2020年经济学人 美国黑人的医疗状况不容乐观(3)（在线收听）

The advances of the civil-rights period led to a big improvement in black health, which by the mid-70s had levelled off. Barack Obama's Affordable Care Act, which followed the example of Medicaid in trying to improve the health care of all poor Americans, can be viewed as the third major effort to correct the disparity. The 20m Americans who received health insurance under the act were likeliest to be black or Latino. Yet the fury this elicited among some whites-fuelled by a vague feeling that their tax dollars were being squandered on the undeserving-helped get Donald Trump elected. Having failed to repeal the act, as he had promised to, the president has since sought to shrink it through technlcal changes.

民权的推进导致黑人健康状况大为改善，到70年代中期已经趋于平稳。贝拉克·奥巴马提出的平价医疗法案，延续了医疗补助计划，试图改善所有贫困的美国人的医疗保障。这一法案可以被视为纠正差距的第三大努力。根据该法案获得医疗保险的2000万美国人最有可能是黑人或拉丁裔。然而，一些白人燃起了怒火，他们模糊地感觉到，自己的税收被浪费在不值得的东西上，这有助于唐纳德·特朗普当选。由于未能像他所承诺的那样废除该法案，总统后来试图通过技术变革来减小法案。

Some dare hope the pandemic may lead to a fourth push to close the gap. "I'm always optimistic-especially when there are trillions of dollars circulating," said Muriel Bowser, Washington's mayor. African-Americans' electoral heft might help. Even Mr Trump has been courting their votes; Joe Biden's health-care plan was aimed at blacks even before the pandemic struck.

一些人大胆地希望，这次疫情可能导致第四次推动缩小差距的努力。华盛顿市长穆里尔·鲍泽说：“我一直都很乐观，特别是当还有数万亿美元在流通的时候。非裔美国人的选举影响力可能会有所帮助。就连特朗普先生也在争取他们的选票；甚至在疫情爆发之前，拜登的医疗计划就针对黑人。

Covid-19 has also made dear that such an intervention should not be considered ideological. Perhaps government action is not the best way to raise blacks economically, as conservatives argue; but their poor health cannot be improved otherwise. The virus afflicts the industrious and work-shy alike-a point made by Mr Trump's trim African-American surgeon-general, Jerome Adams, when he acknowledged his own asthma, high blood pressure and heart disease. Indeed the most industrious blacks-such as Bertina's son, labouring in harm's way at Costco-are likeliest to expose themselves and succumb to the virus. Poor black health is a disincentive to work that work alone cannot fix.

新冠肺炎也为我们指明，这种干预不应被视为意识形态干预。就如保守派主张的那样，也许政府的行动并不是在经济上提升黑人地位的最佳途径，但是他们的健康状况却无法得到改善。这种病毒同样折磨着勤劳和懒惰的人——这是特朗普的非洲裔美国外科医生总干事杰罗姆·亚当斯在承认自己患有哮喘、高血压和心脏病时提出的观点。事实上，大多数勤劳的黑人——比如伯蒂娜的儿子就在好市多工作并身处危险中——最有可能暴露在病毒之下，并屈服于病毒。黑人健康状况差是工作的障碍，光靠工作是解决不了的。

It only remains to be seen, to revert to Du Bois's difficult problem, whether a majority of Americans can be mobilised behind the issue. That must surely be possible, after the vulnerability of millions has been so cruelly exposed. If not now, indeed, when?

至于杜博伊斯的难题，是否能动员大多数美国人支持这一问题，我们只能拭目以待。在数百万人残酷地暴露在病毒中且易感病毒之后，这肯定是可能的。如果现在不去改变，那又在什么时候呢？