For those of you who could not attend the Seattle Race Conference, I’m sharing an edited transcript of the talk I gave there. I hope to post a ten minute video on You Tube soon. Thanks especially to Dove John and Jacque Larrainzar for their help at the conference. Jacque co-presented with me. Look for notes from her talk coming soon.
Hi, My name is Jordan Van Voast, I work at CommuniChi, a community acupuncture clinic on Beacon Hill in Seattle. I’m excited to be here today with Jacque Larrainzar to help facilitate this conversation around racism and health care and to make new friends and allies in this work.. As Jacque and I are going to talk about, the beginning, middle, and end of this work is all about community. Building community so that we can create healthy community. So today, you are my community and I’m hoping that in the next hour we can all learn something together and maybe share some laughs.
Any doctors in the room? No? Okay then. Did you hear the one about the patient who asked a doctor whether he could get acupuncture? The doctor said, “we don’t use acupuncture here, we just stick you with the bill!” Or, the patient who called her acupuncturist and said her back was hurting? The acupuncturist said “take two thumb tacks and call me in the morning”.
Too often conference presentations are left brained intellectual, inside the box thinking – which misses the entire point of how to connect as community with our whole hearts and minds. We need to share information, but we also need to experience the power of community as transformative energy, so we can reshape dysfunctional power systems to serve us instead of oppress us. So let’s start with some Qi Gong exercises in a circle and feel our breath go in and out of our bodies.
What is acupuncture? – acupuncture is the insertion of hair fine needles into specific points of the body for the purpose of healing. Recent evidence suggests it may be at least 7000 years old and not exclusively from China. A corpse found mummified inside a glacier near the Austrian-Italian border had tattoos on his body at or near several acupuncture points. However, the most extensive body of literature to be found about acupuncture originates from China beginning around two millenia ago. Today, the WHO recognizes acupuncture as effective for nearly 4 dozen common conditions – Neuromusculoskeletal – arthritis, insomnia, dizziness, joint pain; Emotional – stress, anxiety, depression; Circulatory – hypertension, angina, anemia; Respiratory – allergies, asthma, emphysema, bronchitis; Gastrointestinal – nausea, indigestion, constipation, diarrhea, gastritis, ulcers. It’s quite comprehensive, and except for surgery, it can treat anything that pills can treat, though from a completely different paradigm.
Many people seem to think that acupuncture came to the U.S. in 1972 following Nixon’s visit to China, but in fact, Chinese immigrants brought it with them in the 1850s.
The theory underlying health in Chinese medicine is based upon the balance between Yin and Yang. Yin and Yang correspond to relational pairs within any system or conceptual framework: Mind-Body. Man and Nature. Male-Female. Winter-Summer, Night-Day, Moon-Sun, White-Black. So this interdependence, and interconnection is not limited to medicine, but extends to everything, including the social environment. The health of each one of us is related to the health of all humanity and the Earth ecosystem as a whole. So extrapolating from this basic tenet of Chinese medicine, one can infer that because humanity is a circular family, where all of us are connected in one way or another, racism harms everyone. That’s why it’s important to stop it, in all its many hidden manifestations.
Let’s talk about acupuncture education. In the U.S., in order to be an acupuncturist, one needs to complete a 3-4 year Masters level program in order to practice. The cost to attend acupuncture school…and this should be your first clue as to the institutional racism that exists in this profession…has skyrocketed in the past 15 years.
• 1995: $20 to $30,000 total;
• 2010: $75,000 to $125,000.
• So obviously that’s going to place a lot of restrictions on who gets to practice acupuncture, where it is practiced, and for whom.
So let’s look at the racism and classism in acupuncture in a bit more depth…
• High Cost of Services. Typically, $65 to $200 per session at most clinics. So a course of treatments could easily run from five hundred to several thousand dollars, since most conditions require multiple sessions. The upper middle class assumption here seems to be that insurance should pay. Unfortunately, insurance coverage in America is increasingly a marker of racial disparity and as Michael Moore pointed out in the movie, “Sicko”, managed care does not have as it’s main purpose, taking care of the public, but instead, is focused on maximizing profits for shareholders.
• Acupuncturists are taught in practice management classes to “charge what you are worth”, bizarrely linking one’s self esteem with the degree of audacity one has by setting high fees. From a community perspective, one’s worth would logically be tied to what you give to the community, not how much you can get from it.
• Intellectual Elitism or “the Expert Syndrome” in medicine. And that certainly is present in acupuncture. As I went through acupuncture school, I felt a certain sense of intellectual smugness in my school. We were considered ourselves ambassadors of precious knowledge but I do not recall a single discussion in any of my classes on issues of white privilege or racial disparity in health care. Acupuncture and Chinese medicine has a bit of mystical aura to it, so it’s not surprising that there would be a strong tendency to step into a role of high priest classism that looks down on the public, providing ego-justification to exclude large segments of the population. Another brazen assumption often heard in practice management classes is that people who value their health care will figure out a way to pay your fees, being somewhat clueless to the fact that of course every sane person does value their health, but when faced with a choice between food, rent, and elective, out of pocket health care expenses, will nearly always choose the former over the latter. Needless to say, this attitude, practically invisible to those who hold it, is intensely alienating to people of color.
In a more general context, the medical profession in America has a history of glorifying itself at the expense of those it is designed to support. Although medical historians refer to “ heroic medicine” as having ended 150 years ago, the unspoken assumption prevails to this day, that disease can be objectified as a particular virus or form of cancer and that the preferred mode of treatment is surgery, radiation, and/or chemotherapy. One can draw parallels between the sword of the conquistador and the internalized militarism of medicine. I’m not suggesting for a moment that people forgo conventional medical care for cancer or AIDS. Once the body has reached a certain state of disequilibrium, then radical (or conventional depending upon one’s perspective) means are called for. But why not look at disease as a state of imbalance (rather than an evil within), and health as an empowering awareness that each person is ultimately capable of assessing for themselves? This dilemma underscores the division between a system of medicine controlled by an elite group of experts versus a medicine that is accessible and affordable for everyone.
The acupuncture profession, in its desire to be accepted by the mainstream medical players of America, is in danger of forsaking its roots as a medicine available to everyone, in order to arrive at the corporate managed care (profits before people) model. Currently, there is a faction within the acupuncture profession pushing for an entry level Doctorate in Acupuncture. In other words, everyone would need to attain this credential in order to practice acupuncture. Great for schools, and bureaucrats, but more barriers for patients, and more unmanageable debt for students. This egotistical reach for grander titles does not acknowledge the reality that most Americans cannot afford the high prices that acupuncturists typically charge, and that trend certainly isn’t going to reverse itself with more years of required education.
And unfortunately, this medical elitism, perpetuates a disempowerment of patients, teaching them that they cannot take responsibility for their own health. And so we remain trapped in an expensive war on “the enemy” – whether that enemy is internal (virus), or external (terrorist). High medical costs, lack of access to medical care, extensive taxation, and reductions in social services – we are told – are lamentable, but necessary consequences of winning the war (on either front). My local library system is closed for the week, paying off the economic collapse, the origins of which are complex, but for the purposes of this analysis, can be summed up as the end result of an unjust and racist system. Meanwhile, a few profiteering individuals make millions off of these internal and external wars.
• Redlining. Another factor is redlining. Redlining is the practice of denying services to specific, often racially determined areas. Jacque spoke of this in a broader context, and it definitely happens in acupuncture. How does it occur? Simple…acupuncturists…who as a rule, face a difficult challenge succeeding in business, set up their clinics in wealthier, more affluent areas….those areas where people are more able to afford high out of pocket expenses or who would more likely have comprehensive health insurance. In Seattle, that would primarily be in the north end, which is more white, less racially diverse, in part due to the redlining practices of real estate agents and banks before this practice was exposed. This is a good example of high institutional racism is compounded and reinforced by multiple causes in a racist society.
• Medical materialism. Acupuncture is frequently marketed as a spa like experience, with exotic cultural overlays such as Chinese art objects, calligraphy, zen gardens and waterfalls in the waiting rooms). All of these things are aesthetically pleasing and appeal to upper middle class materialistic tendencies, but have no functional purpose in terms of optimizing health in the community. To the extent that acupuncture has become a consumer experience, it is viewed as just another individual relationship that upper class folks can purchase, sending a message to people of color that this medicine is not for them.
• Privacy. Related to this is our American obsession with privacy. Although there are legitimate areas where privacy values need to be protected, especially in this era of data tracking and data mining, etc….the idea that somehow we all need our own private treatment room for a fully clothed medical procedure is – from a community perspective – simply another wasteful American practice of overconsuming scarce resources. Private treatment rooms cost money and divides society into those that can afford the room, and those who can’t. That isn’t to say that in community acupuncture there is no privacy, and all your personal details are shared with everyone in the room. No, that’s definitely not the case….it’s never difficult to arrange a private conversation and usually all it requires is a not so high-tech procedure known as…..w h i s p e r i n g.
• Lack of diversity amongst practitioners. Very few people of color (except Asians) represented in the acupuncture profession. 70.4% white 21.6% Asian 5.2% “other“. (2010 NCCAOM) Poorly funded study doesn’t even seem to acknowledge that “other” is excluding huge parts of the American population. According to a recent U.S. census, the American population is 80% white, 13% black, 16% Hispanic, 1% American Indian, 5% Asian. The fact that the National Certification Committee for Acupuncture and Oriental Medicine lumps Blacks and Hispanics…who together comprise around 30% of the population in America… into “other” tells us something about the multi-cultural disconnect in the profession.
• Acupuncture non-profits and charity clinics – bandaids for a broken system. As a majority of new acupuncture graduates struggle to succeed in their practices many look for any opportunity to practice their skills, providing a constant supply of practitioners willing to volunteer in addiction treatment centers, or in military veteran stress clinics, etc. And while they often provide a much needed service, it does very little to remove the barriers to access facing the vast majority of people of color and working class Americans to getting affordable acupuncture. As Common Ground, an organization that formed in New Orleans after Katrina coined the phrase… “Solidarity, not Charity”. People don’t want hand outs that come with the power dynamic of superior elite condescending to help an unfortunate wretch. In many of these “charity” clinics, one needs to prove how poor they are before being eligible to receive care. A bitter pill indeed.
• I helped found a nonprofit called Acupuncturists Without Borders in 2005, after volunteering in post-Katrina New Orleans and was inspired by the opportunity to offer healing skills in a disaster setting. But after going to Haiti in February of this year (with a different organization), I came back to Seattle and spent a lot of time trying to understand the roots of the disaster and where my energies would be most effective to alleviate suffering on the planet. I realized that the root causes of disasters like the New Orleans flood, and the Haiti earthquake – is not simply the weather, or the shifting of tectonic plates beneath the Earth, but the poverty and social oppression which set up the conditions for those disasters to happen. So this is what we need to fight against, and this will take time, to bring about a society in which all of its members share equally in the basic requisites of a happy, and healthy life. To accomplish that, we need to organize at the local level, connect with one’s community and to create and support innovative solutions which change the system, which is the mission of the Community Acupuncture Network.
• Profit motive (greed). Finally, there is that cherished cornerstone of the American economic system – capitalism, or the profit-motive. As planet Earth teeters under the environmental load of 7 billion humans all fighting for the biggest share of pie, the irrationality of this system should by now be seriously in question by everyone. Not surprisingly, because the media is in the hands of a few people, much smoke and mirrors are still being used to confuse the basic issues of social equity. For many years, acupuncture schools have used a combination of easy access to Federal student loan money and unrealistic promises to graduates in order to enrich themselves. Right now, the Dept. of Education is conducting a review of these abuses by all colleges, and the comment period on the DOE website is open until September 9. Again, this limits access to acupuncture by making it a very expensive medicine, resulting in higher costs to the consumer, and limiting practitioners to primarily whites, based on pre-existing economic disparities.
Further limiting access to acupuncture is the fact that large corporations have a vested interest in maintaining the (allopathic/western medical) status quo. Stainless steel needles are super cheap…about two cents a piece, and, nobody has figured out how to patent the life force (chi), though many tyrants and dictators have tried. Pharmaceuticals are ridiculously expensive by comparison and it is no secret that in many places of the world, millions of preventable deaths occur due to lack of affordability to medicine. Therefore, because there are no huge profits to be made in acupuncture in its traditional community context, it is dismissed as quackery. Much of the so-called scientific research in medicine is funded by large drug manufacturers who have a direct interest in promoting their products. Further biasing the so called “evidence based care” is the revolving door employment between government and industry medical elites. It’s a vicious and insane system – many of the root causes of disease – toxic wastes, poisons in our food and water, and the mental stress and trauma which arises out of oppression, are a direct result of the corporate system which sells us the pills to alleviate (but not cure) those problems.
• So this is just a brief summary of some of the ways in which the healing power of acupuncture as a potential low cost solution for the current failing health care system, has been marginalized by the institutionally racist and classist forces within American culture.
The Solution: The medicine to heal this is compassion, altruism, and community action.
COMMUNITY ACUPUNCTURE NETWORK (CAN)
• Founded in 2006 by a group of acupuncturists in Portland, OR who started “Working Class Acupuncture”.
• Mission Statement: Community Acupuncture Network (CAN) is a nonprofit organization of practitioners, patients, and supporters whose goal is to make acupuncture more affordable and accessible by promoting the practice of offering acupuncture in community settings for a sliding scale ranging within $15-40 a treatment.
• 150+ member clinics in U.S. and internationally.
• CAN is politically active to challenge the dysfunctional institutionally racist and classist policies of the acupuncture bureaucracy.
• Community Acupuncture training workshops explore diversity awareness as an integral feature of the curriculum.
• Excellent article profiling CAN in Yes Magazine 2008.
• Website: www.communityacupuncturenetwork.org
• 7 member clinics in Seattle. West Seattle, Beacon Hill, Columbia City, Capitol Hill, Fremont, Northgate and Shoreline.
• Promotes community building by creating a treatment space that connects people to the powerful life energy (Chi, pronounced Chee) uniquely available in a group healing environment.
