Vanderbilt Professor Says Racial Prejudice Keeps Rural Tennesseans From Embracing Obamacare



A Vanderbilt professor says rural Tennesseans are too racially prejudiced to realize Obamacare is good for them.

That professor, Jonathan Metzl, told Boston University Today that he knows this about rural Tennesseans because he’s interviewed them.

As The Tennessee Star previously reported, Metzl recently wrote a book called , Dying of Whiteness: How the Politics of Racial Resentment is Killing America’s Heartland.

In the book, Metzl said people in the United States refuse to pass more gun control laws because of white supremacy and “white privilege. He also said white Tennessee residents endanger their own health by rejecting government health care programs and by embracing pro-gun and anti-tax policies.

Metzl spoke to BU Today this week to promote his book.

“One of the most jarring parts of the research was talking to people in rural Tennessee. These were white Americans who would have really benefited from healthcare reform, but who were loath to support Medicaid expansion and the Affordable Care Act because they didn’t want, as they put it, Mexicans and welfare queens and other minorities to benefit. For them, there was an ideology that was more powerful than self-preservation,” Metzl said.

“I think there was this liberal fantasy that the minute Republicans saw the effects of Trump’s policies they would wake up and change course. But I spoke with people who were literally laying their lives down on the line in support of a racial hierarchy they felt was threatened. Issues like healthcare, education, and guns have centuries-old histories of racial resentment. Offering everyone healthcare won’t change people’s opinions if you don’t address the underlying racial issues. Things are far more complicated than the liberal vision of common sense when race is involved.”

Metzl also told the website that Tennessee’s refusal to expand Medicaid cost every single white resident two weeks of life.

As The Star reported in March, Metzl’s book focused on three specific areas — Medicaid expansion in Tennessee, school funding in Kansas, and gun laws in Missouri.

“In his book, Metzl explains that today’s skepticism toward gun control and government programs has a long history in the segregated South and Midwest, where gun ownership, affordable health care and quality education were considered privileges that only whites deserved,” according to a Vanderbilt press release about the book.

“Likewise, those attitudes reflected a view of whiteness that emphasized extreme self-reliance—the idea that individuals can and should be solely responsible for the health, safety and well-being of themselves and their loved ones.”

Quoting Metzl, the Vanderbilt press release said this view is linked to backlash following the U.S. Civil War and federal interventions to end segregation. Metzl also said these attitudes resurged following the election of former Democratic President Barack Obama.

Metzl has said “whiteness itself has become a negative health indicator.”

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Chris Butler is an investigative journalist at The Tennessee Star. Follow Chris on Facebook. Email tips to [email protected]





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39 Thoughts to “Vanderbilt Professor Says Racial Prejudice Keeps Rural Tennesseans From Embracing Obamacare”

  1. […] “One of the most jarring parts of the research was talking to people in rural Tennessee. These were white Americans who would have really benefited from healthcare reform, but who were loath to support Medicaid expansion and the Affordable Care Act because they didn’t want, as they put it, Mexicans and welfare queens and other minorities to benefit. For them, there was an ideology that was more powerful than self-preservation,” Metzl said.Read more at […]

  2. Chili Dogg

    We should also consider market-based solutions that some people are working on. You can look them up online. There are such efforts going on under the radar that don’t get much publicity. I don’t want a monopoly health care system, public or private. The negative effects of monopolies are well documented. Look at the VA as an example. A government takeover that ends these private sector efforts at improving medical care would, at the least, cause problems for a lot of regular folks who would lose those options they were already using.

    A few years ago, I read that in Switzerland, 90 percent have private insurance and only 10 percent use gov’t insurance/programs. Switzerland ranks very high in measures of human well being. I plan to do some research on their system. Maybe we can learn something from them.

    As for the book, I haven’t read it, so I have to qualify my following comments. That said, my concern is that the author paints with too broad a brush, and that his focus on race might cause him to miss or downplay substantive criticisms of Obamacare. We cannot deny it has had its share of problems. Also, he seems overly critical of the emphasis on taking care of oneself and one’s family, and not forcing others to do so. By doing so, he’s throwing out the baby with the bath water. Finally, we have to keep an eye out for confirmation bias.

  3. F. Dalton Williams

    Excuse me while my laughter subsides, most of the comments I’ve read are coming from some if the most ignorant people on the planet, obvious ” Donald Duck Trump ” supporters, to damn dumb to even realize how pathetic you really are, and can’t help but let your blatant racism show, but let me help your supremely stupid asses, the people of color have evolved, we do not need your acceptance, nor your mentality, your thoughts, or opinions on anything we have going on, we actually couldn’t give 2 damns about how you feel, you clowns have been peddling this superiority bs so long, you”ve convinced yourself that you really are superior; unfortunately for you that us not, nor have it ever been the case. Your.problem now is because of Blacks, Asians, Hispanics, and other ethnic groups, guess what ??? You are now the minority, and it’s that fact that’s the driving force behind the racist and inhumane immigration policies, also the motivation behind the racist and restrictive voting laws, you”re so fucking afraid of losing your precieved notion of superiority, you’re doing all you can to maintain it, it’s not working, America is a country of immigrants, this includes each and every one of you, but you”ve murdered, lied,raped, stole, so much so, you really don’t know anything else, but here’s a word for all of you from the various minority communities: F___k, collectively all of you !!!!!!!!!!

  4. Jerry Hinson

    Just look at the guy. He’s enough to make the whole white race ashamed of being white, no book needed. I bet he cried himself to sleep for a month after Trump was elected. What else could he be but a liberal? The book he wrote is just his revenge.

  5. Thoughts Prayers

    If racists choose to die from their racism, I say let them. Who am I to keep an idiot from reaching their poetically just Darwinian end? I’m not interested in trying to help them see light, and have even less desire to “save them.” Play stupid games, win stupid prizes and whatnot,lol. Fact is hate should have consequences, ugly ones. I’m fine with that.

    1. Alix

      Racists aren’t the only ones who are suffering & dying. And they’re not the only ones who’ve howled against states’ taking the ACA Medicaid Expansion package. The AMERICAN MEDICAL ASSOCIATION has spent years & $$$ trying to keep red states from taking the expansion package. Now their younger members have outvoted the older, primarily greedy ones. Meanwhile, people in my position, college teachers who’ve experienced idiotic age discrimination & have not been offered benefits packages, now depend on Medicare & Medicaid. We worked 70 hours a week, but if you cannot afford a $20,000 yearly “policy,” or if NONE is even offered, you’re not a bum. You’re simply a victim of idiot lobbying & legislating.. Many rural people are in the same fix. But they cling to the old “I’m trash, but at least I’m WHITE trash!” mindset of the late 1800s.
      There’s a name for it: piteous IGNORANCE. It’s not an opinion if they don’t understand that they have a choice. Monsters like the sycophant GOP legislators who LIED OUTRAGEOUSLY in Congress today? Jail time. They’re feeding the ignorance. Perjury needs refereeing & consequences.

    2. Robert E Lee

      My, my. my. Such unladylike vitriol ! I couldn’t agree with you more. Inbreeding & incest, decades of it, do appear to have consequences.

  6. Ethel Rhodes

    As an Assistant Public Defender in East Tennessee, I see and represent the proud poor mountain people who cling to skin color as a badge of “better than you.” It was startling to hear what some of my clients said about President Obama. I don’t have an answer to address their isolation from more progressive thinking but I often feel that they are stuck in the past. And then I look into the faces of their children…..

  7. Let’s not forget to mention a notable fact about ACA. It now requires such restraint with use, preauthorization for just about everything, including prescriptions!

    1. Kali

      The article you linked has nothing to do with presuthorizations. Preauthorizations are primarily a feature of insurance companies trying to reduce costs and aren’t related to the ACA. They’ve been demanding preauthorizations for ridiculous things for at least 20 years (that’s as long as I can speak to them from personal experience, going back to my mid-teens).

  8. Meowmix

    Awwww the racists sound upset…..
    Reagan literally used this strategy in his efforts to win over whites. Where white people became super angry at the idea of welfare ONLY when he sold them the image of a black welfare queen milking the system even though the majority of people on welfare were white…..You literally had white people on welfare thinking they were better than the blacks on welfare…

    1. Attica House-Finch

      Under the auspices of the United States Agriculture Dept. billions of dollars are spent in rural areas all over these United States. It’s not called welfare, but indeed it is. Drinking clean water ? A convenient place to get your colostomy bag cleaned ? Do you drive on paved roads ? All Welfare &…………………………..
      SOCIALISM ! Keep your filthy government hands off of my Medicare, damn Commie Socialists !

  9. Trisha Farmer

    I mean, he’s not wrong. Studies show that states that expanded Medicaid had stronger rural areas, less hospital closures and fewer preventable deaths. Failure to expand Medicaid is one of the largest legislative failures in Tennessee’s history. We have more hospitals closing per capita, 300k people without health insurance, and higher healthcare costs than other states because we have more people utilizing emergency rooms bc they cannot access primary care. The hatred of Obama and the ACA is keeping Tennesseans sick and we have a much poorer quality of life because of it. The plan Haslam came up with, Insure TN, would have cost the state zero, meanwhile our tax dollars are being sent to other states. What a failure.

  10. 83ragtop50

    Yet another stellar example of the lunacy that defines Vanderbilt.

    1. Dan

      How so? He did research, talked to actual people in rural areas and published his findings. Is it just lunacy because you want it to be to not feel guilty or do you have proof behind your claim?

      1. Youcalledhimout

        I notice 83ragtop50 has yet to reply to you. Hmmm…..

    2. Dean

      The best hospital in the state. One of the best universities in the country. Amazing medical and scientific research. But, yes, tell us about Vanderbilt’s “lunacy.”

    3. ams

      Typical mindless retort with a big McNothing burger to back it up. Watch Fox news much?

  11. Anne

    Nothing about race is keeping me from embracing Obamacare. It’s the FACT that I lost my great health insurance and now am paying 4x the cost for everything from premiums to copays to now coinsurance that I had never had before this “great” Obamacare was mandated. I can’t afford healthcare as I could prior to this brilliant plan. HE took away my wonderful healthcare insurance AND replaced it with crap.

    1. Jeff

      Have you tried shopping around? Would you have been eligible for Medicare subsidies if TN had approved them?

    2. Peggyyoung25

      I hope is that you did not have preexisting condition.
      Without the ACA I would be dead. But in order for the ACA to pass, big Pharma and the insurance companies were given almost unlimited power to deprive you of treatment you might desperately need. Without the AcA your job can continue to give you your health care. But insurance companies can and do override doctors orders. The insurance companies can do as they please. And they do. .

    3. Tom Barclay

      Sorry, Ms. Anne. Your analysis of who did what and to whom is incorrect, due to shortsightedness and a desire for simple answers.
      The insurance companies wiped out entire classes of insurance in response to ACA so that they could reorganize jacked-up price schedules and protect their profits.
      Read that again. The healthcare insurance industry moved to protect their profits. Why?Profits are their only interest.
      I worked in the healthcare insurance industry while this was happening, as did my wife until she became too ill to work. My employer laid off a wide swath of employees who were either using high levels of their corporate healthcare benefits, or had dependents who did. They laid me off, cut off our coverage including Part D, and my wife died.
      The corporation, of course, never failed to return record profits to its vultures . . . I mean, shareholders.

  12. Ron Welch

    Well then, according to the prof, Democratic presidential candidates like Elizabeth Warren and Bernie Sanders are the worst racists since they want to totally abandon and outlaw “Obamacare” which incorporates private insurance. So far, the only change that the Republicans made was to make it pro choice. And that was according to “the rule of law” since the government may not lawfully require us to purchase a good or service. But then, leftist Democrats and socialists are only “pro choice” for allowing the killing of unborn children for any and all reasons up until and even after birth.

    1. Christina

      Ok Boomer 🤣

      1. Chili Dogg

        Snotty answer…

    2. Dr. Mike

      How can one guy be so wrong about so many things? I’m gonna start calling you John Snow.

    3. Intellectually Honest

      Not that long ago having insurance was a conservative idea. In fact the basic outline of the ACA was a plan that the Heritage Foundation created. You were supposed to prepare for medical expenses and take care of your family, not refuse to buy insurance and then rely on the Emergency room to take care of you when an accident occured. And before the ACA, preexisting conditions exclusions, annual limits and lifetime limits meant that even buying good (not just catastrophic) insurance would NOT guarantee you wouldn’t end up bankrupt IF you lived through a medical crisis or
      of myself, just an expensive chronic condition.

  13. William R. Delzell

    I hope Dr. Metzl is wrong about his evaluation of white Tennesseans and their alleged opposition to something that would benefit THEM as well as non-whites, but I fear the allegation is true.

    I know of an incident that appeared in a book written by a while male Tennessean pro-civil rights activist that took place in the 1980’s. At a major hospital in Nashville, a white female patient needed surgery right away in order not only to survive but to have any chance of returning home in good health. The hospital during her admission into the hospital had only one doctor available, a highly distinguished surgeon who happened to be black. The woman’s domineering white husband insisted that only a WHITE doctor operate on his wife. Instead of putting its food down with the husband by insisting that his wife’s welfare required her to rely on the able black surgeon, the hospital cravenly caved into the demands by this husband of hers. Luckily for the wife, the hospital found an off-duty white surgeon who made it barely in the nick of time to operate on the woman. But what if that white surgeon had failed to make it on time due either to traffic or an accident of his own? That woman would have died or suffered permanent health disabilities all on account of her selfish white husband and a cowardly hospital administration too scared to do the right thing.

    This is a blatant example where white prejudice endangers white people. It almost cost this white female patient her life!

    1. Bill

      Nice story. You should pitch it to Hollywood. Has all the action, drama, and suspense that sells in the theaters. I was on the edge of my seat as I read it!!!!! Reiner would love to produce it

  14. Steve Allen

    Professor Metzls’ ideology is the epitome of how Liberal America views itself and how it views “The Deplorables”. If you do not subscribe to their Liberal/Socialist ideology, you are not capable of make your own decisions, and the Left has a never ending list of reasons, they believe, that are keeping you from seeing the true light of Liberal/Socialism. Coming from a long ancestry of Scots-Irish, I’d rather be dead.

    1. wormcast

      ” I’d rather be dead.” If you live in Tennessee you are two weeks closer to your wish…

    2. Mimi

      Yeah. That’s what he said. Y’all would rather be Dead, and here you are, agreeing with him.

    3. Jeff

      That is ridiculous. We’re just talking about universal health-care coverage, not actually telling anyone what to do. That canard has been around for at least seventy years now, and there’s next to nothing to it.

      1. Asante Lake

        Simple question that exposes the fragile, socially constructed racial category of “white.”

        What is white? I will wait.

        Thank you.


    4. m

      Yes, that is what Metzl says: you’d rather die than support a plan that would help you, if it also helped people different from you.

  15. Traditional Thinker

    Whiteness is killing America’s heartland? Hardly. The true potential murderers as we in the south well know, are the liberal idiots who like metzi, blanket themselves under the cloth of political correctness pushing racism and immorality in the hopes of dividing and conquering this great nation. If what he said was actually the least bit true, I doubt he would still have the luxury to make such an assumption and still have the freedom to push his ignorant ideology within the area. Take your liberal propaganda to where it belongs metzi, california, where all of your depraved people reside. Btw stupid, high premiums and lies about your “great Obamacare insurance” is the true culprit not whiteness.

    1. Jeff

      Well, if we had single-payer health care funding, the premiums wouldn’t be so high. Looks like all that traditionalism is keeping you from actually THINKING.

      And the only people looking to divide this country are your guy Trump and his supporters like you.