Last night, Bernie Sanders attracted an overflow crowd to hear him speak in Birmingham, Alabama. For a so-called “democratic socialist,” this was an amazing sight.
Of course, there is a reason that Bernie’s message resonates in America’s South, which has health and social indicators as poor as many developing countries, and certainly worse than Cuba, Costa Rica — the poorest Americans die sooner than the poorest Costa Ricans— and many middle-income countries with functioning health systems.
Case in point: impoverished Marion, Alabama’s horrific tuberculosis outbreak. An outbreak that undoubtedly would have been halted in a small (statistically poorer) Costa Rican or Southern Italian village with single-payer national health infrastructure. As you might expect, Alabama never expanded Medicaid under the Affordable Care Act.
When Patricia Church, a 41-year-old warehouse worker, felt sick recently, she suspected that she had a cold. But she also feared something more deadly that has been going around this small, impoverished city: tuberculosis.
“I feel like I had been around someone that had it, and I might die from it if I don’t find out whether I got it or not and get it treated,” Ms. Church said after she learned last week that she did not have the disease. “I was nervous. I was real nervous.”
Marion is in the throes of a tuberculosis outbreak so severe that it has posted an incidence rate about 100 times greater than the state’s and worse than in many developing countries. Residents, local officials and medical experts said the struggle against the outbreak could be traced to generations of limited health care access, endemic poverty and mistrust — problems that are common across the rural South.
The consequences of the ongoing outbreak have been horrific for the small community.
In Marion, a city of fewer than 3,600 people, the toll of the slow-growing bacteria, commonly referred to as TB, has been staggering. Since January 2014, active tuberculosis has been diagnosed in 20 people, nearly all of them black; three have died. (Six people who live in other cities in Alabama have also received diagnoses of active tuberculosis and have been linked to the outbreak here.)
How would things be different if — like most European countries — Alabama benefited from a functional, equitable and free-at-point-of-use health care system for the past 50-70 years? How might things be different, in the future, if Bernie Sanders is elected and succeeds in building a national Medicare-for-all single-payer system? I would dare Hillary Clinton to visit this community and tell these suffering people they don’t deserve single-payer health care.
There is way too much human suffering in impoverished Southern towns and cities — and only one Democratic candidate has the ambitious policy agenda necessary to begin chipping away at it.