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Remarks at the UNC Health Care Martin Luther King, Jr. Program

January 13, 2012
Remarks at the UNC Health Care Martin Luther King, Jr. Program

Children's Hospital Lobby, UNC-Chapel Hill - I very much appreciate the invitation to share this Martin Luther King observance with you. It is entirely fitting that UNC Heath Care set this time aside, for the work you do in this community and across the State is directly related to Dr. King's message and mission: to make people's lives better in the ways that matter most and that overcome past deprivation and injustice. As Dr. King himself said in 1966, addressing the Medical Committee for Human Rights, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane." By the same token, it is a cause for satisfaction and celebration when we can alleviate suffering, can enhance the quality of life, and can extend the benefits and blessings of medical science to those who have previously been denied them. The challenge of the King holiday is to reconnect our work, our daily activities, to our moral vision, to our sense of the kind of community we want to live in and contribute to. In few areas is that connection as strong as in the practice of medicine and the provision of health care.

For me and others of my student generation, there is another, more personal, connection between this campus and the King legacy. I had the good fortune to come to UNC as a transfer student in 1959, as the civil rights movement swept across the south. I say "good fortune" advisedly: I remain grateful that those were my formative years, years that forever altered my religious, political, and social outlook. Many in our generation came to realize that our faith did not touch us merely as individuals, nor could our moral code be simply personal. We were called to envision and to help realize a just society. Dr. King helped us rediscover the Hebrew prophets with their stirring admonition to "let justice roll down like waters, and righteousness like an ever flowing stream" (Amos 5:24).

We also learned something about social change; about the importance of reaching across racial and religious and economic barriers to find common ground; and, yes, about politics as an instrument for positive change in a democratic society. We learned that enough dedicated people, working together, could right ancient wrongs. Whatever else happened in my life – and I certainly didn't think that would include running for Congress – the civil rights experience guaranteed that I would understand the potential of politics and government as instruments of our common purpose and would strive to be attentive and engaged.

Some victories came remarkable quickly, especially when we compare them to the sluggishness and frustrations of political change before and since. These victories owed a great deal to Martin Luther King's ability both to prick the nation's conscience and to strategize effectively. It was a mere four years between our picketing on Franklin Street – to integrate the restaurants and the theaters of Chapel Hill – and the passage of the Civil Rights Act of 1964. I was working as an aide in the U.S. Senate that summer, and I will never forget the moment, crowded into the Senate gallery, when I witnessed the decisive vote. It could not have been more dramatic: one senator, who was dying of cancer, was brought into the chamber on a stretcher and, too weak to speak, raised his finger in assent.

Those are indeed memories, and the culmination of a movement, to be grateful for and to take inspiration from. Dr. King often spoke the language of liberation, invoking Isaiah's account of the prophet's calling: "[The Lord] has sent me to proclaim release to the captives and recovery of sight to the blind, to let the oppressed go free" (Isaiah 61:1). And who were the captives? Certainly the African Americans still living in the shadow of slavery, their liberties violated, their opportunities blocked, their dignity denied. But the entire society was captive to the divisive and destructive practice of segregation and discrimination, to the poison of racism and prejudice. The entire community was in need of liberation, and we can look back in gratitude for the work of Martin Luther King and many others – including those who pressed for change in this university and this community – that lifted a burden from us all.

And Dr. King would be the first to tell us, as powerful as our remembrance and our gratitude may be, they are not enough. Dr. King's message and the movement he led changed our country forever, but the vision of justice "rolling down like waters," and of what he called the "beloved community," remains a clear and present challenge. This day of remembrance must also be a day of re-visioning and rededication. Dr. King himself moved on from those remarkable legislative victories of 1964 and 1965 to take on the even tougher challenges of economic inequality and injustice and the misbegotten war in Vietnam. Let us remember: King was martyred in the midst of a struggle for dignity and fair pay for Memphis sanitation workers.

And so the struggle for justice goes on on various fronts, including the front lines of health care. Sometime we yearn for what in retrospect seems the clarity of the civil rights challenge and the remarkably rapid advance from marches and protests to landmark legislation. I do wonder sometimes how even a cause as compelling as the one Dr. King led would fare among the deep divisions and ideological rigidity and opposition-for-opposition's sake that characterize our politics today. But I do know this: the quest for "liberty and justice for all" remains before us. The way forward may not always be as clear or as tractable as we would like, but the cause is no less compelling. Our observance of the King holiday falls short if we fail to ask ourselves what contribution to a more just and peaceful world, in whatever ways are open to us, we are prepared to make.

And that, I believe, brings us back to health care, whether as practitioners or as policy makers or as citizens concerned about what kind of community we wish to be. Health care remains one of the most significant indicators and causes of inequality in our society. Much of the burden still falls on racial and ethnic minorities, who are less likely to receive preventive care and routine medical procedures, and who have higher rates of morbidity and mortality than their fellow citizens. We also have a long history of inequality of access to health insurance. Women have paid more just because they are women. People with pre-existing conditions or risk factors have been denied or priced out of coverage. Until recently, it has been all too easy for insurance companies that were so inclined to deny benefits to patients just when they need it most. And only now are we beginning to attend to the full range of health needs presented by returning service men and women and our veterans.

Health care and health care reform therefore remain critical areas of soul-searching and policy debate for our country – whether we are struggling to give North Carolina families the access they need to mental health services, to make Medicaid in this state a model of collaborative care that both contains costs and improves outcomes, to expand the remarkable work of our community health centers, or to create an insurance exchange that makes coverage accessible and affordable to individuals not covered at work and to small businesses. At the federal level we have already enabled families to keep children on their insurance policies into their mid-twenties – the aspect of the Affordable Care Act that constituents probably most often mention to me – we have outlawed the denial of coverage to children based on pre-existing conditions, we've begun to close the infamous "donut hole" that has limited senior citizens' prescription drug coverage, and we've held the line on critical research funding.

So health care is on the front lines of the struggle for a more just and inclusive society. Very little of this, unfortunately, comes without political controversy. It is critically important that we find agreement when we can but fight when we must. The Martin Luther King holiday is an opportune time to pause and consider these obligations and how we live up to the values we profess. The men and women of UNC Health Care are not waiting for the policy debates to be resolved: you are delivering compassionate and competent care every day, and our community is grateful to you for your service. But the policy debates are also important. May we take this occasion to reflect on where we've been and where we need to go – and what our own contributions can be – as we consider the health and wellness needs of all our people and the place they take in our quest for a just society.