1 - Among your fellow citizens are forty million who identify as black, and whom I shall refer to as black. The cumbersome (and MLK-noncompliant) term “African-American” seems to be in decline, thank goodness. “Colored” and “Negro” are archaisms. What you must call “the ‘N’ word” is used freely among blacks but is taboo to nonblacks.
2 - American blacks are descended from West African populations, with some white and aboriginal-American admixture. The overall average of non-African admixture is 20-25 percent. The admixture distribution is nonlinear, though: “It seems that around 10 percent of the African American population is more than half European in ancestry.”
In 1974, the RAND Corporation ran the then largest randomized control trial on healthcare.
They recruited 2,750 families, totaling 7,700 people under the age of 65. Families were randomly assigned to one of five types of health insurance plans:
- Three cost-sharing plans: 25 percent, 50 percent, or 95 percent coinsurance, subject to a co-pay limit (~$5000 today)
- Unlimited fee-for-service care (the same plan as above, but with a 0% co-pay)
- Free care from a nonprofit HMO
The RAND Health Insurance Experiment followed these families for 8 years.
It found:
- Cost-sharing reduces healthcare utilization by 25-30%, with no effect on health outcomes for almost everyone.
- Poor people in the top 80% of initial health ended up with a 3% lower general health index under free medicine than under full-priced medicine.
- Low-income participants with chronic conditions did have a small measurable increase in hypertension, but this was the only one of thirty measures that was significant.
- No meaningful differences in rates of death.