healthcare system.Copyright © AAIHS. May not be reprinted without permission.