As a pediatric endocrinology fellow, there are months where your life is just dedicated to the job.

That’s what happened in March… and April.

And God it was miserable.

As I slowly come out of my endocrinology hole, I am excited to spend more time writing.

But as I was sitting on the sidelines watching the world fall apart

I was devastated and overwhelmed.

I long for the times where, we do not hear from Washington everyday.

I long for the peace we had as Americans, that seems to be hidden since January 20th, 2025

And through all of this,

the medical world has treated this as business as usual,

leaving me to scratch my head wondering why?

That was until March 30, 2025 7:00 pm EST.

When 68-year-old Cory Booker decided the world needed to stop.

We needed to stop treating this moment as business as usual

We needed to stop acting as though people were not getting harm

That norms were not being changed

And that our freedoms were not being placed at risk.

Though, the moment was brief, the impact was long.

Bringing needed attention to government programs such as Medicaid and Medicare with new tune, but it is still under threat.

For me, it was enough to remember why I needed to finish this story about why Medicaid and Medicare are important and foundational to American health care system.

Just to recap, we discussed the following:

🔹 The Story of Medicare & Medicaid – The President Who Changed History
🔹 The Story of Medicare & Medicaid – The Lone Black Doctor Who Demanded Change
🔹 The Story of Medicare & Medicaid – How Black Health Changed for the Better

We will end the journey around, The Story of Medicare & Medicaid – How We Have Shortchanged the Fight for Health Equity. I am excited to be able to finish this series with a bang and cliffhanger as we need to continually think about how we can not only keep these programs but also reform and improve them.

To end this long prologue, I am excited to switch gears and talk about how children’s health insurance (CHIP) came to be.

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The Birth of the Children’s Health Insurance Plan (CHIP)

If you’ve been following health care headlines like I have, chances are you’re sick of hearing the name Kennedy.

And no, it’s not because of the measles making a comeback.

It’s because one Kennedy in particular has taken “wellness” and warped it into a weapon against public health.

But not all Kennedys have carried that torch.

In fact, if RFK Jr.’s uncle, the great Sen Ted Kennedy knew what was happening in his name, he’d be doing somersaults in his grave.

And not the kind you clap for.

While most people remember Ted Kennedy for his role in passing the Patient Protection and Affordable Care Act, known widely as Obamacare.

His legacy in children’s health care, like children’s health itself, is overlooked.

Before the ACA, before the headlines, there was CHIP.

The Children’s Health Insurance Program.

And Ted Kennedy helped build it.

The Children’s Health Insurance Program

Signed into law on August 5, 1997, when bipartisanship was still a thing, CHIP was the product of an unexpected alliance between Senator Ted Kennedy (D-MA) and Senator Orrin Hatch (R-UT)—a true “for the kids” moment.

Together, they co-sponsored the State Children's Health Insurance Program (SCHIP), established under Title XXI of the Social Security Act.

It was inspired by a state-level initiative in Massachusetts, and it followed the Goldilocks principle of health policy:

Not too much.
Not too little.
Just right.

CHIP was designed to cover children in families that earned too much to qualify for Medicaid but not enough to afford private insurance—the kids who fell right through the cracks.

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Kid-Centered Health Policy, By Design

Think of CHIP as the kid-friendly cousin of Medicaid—a federal-state partnership with enough flexibility for each state to shape it in their own way. States could:

• Expand their Medicaid programs

• Build a separate CHIP program

• Or do a hybrid of both

Both the federal government and the states chipped in (pun fully intended), with the feds matching state funds and throwing in a little bonus.

But here’s the catch—unlike Medicaid, CHIP funding is capped.

That means both the money and the number of children who can be covered are limited. And every time reauthorization rolls around, CHIP becomes a pawn in budget politics.

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CHIP Under Fire (and Still Standing)

Let’s talk receipts.

📈 2009: The Children's Health Insurance Program Reauthorization Act (CHIPRA) expanded coverage to an additional 4 million children and pregnant women.
📈 2018: The Bipartisan Budget Act extended CHIP’s authorization through 2027.

Even as it gets tossed back and forth by both parties, CHIP’s success is undeniable.

The Numbers Don’t Lie

Since CHIP’s inception in 1997:

✔️ Uninsured rates for children have dropped from 14.2% into the single digits
✔️ As of May 2025:
→ Over 7 million children are enrolled in CHIP
→ Over 37 million children are enrolled in Medicaid

From routine checkups and immunizations to emergency care and hospital stays, CHIP has transformed the way children receive healthcare in the U.S.

This is anti-poverty healthcare at its finest.

It’s not perfect. It’s not fully protected. But it’s working.

The System Keeps Changing—But Who’s Still Being Left Behind?

CHIP didn’t come out of nowhere.
It was built on the foundation Medicare and Medicaid laid—programs born from struggle, protest, and policy courage.

We’ve looked at how these programs forced hospital integration, lowered infant mortality, and brought health care to Black and low-income communities once completely locked out of the system.

But access is only part of the story.

Because as CHIP and Medicaid expanded coverage, another reality came into view:

🩺 Coverage doesn’t always mean care.
📉 The gaps didn’t vanish—they evolved.
🧬 And the roots of racial health disparities run deeper than eligibility and enrollment.

So in the next dose, we’ll ask harder questions:

🔍 Who still gets the short end of the stick when it comes to quality care?
📊 How do these programs reinforce—or resist—structural inequities in the healthcare system?
📜 And what role did the Affordable Care Act really play in closing the gap… or leaving it wide open?

Because a changing system means nothing if it still fails the communities it was supposed to protect.

💊 See you in the next dose.

And if you haven’t already, now’s the time—subscribe to The Advocacy Dose so you don’t miss a single truth bomb.

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You have to understand this…

For Black Americans, Medicare and Medicaid is more than just health insurance programs—they are lifelines programs.

As mentioned multiple times before…

Before 1965, Black Americans were largely shut out of the healthcare system, forced to rely on segregated, underfunded, and often neglectful hospitals. This wasn’t just an inconvenience—it was a death sentence for many.

Take Black infant mortality rates, as just one example:

📉 1916: Black infant mortality was 184.9 deaths per 1,000 live births, a staggering 87% higher than white infant mortality.
📉 1920: Black infant mortality was still 43% higher than white infant mortality.
📉 2017: It dropped to 10.8 per 1,000 live births—a massive improvement since the passage of Medicare and Medicaid.

But hold on—Black babies are still dying at disproportionately high rates.

In 2017, Black Infant Mortality Rate was 122% higher than the white infant mortality rate of 4.9 per 1,000 live births.

So no, Medicare and Medicaid didn’t fix everything, but they closed health disparities the size of the Grand Canyon.

For all the physicians who complain about the inefficiencies of Medicare and Medicaid, there are those who understand the alternative—a country where entire communities were left to die without care.

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Who’s Holding Up the System? URiM Physicians.

In 2024, the The Annals of Family Medicine (Fancy medical journal name) released a paper called …

A Few Doctors Will See Some of You: The Critical Role of Underrepresented in Medicine (URiM) Family Physicians in the Care of Medicaid Beneficiaries

They highlighted three truths about URiM physicians:

1. Black and Latino family physicians are more likely to participate in the Medicaid program compared to their white and Asian counterparts.

2. URiM physicians tend to care for a higher number of Medicaid patients, addressing a critical need in underserved communities.

3. The study suggests that URiM physicians play a crucial role in providing healthcare to socioeconomically disadvantaged populations, potentially reducing health disparities.

Translation? Not enough doctors are accepting Medicaid patients—but those who do? They are disproportionately Black and Latino physicians.

Why do these doctors take on this burden?

Because they know the history. They understand that Medicare and Medicaid were hard-won victories, designed to protect the people that the healthcare system had ignored for centuries.

And without them?

This country’s healthcare system would be in shambles.

Because as money, power, and greed continue to take over healthcare, it’s these doctors who are holding the line.

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But What Happens If That Line Breaks?

On February 25, 2025, the House of Representatives voted to include steep Medicaid cuts ($880 Billion Dollars) in the next federal spending bill.

So let’s be clear about what’s at stake:

🛑 If these programs are cut…
❌ Black communities will lose access to vital healthcare services, reversing decades of progress.
❌ More Americans could be pushed into medical debt, deepening racial wealth disparities.
❌ Without federal funding tied to civil rights laws, hospitals could be less accountable for discrimination, setting back healthcare equity by decades.

The dismantling of these programs would be a direct attack on racial justice in healthcare.

We know this because we’ve seen it before.

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Will We Let History Repeat Itself?

Dr. W. Montague Cobb. Dr. George Simkins. So many others.

They fought for a future where healthcare was a right, not a privilege.

But today, the very programs that broke down racial barriers in medicine are under attack.

Medicaid protects over 72 million people.
34 million of them are children.

If we stay silent, that future disappears.

So now, Dose Squad, the question is:

💊 What will we do to protect the future of healthcare in America?

Take Action—Right Now.

This isn’t just another headline. This is a call to arms. Here’s how you can fight back:

📞 Take 5-10 minutes and call your United States Senator’s office
✍🏾 Write your Congressperson—at the federal, state, AND local level.
📢 Flood their offices with your concerns. Demand that they protect these programs.

Remind them: their job is to represent their communities—not corporate healthcare interests.

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The System Keeps Changing—But Who Does It Serve?

We’ve seen how Medicare and Medicaid forced hospitals to desegregate.
We’ve seen how Black health outcomes started to shift when access to care expanded.
We’ve seen how the physicians who fought for these programs shaped a future they weren’t sure they’d live to see.

But the system didn’t stop evolving.

Because while Medicare and Medicaid changed the game for Black health, they weren’t the final chapter.

The next frontier? Children’s health.

So in the next dose, we’re diving into:

👶🏾 How these programs transformed children’s health in the U.S.
📜 The policies that expanded and threatened their impact.
🏥 And how it all set the stage for the Affordable Care Act.

The system keeps changing—but is it changing for the better?

Get ready for your next dose. 💊🔥 #TheAdvocacyDose

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Sources:

Singh GK, Yu SM. Infant Mortality in the United States, 1915-2017: Large Social Inequalities have Persisted for Over a Century. Int J MCH AIDS. 2019;8(1):19-31. doi: 10.21106/ijma.271. PMID: 31049261; PMCID: PMC6487507.

Anushree Vichare, et al. lA Few Doctors Will See Some of You: The Critical Role of Underrepresented in Medicine (URiM) Family Physicians in the Care of Medicaid Beneficiaries. The Annals of Family Medicine Sep 2024, 22 (5) 383-391; DOI: 10.1370/afm.3140

Their challenges to get our nation to value everyone lives is always inspirational and helps me to continue on the journey to being a better physician, advocate and overall human being.

Being a Black physician, or just a Black health care worker at times places you in predicaments where if you do not speak up people will get harm

If you do not challenge someone’s belief, someone might lose their life.

It’s a blessing and a curse to have this responsibility,

Unlike some of our colleagues we cannot just focus on the “objective” science/medicine.

But it’s a responsibility Black health care workers understand is a part of who they are.

And as the famous line goes … “With great power comes great responsibility”.

With that, let’s dive deep into the story of Dr. W. Montague Cobb

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Breaking the Color Line in Medicine

Imagine spending your life learning medicine, training for years to heal the sick, only to be told you cannot enter the hospital—not because of your skills, but because of the color of your skin.

And when rushing your loved one to an emergency room, you are turned away—not because there aren’t enough beds, but because the hospital doesn’t treat Black patients.

This was the reality for Black doctors and patients in America before Medicare and Medicaid.

Dr. Cobb decided that had to change.

Integrating Washington, D.C. Hospitals in the 1940s and 1950s

Dr. Cobb wasn’t just a doctor—he was a warrior for health equity.

As the first Black person in the U.S. to earn a Ph.D. in physical anthropology, he understood that racism wasn’t just a social issue—it was baked into the very institutions that determined who lived and who died.

And nowhere was this more evident than in the hospitals of Washington, D.C.

Dr. Cobb, as president of the Medico-Chirurgical Society of the District of Columbia ( local medical society of DC) in the 1940s and 1950s, led a relentless fight to integrate hospitals in Washington, D.C.

And in 1952, he won.

For the first time, Black physicians were granted access to white hospitals, and Black patients were no longer turned away.

A seismic shift.

His work in Washington, D.C., became a blueprint for national desegregation efforts.

In 1957, Dr. Cobb would successfully organize the first Imhotep National Conference on Hospital Integration.

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Advocacy for Medicare and Medicaid in the 1960s

By the 1960s, Cobb’s influence extended beyond Washington, D.C.

As president of the National Medical Association (NMA)—which represented Black physicians—Dr. Cobb was the only medical leader to testify in favor of Medicare and Medicaid during the congressional hearings leading to their passage.

At a time when the AMA aggressively opposed Medicare, Cobb stood alone in advocating for it, recognizing it as a tool to expand healthcare access and dismantle racism in medicine. His testimony directly influenced the passage of these programs.

Because of his unwavering advocacy, Cobb was invited to the signing ceremony of the Medicare and Medicaid Act by President Lyndon B. Johnson—an acknowledgment of the critical role Black medical leaders played in the passage of this legislation.

His legacy is a reminder that the fight for healthcare is inseparable from the fight for civil rights.

But why was the creation of Medicare and Medicaid so impactful for Black health? How did these programs uplift the Black community in America?

The Generational Health Care Impact

We’ve talked about the fight to create these programs.

We’ve talked about the lone Black physician who stood in the room when history was made.

But here’s the real question: What happened next?

Because Medicare and Medicaid weren’t just healthcare policies—they were civil rights victories.

They forced hospitals to desegregate.

They gave Black Americans access to care that had been denied for generations.

So in the next dose, we’re diving into the receipts.

🩺 How did Black health outcomes shift after Medicare & Medicaid?
🏥 How did hospital desegregation change the game?
📉 What progress was made—and what’s still at risk today?

The next dose is coming in hot. 🔥

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Today is supposed to be a day to honor those who have sat behind the Resolute Desk, shaping the course of American history, making decisions that ripple through generations.

But let’s be honest—we’re not living in normal times.

(I mean I got a flat tire today … not normal times…sigh)

And while we could spend today reflecting on the usual Presidential achievements—wars fought, economies built, policies passed—there’s one battle that should have been won decades before it was.

Healthcare.

Imagine for a moment: What if America had reformed its healthcare system right after World War II?

What if, in the booming years after the war, when highways were built and industries flourished, we had also decided that every American deserved the security of medical care?

We almost did.

In fact, one president saw the future—he knew exactly what needed to be done.

But he couldn’t change it.

It would take two more decades, political fights, civil rights activism, and an economic shift before the nation finally caught up to what should have been obvious.

So why did it take so long?

Why was a healthcare system that protected millions delayed until the 1960s?

And most importantly—what does that history tell us about the fight we’re in today?

We are going to dive into this for the next couple of days but first…

Let’s take a journey back to the beginning.

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Right or Privilege? The Story of Healthcare in America

Picture this: It’s 1945.

The War is Over.

The world is trying to rebuild itself after its devastation. Factories that once produced tanks are now making cars. Soldiers are returning home, hopeful for a fresh start.

The American economy is booming.

But beneath the surface of this post-war optimism, there’s a crisis that no one wants to talk about.

Healthcare as a privilege reserved for those who can afford it.

Doctors’ visits? Hospital stays? Prescription medicine? If you’re not wealthy or lucky enough to have employer-based insurance, you’re on your own.

The elderly, the poor, and even working-class families live in fear of a medical emergency that could send them into financial ruin.

One man decided to fix this problem.

President Harry S. Truman knew that if America was truly to prosper, its people needed a safety net—a healthcare system that didn’t punish the sick for being sick.

So in November 1945, just months after the war ended, Truman stood before Congress and delivered a bold, unprecedented vision:

"All citizens should be able to get medical and hospital service, and the economic barriers to the prevention and treatment of illness should be removed."
—President Harry S. Truman

His vision?

A national health insurance program that would cover every wage-earning American. Workers would pay a small tax or fee to guarantee medical care—no one would be denied treatment because they couldn’t afford it.

Working with Senator Wagner and Murray and Rep. Dingell they introduced the National Health Act.

Patients could choose their own doctors, and hospitals would remain independent—this was not the "socialized medicine" that fearmongers would claim.

But with American politics, it’s never just about the policy—it’s about who holds the power.

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The American Medical Association (AMA) launched an all-out war against his plan.

They called it "socialism" and warned of government overreach, flooding the media with propaganda designed to terrify the public.

They compared Truman’s plan to communist healthcare models in the Soviet Union, playing on Cold War fears.

As usual, congress—filled with lawmakers with ties to the medical lobby—folded under the pressure.

Truman’s national health insurance plan never even made it to a vote.

Though they attempted again in 1948, the bill would die again.

But ideas that are ahead of their time, don’t die.

Truman’s fight for healthcare may have ended, but it planted a seed.

Two decades later, that seed finally took root.

In 1965, President Lyndon B. Johnson signed Medicare and Medicaid into law, calling Truman the "real Father of Medicare."

But 60 years later, in 2025, Medicare and Medicaid—the very programs that proved Truman right—are once again under attack.

And the question remains: Will we let history repeat itself?

Well let’s dive deeper into history to see.

The Fight to Create Medicare and Medicaid

By the mid-20th century, America faced a healthcare crisis.

Medical advancements were improving health outcomes, but access to care remained deeply unequal.

Efforts to create a national health insurance system continued in the years after Truman’s presidency but were repeatedly met with resistance.

The AMA once again opposed these efforts, branding them as "socialized medicine" and stirring fears that government involvement in healthcare would destroy medical practice as they knew it.

But seeds always grow, despite the opposition, momentum grew.

With a good economic boom, post-World War II, Americans wanted the disparities in medical access addressed

And the civil rights movement brought further attention to systemic inequalities in healthcare.

Then, in 1965, President Lyndon B. Johnson seized the political moment.

With a Democratic-controlled Congress and a public eager for progress, he championed the Social Security Amendments of 1965, which established Medicare and Medicaid.

The signing ceremony on July 30, 1965, was held in Independence, Missouri, in honor of former President Harry S. Truman, recognizing his early efforts toward a federal health insurance program.

As a symbolic gesture, Truman was enrolled as Medicare’s first official beneficiary.

So Pause… Wasn’t This Series About Black People, Medicine, and Civil Rights?

And it still is.

Because you can’t talk about healthcare in America without talking about the fight for civil rights.

You can’t talk about Medicare and Medicaid without talking about how it forced hospitals to desegregate overnight.

( most successful systematic integration in America .. by the way)

And you definitely can’t talk about who fought to make that happen without talking about the lone Black physician was invited to the signing ceremony.

The signing of Medicare and Medicaid wasn’t just about expanding healthcare access.

It was about breaking barriers, defying the medical establishment, and forcing a system built on exclusion to finally open its doors.

And while nearly every major medical association tried to stop it, he stood firm.

So in the next dose, we’re talking about Dr. W. Montague Cobb—the man who refused to let hospitals remain segregated, and one of the most influential Black physicians in American history.

Get ready for your next dose.

Because history isn’t just something to remember—it’s something to learn from.

Don’t miss it—subscribe to The Advocacy Dose and make sure you’re always on the right side of the fight. 💊🔥

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Growing up as a Black girl in Connecticut—especially in a time when low-to-middle-class Black girlhood was overlooked, unseen, and undervalued—I often felt like I was slipping into the void.

You spend so much time proving you belong in the room that it drains you.

The constant effort to be seen, to be heard, to be considered… it’s exhausting.

Racing thoughts. Heavy emotions.

A paralyzing need to achieve—because failure isn’t an option.

My Mother’s Question That Grounded Me

Whenever I found myself spiraling, my mother would pull me aside, lower her voice, and ask:

"Faith, how do you eat an elephant?"

Even as a child, I knew the answer.

"One bite at a time."

Now, obviously, no one is out here eating elephants, nor would I want to.

But that question always brought me back to myself.

It forced me to stop drowning in the big picture and start seeing the steps in front of me.

One bite at a time. One step at a time.

That lesson stuck with me.

Breaking Down Big Ideas: The Story of Medicare & Medicaid

And I’m reminded of it every time I try to explain the history of Medicare and Medicaid—because this is a story that needs to be broken down piece by piece,

Or rather dose by dose.

I didn’t fully understand its impact until my 3rd year of medical school.

Learning this history shook me.

The years 1964 and 1965 stood out to me—not just as moments in time, but as personal milestones.

As those were the years my parents were born.

That meant that I was the first generation in my family born under Medicare and Medicaid.

The first to grow up in a world where hospitals were desegregated.

The first to assume that walking through the front doors of a hospital as a Black physician was normal—when, in reality, it was a privilege that had been fought for.

Because the truth is, most people don’t know the fight it took for Black physicians to be treated as equals.

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The Forgotten Fight of Black Physicians

We talk about Jim Crow and how Black patients were barred from white hospitals—but what about Black doctors?

Where did we go?

Where were we allowed to train, to practice, to heal?

So much of our history has been swallowed by the void.

But not today.

Today, we bring this story forward.

For many Black physicians and healthcare providers, the names of those who fought for change are familiar—if you dare to study beyond your anatomy and physiology textbooks.

But to the greater world, they are unknown.

And that’s exactly why I want to share them with you.

How the story of Change in Healthcare Will Unfold

This is how Lesson Three will be given dose by dose:

🔹 The Story of Medicare & Medicaid – The Presidents Who Changed History
🔹 The Story of Medicare & Medicaid – The Lone Black Doctor Who Demanded Change
🔹 The Story of Medicare & Medicaid – How Black Health Changed for the Better
🔹 The Story of Medicare & Medicaid – The Evolution of a System That Keeps Changing
🔹 The Story of Medicare & Medicaid – How We Have Shortchanged the Fight for Health Equity

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Yes, this is a mini-lesson within a lesson. But if we’re going to truly understand this history, we have to break it down—dose by dose.

So throughout the week, these lessons will land directly in your inbox.

Ready for you to engage with the story, and take away something new.

I’m excited to share this with you.

To change the way this history is taught.

To make sure we never forget.

And if this is your first time seeing my post or email—welcome to The Dose Squad.

You’re right on time!

See you in class !

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✅ The political fight to pass Title VI and the Civil Rights Act
✅ Why hospital desegregation was driven by policy and funding
✅ Why racial health disparities persist despite Title VI
✅ Why Title VI remains powerful but poorly enforced

Beyond Desegregation: The Fight for Health Equity Continues

In our last lesson, we discussed Dr. George Simkins Jr., a Greensboro dentist and civil rights leader who played a pivotal role in challenging segregated healthcare facilities.

Quick Recap: In 1962, Dr. Simkins, along with other Black physicians and patients, filed a lawsuit, Simkins v. Moses H. Cone Memorial Hospital, which became a landmark decision, with the Fourth Circuit Court of Appeals ruling that "separate but equal" racial segregation in publicly funded hospitals was unconstitutional.

If you have not check out Lesson one click here!

Despite this legal victory leading to the subsequent passage of Title VI of the Civil Rights Act of 1964, significant health disparities still persist.

If equality was achieved, why does healthcare still feel so unequal?

Because equality gives everyone the same rules—equity ensures those rules work for everyone.

Title VI was a landmark victory, but it was only the beginning.

Let’s explore its origins, the political battles that shaped it, and why the fight for health equity continues.

The Political Battle Behind Title VI

The journey to passing the Civil Rights Act was fraught with intense political struggle.

In June 1963, President John F. Kennedy proposed comprehensive civil rights legislation in response to nation widespread resistance to desegregation and the assassination of civil rights leader Medgar Evers.

Yet, the bill faced strong opposition in Congress, particularly from Southern legislators who employed filibusters and other tactics to block its progress.

No memorial oration or eulogy could more eloquently honor President Kennedy's memory than the earliest possible passage of the civil rights bill for which he fought so long,"

Then, serving notice on his fellow southern Democrats that they were in for a fight, he said: "We have talked long enough in this country about equal rights. We have talked for one hundred years or more. It is time now to write the next chapter, and to write it in the books of law."

- President Lyndon B Johnson to Congress after JFK’s assassination

After President Kennedy's assassination in November 1963, LBJ took up the mantle, leveraging his political capital to push the bill forward.

He emphasized the moral imperative of the legislation, stating, "Let this session of Congress be known as the session which did more for civil rights than the last hundred sessions combined."

Even with a president pushing for this agenda, the bill encountered significant hurdles.

In the House of Representatives, it was stalled in the Rules Committee, leading supporters to threaten bypassing the committee to bring the bill to the floor.

In the Senate, a coalition of 27 Republicans and 44 Democrats overcame a prolonged filibuster, marking the first time in history that the Senate voted to end debate on a civil rights bill.

Yet they persisted and won.

On July 2, 1964, President Johnson signed the Civil Rights Act into law, marking a pivotal moment in the fight against institutionalized and systemic racism.

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What Title VI Did Right: The End of Hospital Segregation

Before Title VI, hospitals were brazenly discriminatory and engaged in racist tactics.

Black patients were often:

• 🚫 Denied care outright if a hospital was whites-only

• 🚫 Forced into overcrowded, intentionally underfunded “colored” wards with fewer doctors and outdated equipment

• 🚫 Treated as medical afterthoughts, receiving lower-quality care than white patients

When Medicare and Medicaid launched in 1965, the federal government used funding as leverage—hospitals had to integrate if they wanted access to those dollars.

Within two years, hospital segregation was (officially) over.

Dr. Simkins and his colleagues had fought tirelessly for this moment.

On paper, Title VI delivered equality—hospitals could no longer openly discriminate.

But equality does not equal equity.

Where Title VI Fell Short: Healthcare Disparities Didn’t Disappear

Title VI could end legal segregation, but it couldn’t undo centuries of embedded medical racism.

Here’s what we’re still dealing with today:

• Black and Brown patients still receive lower-quality care. Studies show that doctors are less likely to believe Black patients' pain or take their symptoms seriously.

• Language barriers still prevent non-English speakers from getting proper care. Hospitals are required to provide interpreters under Title VI—but many fail to do so.

• Hospitals that serve Black and Brown communities are still underfunded. While wealthy, predominantly white neighborhoods have top-tier medical facilities, Black and Brown communities often rely on hospitals with fewer specialists, outdated equipment, and long wait times.

This is the difference between equality and equity.

Why Title VI Still Matters—And Why We Need More

Title VI is still a powerful tool—but it’s only as strong as its enforcement.

Right now, too many hospitals get away with violating Title VI without consequences. That’s why we still see:

• ❌ Hospitals failing to provide interpreters for non-English-speaking patients

• ❌ Black mothers being ignored in labor, leading to preventable deaths

• ❌ Discriminatory treatment decisions, like Black patients receiving less pain medication than white patients with the same conditions

If hospitals refuse to follow Title VI, they should lose their federal funding.

But Let’s be real, how often does that actually happen?

Title VI isn’t enough on its own—it’s up to us to demand stronger enforcement and push for policies that address these ongoing disparities

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Next Lesson: The Fight for Healthcare Access Isn’t Over

Title VI forced hospitals to desegregate, but access to healthcare didn’t become a reality for millions until the creation of Medicare and Medicaid.

These landmark programs changed the game—giving elderly, disabled, and low-income Americans the healthcare coverage they’d long been denied.

But here’s the thing:

Medicare and Medicaid didn’t just happen—they were fought for.

And today, they’re still under attack.

🧐 Why did some politicians resist Medicare and Medicaid in the 1960s?
⚖️ How did these programs help enforce Civil Rights laws?
🚨 Why are Medicare and Medicaid STILL facing cuts and restrictions today?

The fight to protect healthcare access is just as urgent now as it was then.

Don’t miss our next lesson—subscribe to stay in the know! 👀💡

✅ How Dr. George Simkins Jr. fought to desegregate hospitals
✅ How his legal victory paved the way for Title VI of the Civil Rights Act
✅ Why hospital desegregation wasn’t just about morality—it was about federal funding and policy enforcement
✅ Why racial disparities in healthcare persist today

Picture this...

A Black mother rushes her feverish newborn to the nearest hospital, desperate for help. But at the entrance, a nurse shakes her head. "We don’t treat Negroes here." The child is turned away. Hours later, the newborn passes away. Not because there wasn’t a doctor who could have saved her. But because that doctor wasn’t allowed inside the hospital either.

This wasn’t a rare tragedy before the 1960s, it was reality. Across the Jim Crow South, hospitals took federal tax dollars while openly denying Black patients care.

Black doctors who trained for years to save lives? They were locked out of residencies and barred from admitting their own patients to white hospitals. And for decades, the government let it happen.

Until one Black dentist named Dr. George Simkins Jr. said, Enough.

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The Forgotten Civil Rights Battle in Medicine

When we reflect on the Civil Rights Movement, the focus is often on voting rights, school desegregation, and fair housing—the landmark battles that dominate history books and classroom discussions.

But what about healthcare?

What about the reality that Black Americans were dying—not because medicine lacked the ability to save them, but because hospitals refused to treat them?

The Medical Civil Rights Movement was one of the most overlooked yet transformative fights of the Civil Rights era.

Despite being one of the most effective racial integration efforts in American history, the desegregation of hospitals is rarely taught in schools.

It is missing from history textbooks, absent from medical, nursing, and pharmacy school curricula, and barely mentioned in mainstream discussions of civil rights.

Why?

Because the desegregation of hospitals wasn’t framed as a moral victory—it was framed as an economic and political issue.

The legal battles weren’t fought on the premise that healthcare is a fundamental human right; they were fought on the principle that hospitals taking federal funds must comply with civil rights laws.

It was federal funding, legal leverage, and economic pressure—not ethical responsibility—that forced the change.

This movement also exposed the deeper systemic inequalities within the healthcare system, revealing how racism had long dictated who had access to life-saving treatment and who did not.

To fully understand racial health disparities today, we must acknowledge this buried history. Because when we fail to recognize the past, we set the stage to repeat it.

And if you’ve been paying attention to the world around you—it’s already happening.

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A Law That Protected Segregation

This injustice wasn’t just allowed—it was protected by law.

In 1883, the Supreme Court ruled that private businesses could legally discriminate, even if they were the only hospital in town.

And as long as segregation wasn’t government-enforced, it was untouchable by the Equal Protection Clause of the 14th Amendment.

This meant that hospitals could take federal money, build new facilities, and still refuse to treat Black patients.

And they did. For nearly 80 years.

Until Dr. Simkins changed everything.

The Hill-Burton Act: A Law That Helped—and Hurt

In 1946, Congress passed the Hill-Burton Act, which provided federal funds to build and expand hospitals across the country.

The goal: To ensure that every American had access to healthcare.

But there was a catch.

The law allowed hospitals to receive federal funding while still maintaining "separate but equal" facilities for Black and white patients.

In reality, this meant that Black patients were often treated in overcrowded, underfunded, and poorly equipped hospitals—or denied care altogether.

Even worse, hospitals built with Hill-Burton funds were not required to desegregate, despite using taxpayer money.

Black communities had paid into a federal system that actively excluded them.

So how did hospitals get away with this for so long?

By the 1950s, the federal government had spent billions on hospital construction, yet racial disparities in healthcare were worsening.

But in Greensboro, North Carolina as president of the Local NAACP chapter, Dr. Simkins had seen enough, it was time to hold the health care systems accountable.

He along with several others, sued local hospitals Moses H. Cone Memorial Hospital and Wesley Long Community Hospital, knowing they weren’t just fighting against local policies

But challenging the entire structure of federally funded segregation.

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The Moment That Changed Everything

It wasn’t a lawyer or a politician but a dentist, Dr. George Simkins Jr. that became enraged by how his patients were treated.

One night, a Black man came into Simkins' office with a severe tooth infection. If left untreated, it could be deadly.

Simkins stabilized him and then sent him to the nearest hospital for further treatment.

But the hospital had a policy: No Black patients allowed.

The man was denied treatment.

Simkins knew he had two choices: accept this as the way things were—or fight back.

The Lawsuit That Shook the Medical System

In 1962, Dr. Simkins and a group of Black doctors sued Moses H. Cone Memorial Hospital and Wesley Long Community Hospital in Greensboro, North Carolina.

Their argument? If a hospital takes federal tax dollars, it must serve all citizens.

Sounds logical, right?

But the hospitals fought back, claiming they were private institutions and could refuse service to anyone they wanted.

The first ruling? The courts sided with the hospitals.

But Simkins wasn’t done.

He appealed the decision to the Fourth Circuit Court of Appeals.

And now, the federal government had a choice:

Side with the hospitals? Or rewrite the rules of American medicine?

The Landmark Decision That Changed Medicine Forever

In November 1963, the Fourth Circuit ruled in Simkins' favor.

This was the first time a court declared that hospitals accepting federal funds could NOT discriminate.

Dr. Simkins, a dentist, had done what generations of Black doctors were told was impossible. He had taken on the system—and won.

This victory would become the foundational win needed to create Title VI of the Civil Rights Act of 1964 and eventually—Medicare.

Why This Still Matters Today

Please know desegregation didn’t fix everything.

The racial disparities in healthcare today are direct results of decades of segregation and systemic racism:

• Black maternal mortality is still 2-3x higher than for white women.

• Medical bias in pain management and treatment is still rampant.

• Black communities continue to face doctor shortages.

Yet, we must continue to fight for better access for all.

📢 Share your thoughts! Do you think federal funding should still be used as leverage to enforce health equity? Let’s discuss in the comments.🚀

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Sources:

• University of North Carolina’s Southern Oral History Program Collection

• Hill-Burton Act

• Simkins v. Moses H. Cone Memorial Hospital, 211 F. Supp. 628 (M.D.N.C. 1962)

Next Lesson:

Dr. Simkins' case set the stage for something even bigger: Title VI of the Civil Rights Act and the creation of Medicare and Medicaid.

But how did these policies force over 1,000 hospitals to integrate overnight?

And how did they transform healthcare access in America?

🔹 Stay tuned for the next lesson to find out!

🚀 Subscribe for more Civil Rights and Medicine 101!

Imagine a world where your zip code, skin color, or income didn’t determine your health outcomes. Now, ask yourself: How did we get here—and how do we fix it?

That’s exactly what Civil Rights and Medicine 101 is about. This course unpacks how the Medical Civil Rights Movement shaped health care—and why those battles are STILL being fought today.

What You’ll Learn

Over 11 power-packed lessons, we’ll cover:
✅ How a landmark court case desegregated hospitals
✅ The Civil Rights Act’s impact on healthcare equity
✅ How Medicare & Medicaid revolutionized access to care
✅ The activism behind free clinics & patient rights
✅ The hard truth about how integration harmed Black hospitals

And because this isn’t just history—it’s strategy—you’ll leave with the tools to connect past movements to today’s continued fight for health justice.

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Course Breakdown

💡 Lesson 1: Intro to Civil Rights in Medicine – Simkins v. Cone
➡️ Why does civil rights still matter in healthcare? (Spoiler: It always did.)

💡 Lesson 2: Title VI of the Civil Rights Act
➡️ The law that made health care discrimination illegal—but is it enforced?

💡 Lesson 3: Medicare, Medicaid & Equity
➡️ How two government programs transformed access to care (and who got left out).

💡 Lesson 4: Hospital De-segregation
➡️ Activists fought to break hospital color lines—but at what cost?

💡 Lesson 5: National Medical Association & Student National Medical Association
➡️ The Black medical organizations that held the door open for future doctors.

💡 Lesson 6: Medical Committee for Human Rights (MCHR)
➡️ When doctors and activists teamed up to make healthcare a human right.

💡 Lesson 7: Black Panthers & Free Clinics
➡️ The radical approach to community healthcare—before "health equity" was a buzzword.

💡 Lesson 8: Lincoln Hospital & Patient Rights
➡️ What happens when patients fight back for their rights?

💡 Lesson 9: The Harm to Black Hospitals
➡️ The unintended consequences of desegregation—did it help or hurt Black healthcare?

💡 Lesson 10: Review & Reflection
➡️ Connecting history to NOW—because the fight isn’t over.

💡 Lesson 11: Final Project
➡️ Your turn to teach the people—summarize a key lesson to educate others!

Why This Course? Why Now?

Because racial health disparities aren’t a glitch—they’re by design.
Because you can’t fix what you don’t understand.
Because health justice is civil rights.

This course is designed to educate, challenge, and inspire action. And we’re not just talking—we’re DOING. '

Every lesson includes interactive assignments like reflections, research, and TikToks to spread the knowledge.

📢 Ready to Learn?

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First lesson drops TODAY—let’s get into it! 💊