The Human Factor

With the implementation of the Affordable Care Act, Dr. Aaron Shirley, an advocate for the improvement in healthcare in underprivileged and underserved communities, believes that politics and misconceptions have muddled honest discussion and explanation of the Affordable Care Act, Medicaid expansion and their benefits for many Mississippians.

Shirley started his medical career in Vicksburg, Mississippi following a tumultuous path through segregated schooling in the South. He attended Meharry Medical College in Nashville, Tenn. in 1959 through a scholarship from the Southern Regional Education Plan, a board of Southern governors who attempted to maintain the segregation of their states’ medical schools, by providing stipends for African-Americans to attend medical school out of state.

As stipulated in the scholarship, recipients were required to return to their homes to practice for 5 years in “needy” areas before being allowed to leave and pursue medical careers elsewhere.

Upon his return to Mississippi, Shirley took part in “Freedom Summer” and provided care for freedom riders injured during their trek through Mississippi. After becoming actively involved in the civil rights movement, Shirley decided to abandon plans of leaving Mississippi to remain in the state to practice medicine.

During this time, Shirley and other African-American physicians were denied admitting privileges at area hospitals, nor could African-American physicians practice in certain hospitals in the State. Despite these denials, Shirley’s resolve to pursue admittance and residency to these institutions was strengthened. In 1965, Shirley was the first African-American in the state to be admitted to the University of Mississippi for residency in pediatrics.

“It was during my training that I realized that health care in Mississippi, especially poor children…in a society that on paper and on Sunday morning said it cared, but I realized the way we provided care to poor people just wasn’t adequate, so I dedicated the remainder of my career to trying to correct some of that.”

Shirley’s determination to improve the plight of the poor and underserved has birthed much advancement in the area of health care in the Metro Jackson area. With his guidance, in 1970, the Jackson Hinds Comprehensive Health Center became one of the State’s largest primary care providers for underinsured and underserved populations.

One of Shirley’s hallmark accomplishments is seen in the partnering of the University of Mississippi Medical Center, Tougaloo College and Jackson State University which under Shirley’s leadership, led to the development of the Jackson Medical Mall in 1997. The Medical Mall brought health services and specialized care to a previously blighted property in northwest Jackson to serve a community with less than adequate access to essential health services.

Shirley’s jovial disposition in the discussion of the controversial topic of Medicaid expansion and the Affordable Care Act, tempered with real life experience is a break from the political speak that many have seen as taking over the debate about healthcare in Mississippi.

“The politicians have done a good job painting Medicaid expansion Black,” he says.

With the Affordable Care Act providing viable options for Mississippians with no insurance and offering providers options to provide care to the uninsured, Shirley says his mission with the Jackson Medical Mall is to help Mississippi citizens and politicians alike understand that the impacts of healthcare reform or the lack there of are far reaching, far beyond barriers of race or ethnicity.

As far as the benefits are concerned, Shirley says the ACA is the best answer to the worst problem, access.

“You have people with insurance money but not enough doctors, hospitals and all, then you have people with a type of insurance, where you have doctors that don’t accept it, then you have those who have no insurance and not enough financial resources to purchase the care that they need,” explains Shirley.

He also points out the dangers that providers operating in smaller hospitals face with the possible elimination of Disproportionate Share Hospital (DSH) payments. Especially in rural areas, this elimination could put some hospitals and providers in danger of closure as they lose funding to treat uninsured patients.

For Shirley, it all comes down to what he calls, “the human factor.”

“The relief of complications or illness that adequate coverage would mean,” says Shirley.

This relief is why he says the ACA and Medicaid expansion are perhaps the most pressing and important factors in the economy of Mississippi.

With his decades of fighting and his significant gains in healthcare, Shirley says he still believes that the expansion of Medicaid in Mississippi is inevitable and something that the State must do.

Until such time, he is committed to celebrating the victories while continuing the discourse on the need for adequate access to care. The Jackson Medical Mall is acting as a direct agent for outreach and enrollment in the insurance exchange, they have sponsored listening sessions concerning the ACA and will continue educating Mississippians on health reform.

Shirley says that his work in this field is far from done, “Personally I will be looking for every opportunity to try and convince people that they should think twice before allowing folks to cause them to oppose policies that could benefit them.”