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Equal Health Care for All

Opportunities to Address Health Care Disparities in Health Care Reform

SOURCE: AP/Gene J. Puskar

Dr. Diego Chaves-Gnecco talks with the Solis family during a visit on to a bilingual clinic that he runs through Children's Hospital of Pittsburgh.

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Read the full report (pdf)

Also see: Fact Sheet: Racial and Ethnic Health Disparities by Sonia Sekhar

The current efforts to reform the health care system provide a unique opportunity for Congress to address the disparities in access to services and quality of services that many racial and ethnic minorities in the United States experience—particularly African Americans, American Indians and Alaska Natives, Hispanics, Native Hawaiians, and Pacific Islanders. These disparities are not just a consequence of lower socioeconomic circumstances, less education, and less-than-adequate health insurance coverage. They at some level appear to reflect biases and stereotyping inherent in the health care system and in individuals. And they are a consequence of a lack of culturally competent care.

Health care disparities generate a significant human and economic cost that is borne directly by the individuals involved and indirectly by all Americans. As minorities become an increasing percentage of the American population, their health status will increasingly define the nation’s health, and the costs of failing to tackle health care disparities will result in higher total health care spending. Addressing these disparities is also an issue of social justice that can be regarded as a moral imperative.

The health care reform bills currently under consideration in Congress make important contributions toward addressing racial and ethnic health care disparities. Particular initiatives that will help close the gap include:

  • Expanding health coverage to as many people as possible, and providing financial assistance to help those with lower incomes purchase coverage.
  • Improving access to primary care and “medical homes” to ensure a regular source of care and care coordination.
  • Focusing on disease prevention and health promotion.
  • Reauthorizing the Indian Health Care Improvement Act.
  • Enhancing the quality of health care services.
  • Improving the diversity, cultural competence, and distribution of the health care workforce.
  • Expanding access to community health centers.
  • Collecting data to better measure the effectiveness of these initiatives.

But these measures alone are insufficient for the task at hand. Additional efforts are needed, including:

  • More research to better understand the underlying causes of health care disparities.
  • Programs and incentives to ensure that all Americans receive the recommended care and treatment, regardless of race or ethnicity.
  • Initiatives to tackle bias and stereotyping in the health care system and in the health professional-patient encounter.

These additional efforts, beyond those in the bills currently under consideration, are crucial to ensuring that data are not just collected, but analyzed and used to inform policy and programs, that programs are better targeted, and that we address the cultural issues that may adversely affect the care minorities receive. The goal is a health care system that is focused on ensuring that all Americans have access to quality care when and where they need it, regardless of race and ethnicity. There are a number of opportunities to address these issues as the health care reform bills proceed. Congress should regard the goal of closing the disparities gap in health care access and quality as an essential and central objective of health care reform.

Read the full report (pdf)

Also see:

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