Frazier on Burnett, 'Power to Heal: Medicare and the Civil Rights Movement'
Charles Burnett, dir. Power to Heal: Medicare and the Civil Rights Movement. Oley: Bullfrog Films, 2018. Documentary, DVD, 56 min.
Reviewed by Nishani Frazier (Miami University of Ohio) Published on H-FedHist (April, 2020) Commissioned by Caryn E. Neumann (Miami University of Ohio Regionals)
Printable Version: http://www.h-net.org/reviews/showpdf.php?id=53496
Frazier on Burnett, Power to Heal: Medicare and the Civil Rights Movement
The Power to Heal: Medicare and the Civil Rights Revolution is a compelling, emotional drama that depicts a rarely studied aspect of the 1960s black freedom movement, while paradoxically ignoring the last twenty years of civil rights historiography. Narrated by the famed actor and 1960s student activist Danny Glover, the film charts how government bureaucrats, black professionals, and activists (less so) pushed for national Medicare and used the program to desegregate healthcare for African Americans across the South.
Power to Heal is a short, hour-long documentary that moves from the history of segregated hospitals and a brief summary of civil rights activism to the internal workings of the federal government that gave rise to integrated hospitals and African American access to health care. It first narrates the early days of health inequity through southern images that powerfully demonstrate how race and poverty coalesced to deny African Americans equal access to healthcare. Without question, the documentary’s interviews beautifully reveal personal stories of African Americans’ struggles with illness and death without adequate healthcare. The film transitions from these personal tales to a broader review of disparities in hospital care throughout the United States.
Returning World War II veterans joined a growing demand from the larger black community to end inferior treatment in institutions across the United States. Hospitals were no different. The film accurately points out that these issues hardly limited themselves to the South. Northern hospitals also managed segregated operations. Black higher education institutions responded by providing medical training for black students. Many of them learned and practiced in all-black hospitals, but white hospitals barred black medical professionals from nurses to dentists from working in their institutions. The film adds an interesting note about the importance of black home remedy and black epistemology on health and medicine absent of standardized treatments.
These dynamics begin to change with the civil rights movement. The film does a strong job of highlighting the work of African American professionals. Among the many histories of 1960s activism, professionals are normally cast as irrelevant to or ambivalent about the freedom movement. It is important to note the many ways that black people—working class and bourgeoise—engaged in movement making. To its credit, Power to Heal breaks ground on this subject. Perhaps the most intriguing portion of the film centers on its discussion of the American Medical Association’s (AMA) opposition to Medicare. The Association’s doctors aggressively blocked support for legislation on Medicare and avoided any attempts to insist that hospitals comply with desegregation in exchange for federal healthcare dollars.
Lyndon B. Johnson manages to turn this opposition on its head by pigeonholing AMA’s president into submission after a meeting and surprise press conference at the White House. However, to ensure Medicare’s acceptance and widespread usage, hospitals receiving federal dollars had to become compliant with the 1946 Hill-Burton and 1964 Civil Rights Act. The legislation provided federal grants and guaranteed loans to improve hospital systems across the United States, but prohibited discrimination based on race or national origin. The president tasked the Health, Education, and Welfare (HEW) division with ensuring Medicare’s expansion, but the department had to end segregation to do it.
With AMA out of the picture, the federal government began an aggressive program of desegregating America’s hospitals before the official launch of Medicare. Aided by civil rights workers and volunteer staff, HEW quickly broke the back of hospital segregation. Black hospital workers and custodians played a particularly important role in providing evidence of compliance or noncompliance by hospitals. In less than a year, helped by the many unnamed heroes, Medicare went into effect with over 90 percent of American hospitals compliant and in the program. Toward the documentary’s end, one interviewee’s voice breaks, unshed tears in his eyes as he recounts how those months were the most impactful and transformational of his life. His account paints an enthralling picture in which the government, on the right side of history, shapes medical access for African Americans and changes the landscape of health care.
It is a beautiful story—but so deeply problematic in its scope that I can only suggest use of this documentary for students no further advanced than junior high school. As high school teachers actively attempt to complicate history, particularly the civil rights movement, Power to Heal most effectively works less for older students and best for younger learners. Bullfrog Films promotes Power to Heal as a documentary that reveals “how movement leaders and grass-roots volunteers pressed and worked with the federal government to achieve justice and fairness.” However, the film does not do this. Whether intentionally or not, the film regurgitates historical tropes that paint the federal government as rescuer, and obliterates action on the ground.
The civil rights struggle for health care emerged from multiple spaces, but particularly among black activists associated with the Medial Committee for Human Rights. John Dittmer’s The Good Doctors: The Medical Committee for Human Rights and the Struggle for Social Justice in Health Care (2009), for example, details the immediate events that created the 1964 Civil Rights Act and the structural and institutional foundations that eventually led to the expansion of Medicare. Dittmer explains how doctors journeyed south and joined Freedom Summer volunteers to organize the Medical Committee for Human Rights (MCHR). The organization pioneered health centers, actively challenged segregated health, and advocated for Medicare expansion, embodying its motto that “Health Care Is a Human Right.”
Thomas Ward’s Out in the Rural: A Mississippi Health Center and Its War on Poverty (2016) provides a follow-up to Dittmer’s work, focusing on the formation of the first rural community health center in Mound Bayou, Mississippi. It became part of a growing network of activists who used War on Poverty programs to expand health centers. Crystal Sanders’s book, A Chance for Change: Head Start and Mississippi Black Freedom Struggle (2016) also mentions the important role healthcare played in the movement to expand Head Start in Mississippi. Most importantly, each of these histories explains in detail the fight to push the federal and local government to enforce its own rules. To be sure, the government volunteers who formed the Medicare movement needed no such cajoling, but these persons trailed behind a phalanx of freedom fighters who used their own bodies to push the state into action. To construct a narrative without them is to grant too much power to the federal government as frontline in the struggle.
Partially, this stems from the documentary’s textual basis—David Smith’s The Power to Heal: Civil Rights, Medicare, and the Struggle to Transform America's Health Care System (2016). The subheading more accurately demonstrates the framing of the film. However, the decision to insist on this narrative over all else confused larger distinctions at work between the government and civil rights activists. The dream of health care access was not Medicare, but equal medical care. Medicare legislation fell short of activists’ goals that asserted health care as a human right. As such Medicare was both a triumph and a failure. To tell the story as a win undermines the larger struggles for health care equity not only then, but also now. The job was not finished, but the film constructs it in that way by centering the movement on the federal government and its legislation.
In doing so, the film also missed an opportunity to distinguish integration from equity, an important distinction between activists and the bureaucratic or professional class. The film breezes past this point eventually, but at the least engaged point, when the credits are rolling. Any film goer would miss this significant argument as Danny Glover’s voice speaks over music and scrolling text.
This distinction was also relevant in order to determine the full meaning of even integration. How does one determine a victory? What was the actual scale of integration within the hospital? Indeed, at one moment in the film a southern hospital declared it had successfully “integrated” its hospital by placing a Native American, an African American, and a white American coma victim in the same room. However ruefully humorous the anecdote, did the hospital succeed at desegregation when it achieved 10 percent, 20 percent, 30 percent, or more integration? Worse, its focus on the South means it missed the way hospitals could find workarounds based on income and location, which eventually became a nom de plume in the North. Thus, to construct the federal government’s victory as an isolated single issue is to confuse why black health disparity is where it is now.
The struggle for healthcare exists within a series of contexts and circumstances where Medicare reflected a stepping stone in a larger battle. To that end, this film must be seen as the middle in a series of educational steps needed to flesh out the history of racial segregation and desegregation in medicine and Medicare. An online site might have greatly strengthened the film with outside readings, teacher lesson plans, current articles on health inequalities, or anything that could give the film more body. The documentary has a who’s who of historians of medicine and the movement (Ditmer included), and yet themes from their work fail to appear in the storytelling. That production and editing selection proves quite revealing not only as a storytelling choice, but also as a decision not to provide links to the books from its own history consultants.
Other aspects from the film are small but combine into a larger concern around production, basic storytelling, and editing. Some interviewees need names and title, and historical events are not presented in linear timeline, which confuses the overall story of how movement emerged. For example, the section on returning veterans proves awkward and out of place. The opening introduces producers and narrators during a key historical setup. It does so again toward the end, which greatly disrupts both narrative and the most significant aspects of the documentary’s history. Editing becomes a problem once more when the film introduces the Medical Committee for Human Rights but provides no background information. Its story appearance is so short, one wonders why include references to it at all. This is especially so given the film neither explains the committee’s importance nor gives it credit for pushing the federal government into action.
Ultimately, the film manages to describe powerfully the history of how professionals and government officials joined the fight to desegregate hospitals. Without a doubt, elements of the film are emotionally gripping, driven by vivid descriptions of volunteers transformed by the movement and its response to the hospital system. However, equally relevant is the awkward production, convoluted narrative, and the silencing of activists and historical record that understood the movement for healthcare as a human right and not just a government-driven policy.
Citation: Nishani Frazier. Review of Burnett, Charles, dir., Power to Heal: Medicare and the Civil Rights Movement. H-FedHist, H-Net Reviews. April, 2020. URL: http://www.h-net.org/reviews/showrev.php?id=53496This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.