Institutional racism in our health care system has been a concerning issue for a long time, but little to no progress has been made since 1970s. For instance, there is a significant increase in the amount of closed hospitals in minority communities, there are barriers to insurance and specialized physicians, and a lack of standardized collection of data on race in terms of provider and institutional behavior which makes it more difficult to obtain an accurate description of the discrimination in health care.
There are some discriminatory factors that are very deeply rooted that cause minorities to be at a disadvantage when it comes to health care. Some of these factors include increased probabilities of minorities becoming ill due to unhealthy environmental practices that take place near their communities. For instance, minority communities are more likely to be exposed to toxins like lead or asbestos than predominately white communities. Minority communities are also more likely to be targeted by marketing campaigns of unhealthy products like tobacco and alcohol. Another problem is the fact that there is a disproportionate amount of minority physicians compared to whites. One could make the argument that if there were more minority physicians, there would be better health care in minority communities because these physicians would be more apt to practice in their communities. Ways of combating this are affirmative action policies, but these policies are under political and legal scrutiny.
Coates would argue that this further exemplifies why we need to have a discussion on reparations. The discussion must take place because there are still so many examples of how black populations in the U.S. are being discriminated against today. Opening the discussion could enable society to recognize and find solutions to these modern instances of discrimination even if an agreement on reparations is not met.