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The Politics of Racial Disparities: Desegregating the Hospitals in Jackson, Mississippi
Author(s) -
SMITH DAVID BARTON
Publication year - 2005
Publication title -
the milbank quarterly
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 101
eISSN - 1468-0009
pISSN - 0887-378X
DOI - 10.1111/j.1468-0009.2005.00346.x
Subject(s) - desegregation , uncompensated care , politics , reimbursement , public administration , incentive , administration (probate law) , political science , health care , federal funds , medicine , medicaid , economics , law , monetary policy , monetary economics , microeconomics
As health care policymakers and providers focus on eliminating the persistent racial disparities in treatment, it is useful to explore how resistance to hospital desegregation was overcome. Jackson, Mississippi, provides an instructive case study of how largely concealed deliberations achieved the necessary concessions in a still rigidly segregated community. The Veterans Administration hospital, the medical school hospital, and the private nonprofit facilities were successively desegregated, owing mainly to the threatened loss of federal dollars. Many of the changes, however, were cosmetic. In contrast to the powerful financial incentives offered to hospitals to desegregate and ensure equal access in the early years of the Medicare program, current trends in federal reimbursement encourage segregation and disparities in treatment.