An unfair accusation of racism in Hennepin County

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Being unfairly denounced as racist ranks among the most hurtful and difficult accusations for people committed to equality. When faced with such a charge, most people of good faith back down to avoid conflict. Unfortunately, people of bad faith leverage this response and weaponize the racist label to gain power and advantage over a situation.

The latest high-profile example of someone weaponizing accusations of racism in our community happened when Hennepin County Board Chair Irene Fernando and Commissioners Angela Conley and Debbie Goettel accused Babette Apland, who previously chaired the Hennepin Healthcare board that oversees HCMC, of making a racist and xenophobic comment.

Based on news reports of Apland’s comments, there’s nothing racist in what she said. Yet, she apologized. When that didn’t satisfy her accusers, she stepped down from the Hennepin Healthcare board. No doubt the experience will leave Apland with deep emotional scars.

The unfair and very public racism accusation goes far beyond personal insult and career and reputational damage. It also shut down free and open discussion around solving HCMC’s severe financial problems. Ironically, this limits opportunities to get to the best solutions and, ultimately, undermines access to health care for the minority communities these Hennepin County commissioners represent.

At this point, it’s important to note that the public, me included, does not know exactly what Apland said because it took place during the nonpublic portion of the Hennepin Healthcare board meeting. Based on Minnesota Star Tribune reporting (“HCMC board leader resigns after apology for comments,” Sept. 15), Apland singled out Somali immigrants as a cause for the rise in uncompensated care costs at HCMC.

If that is all Apland said, there is nothing inherently racist about citing the Somali impact on uncompensated care costs. The main reasons I can imagine for making this point involve a strong interest in helping Somali immigrants gain better access to care. The point highlights how HCMC fills financing gaps to ensure Somalis receive care, regardless of their ability to pay. Moreover, it highlights a population that needs better health coverage and an opportunity for HCMC to address uncompensated care costs by getting more Somalis covered. Finally, welcoming Somali refugees into our community does carry a financial cost. A better understanding of that cost can help justify bringing in more state and federal resources to support our refugee population.

Each of these well-intended reasons to single out Somalis fit squarely with statements given by Apland and the HCMC CEO Jennifer DeCubellis. Apland told the Star Tribune she intended the comment “as a point of pride, that we are taking care of our community.” DeCubellis added that Apland’s comments were intended to demonstrate why the county needs help in financing uncompensated care costs.

The fact is, uncompensated care costs do impose a growing burden on HCMC’s finances. As this burden weakens HCMC, the poorest and most vulnerable patients will be harmed the most. They have nowhere else to turn but to HCMC.

According to Minnesota Department of Health data, HCMC’s uncompensated care costs reached nearly $205 million in 2022, which amounted to 7% of total charges from patient care. That’s the highest level of any hospital in Minnesota on both measures and represents a substantial spike from pre-pandemic levels in 2019, when the cost was $90 million and 3.5% of total charges.

Survey data also suggests health coverage rates among the Somali population may be slipping. U.S. Census Bureau data show the uninsured rate for Somali language households in Minnesota increased from 4.6% in 2019 to 8.9% in 2022. So, it’s entirely plausible that more Somalis are relying on HCMC for uncompensated care, and it is no racist slight to reference them in a discussion on HCMC financing and who HCMC serves.

Unfortunately, accusing Apland of racism may have been a crass power play to gain an advantage in the ongoing dispute over the role of the Hennepin Healthcare board.

Clearly, there is friction between county commissioners and the Hennepin Healthcare board. County actions, proposed by Fernando, approving increased oversight led two Hennepin Healthcare board members to quit last December. In the spring, the nurse’s union issued demands for the county to dissolve the Hennepin Healthcare board.

Friction is inevitable in any public governance structure. People of good faith tend to resolve friction in constructive ways. However, these Hennepin County commissioners stepped off the constructive path to common ground and better policy solutions and, instead, chose power politics.

This power play effectively removed Apland’s voice from future discussions as she has now resigned. More concerning, it creates a chilling effect and silences people with good ideas who worry they might be bullied by similar accusations. As a result, improving HCMC’s fiscal condition and protecting access to high quality care just became substantially harder.

Wielding power politics rarely leads to good results for the people politicians serve. Hennepin County residents, especially Somali residents, deserve better.

Peter Nelson is a senior policy fellow at the Center of the American Experiment.