Question
Will the candidate ensure that health care in America is equitable and take steps to reduce the persistent and pervasive racial disparities that plague this nation’s health care?
The Issue
The extent and breadth of racial and ethnic health disparities is staggering. People of color are less likely to have health insurance coverage, see a provider on a regular basis, and receive preventive screenings or routine health care services. At the same time, they are more likely to be diagnosed at a later stage of disease and be hospitalized for preventable conditions.
Increasing access to insurance coverage would go a long way towards closing the gap in access to care. Racial and ethnic minorities are much more likely to lack health insurance coverage or to be underinsured compared to whites. While people of color make up just one-third of the U.S. population, they comprise over half of the uninsured. In 2007, one-third of Latinos and American Indian/ Alaska Natives lacked coverage, as did 19.5 percent of African Americans, 16.8 percent of Asians, and 19.4 percent of Native Hawaiians and Pacific Islanders, compared with 10.4 percent of whites.
But disparities persist even when health insurance coverage is not an issue. An overwhelming body of evidence demonstrates that racial and ethnic minorities receive lower quality health care than Whites, even when insurance status, income, age, and severity of condition are the same. For example, African-American patients are often less likely to receive high-tech care after a heart attack thate patients; as a result, they were more likely to die within a year.¹ These racial disparities are pervasive and have a significant impact on the overall quality of America's health care system. Any attempt to improve the quality of health care in America must address the problem n whiof health care disparities. An inequitable health care system can never be a high quality health care system.
The Positions
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Senator McCain: Senator McCain does not have a specific plan in his health care reform proposal to address racial and ethnic health disparities. Even more alarming, Senator McCain has often said that “the problem with health care in America is not the quality of health care; it’s the availability and the affordability.” This ignores a huge problem in our nation’s health care system. For example, racial and ethnic minority patients do not receive the same recommended care after a heart attack as white patients.² |
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Senator Obama: Senator Obama’s health care plan addresses the range of factors that contribute to racial and ethnic health disparities. His plan promotes prevention and expands access to health coverage, both of which would have a significant impact on reducing racial and ethnic health disparities. Senator Obama also acknowledges that disparities exist when coverage is the same and proposes a number of strategies to ensure that the care all Americans receive is equitable. His plan would provide a foundation for monitoring racial disparities by requiring hospitals and health plans to collect, analyze and report health care quality for disparity populations; diversify the health care workforce and promote access to culturally effective care; and support and expand the capacity of safety-net institutions, which provide a disproportionate amount of care for underserved populations despite inadequate funding and technical resources. |
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Footnotes
1 Ioana Popescu, Mary S. Vaughan-Sarrazin, and Gary E. Rosenthal, “Differences in Mortality and Use of Revascularization in Black and White Patients with Acute MI Admitted to Hospitals With and Without Revascularization Services,” Journal of the American Medical Association 297 (June 13, 2007): 2489-2495.
2 Agency for Health Care Research and Quality, National Healthcare Disparities Report (Rockville, MD: AHRQ, 2005). The full report and supporting documents and data are available at www.ahrq.gov/qual/nhdr05/nhqr05.htm. |
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