Saturday, October 3, 2009

The Kind Of Health Care System We Need Is Not Likely To Be The One We Will Get

Our nation's health care system is broken. More than 45 million Americans are without health insurance. Many of the uninsured pay dearly for their lack of coverage. Experts estimate that roughly 22,000 people die annually because they are not covered by an insurance plan.

Like most Americans, I've had a very difficult time following the health care debate in Washington. The competing claims about what ails our health care system are nearly as difficult to follow as the competing policy prescriptions being offered to fix it.

What I am most certain of, however, is that repairing our nation's health care system is of critical importance to communities of color.

A report released earlier this year by the Connecticut Citizen Action Group (CCAG) as part of Heath Care for American Now (HCAN) – a coalition of over 1,000 organizations – makes a compelling case that communities of color would benefit most from comprehensive health reform.

"Throughout the nation's history, communities of color have been forced to accept health care that bears little resemblance to what is experienced by members of more advantaged groups," write the authors of the HCAN report, Unequal Lives: Health Care Discrimination Harms Communities of Color in Connecticut.

People of color in Connecticut suffer from the devastating effects of institutionalized racism embedded in our state's health care system: shorter life spans, and more chronic bouts of illness and disability.

  • About 22 percent of Latinos and 18 percent of blacks in Connecticut are uninsured, compared with 8 percent of whites.
  • In Connecticut, 25 percent of Latina and black women received no early prenatal-care, compared with 9 percent for whites.
  • The infant mortality rate for blacks in Connecticut is more than three times that of whites.
  • In Connecticut, 18 percent of black adults have been diagnosed with diabetes, more than twice the rate for whites.
  • In Connecticut, the rate of AIDS cases for whites is 7.3 per 100,000 people, compared with 62 for Latinos and 66 for blacks.

According to the HCAN report, persistent health disparities "are predictable side-effects of a health care system that provides these communities in Connecticut with narrower opportunities for regular health services, fewer treatment options and lower-quality care."

"Unequal Lives" offers a range of recommendations to erase the racial and ethnic health care disparities, along with, "addressing the social determinants [their emphasis] of health, including a clean environment, occupational safety, safe neighborhoods and access to nutritious food."

HCAN offers really good suggestions for fixing the nation's health care system, but, my gut tells me that nothing short of comprehensive health reform resulting in a single payer system – a system in which one entity, perhaps a government run organization, would collect all health care fees, and pay out all health care costs – will really make a difference.

However, with Washington special interest and their allies on Capitol Hill fighting to protect the most harmful features of the current system, and President Obama abandoning his campaign promise to refuse to support a reform that does not include a public option, the kind of health care system we need is not likely to be the one we will get.

This is bad news for the nation's 103 million people of color, including the 896,000 who live in Connecticut.