Since as far back as 1899, W.E.B. Du Bois documented racial health disparities and their link to poverty and discrimination. Today, we have made few advances in addressing what Martin Luther King, Jr, called the “most shocking and inhumane” of all forms of inequality.

As we sit at the cusp of sweeping legislative reform to fix our ailing health care system, Americans who believe in social justice and equality must stand up and support a public health insurance plan that would provide access to affordable, quality coverage for all Americans.

This is a 4-part post. Jump to sections:

1. Introduction (this page)
2. Why We Need a Public Option
3. Beyond Access: Medical Coverage is Just Part of the Equation
4. Call to Action: What You Can Do
5. View all sections

For far too long we have witnessed the effect of a health care system that excludes individuals based on their ability to pay. The result? An immoral and unethical system that renders uninsured Americans separate, unequal and unworthy of health care.

By default, Black and other people of color bear the burden of unequal access to health care. Racial and ethnic minorities make-up one-third of the U.S. population but account for 50 percent of the nation’s 47 million uninsured. Often without a primary care doctor or regular source of health care, minorities experience excess disease, disabilities and deaths at alarming rates. As unemployment increases, these health gaps between whites and people of color, uninsured and insured, will only widen.

A recent report by the Department of Health and Human Services highlights some of the disparities:

• Seven out of 10 African Americans are obese or overweight.
• Blacks are more likely to develop and die of cancer than any other racial or ethnic group.
• Fifteen percent of African Americans have diabetes compared to only 8% of whites.
• African Americans are more likely to delay seeking care and are two times more likely than whites to use the emergency room for health care

Access to a primary care doctor and screenings to prevent or catch health conditions before they worsen is a critical part of reducing these disparities.

Keep reading: Pt. 2: Why We Need a Public Option

Why We Need a Public Option

As the health reform debate heats up, the public health insurance option is proving to be the main point of contention. The public option proposed by Obama and Democratic leaders would create a Medicare-like program that would guarantee coverage for everyone, regardless of pre-existing conditions. This is significant since nearly 50 percent of African Americans have a chronic disease.

The public option offers an immediate opportunity to reduce health disparities by expanding coverage to everyone who needs it. A study published in the April issue of the Annals of Internal Medicine found that with the “near-universal” coverage provided by Medicare when Americans hit 65, racial differences in blood pressure, glucose and cholesterol levels were significantly reduced. The researchers concluded that expanding coverage could not only improve health outcomes, but help black and Hispanics live just as long as whites.

But if Republicans, the American Medical Association and health insurers have their way, a public insurance option won’t be a part of the much anticipated health reform legislation this fall.

Republican leaders are using scare tactics, arguing that a public plan would limit choice, drive private insurers out of business and leave health decisions in the hands of the government. And the AMA recently announced that it would not support a public option that would mandate physician participation and Medicare-type reimbursement rates. The organization seemed to be backtracking from its opposition, but this is only the beginning of a concerted effort to eliminate the public option from health reform legislation.

The president squarely addressed these concerns during his appearance at the AMA meeting in Chicago on June 15. First, President Obama has expressed a commitment to a deficit neutral plan. The projected cost of a public health option is $1 trillion over the next ten years. In his FY2010 budget, the president set-aside $635 billion as a “down payment” for comprehensive health reform. Subsequently, he has outlined a number of new savings and cost-cutting measures.

With health care spending already out of control, we have to take action. A public option would use the bargaining power of the government to lower costs throughout the system (e.g., drug costs, administrative and hospital fees) and provide incentives for better quality and affordable care.

Private insurance will remain. The public option simply provides Americans with a choice of a government health insurance plan.

Last week the TriCaucus, comprised of members of the Congressional Black, Hispanic and Asian Pacific American caucuses voiced their strong support for the public option. “The public health option has to be there,” Rep. Mike Honda, a California Democrat who chairs the Congressional Asian Pacific American Caucus, said at a news conference. “If we don’t have a public option, there’s no discussion.”

Jointly, the three minority caucuses include 91 members and they’re threatening to flex their legislative muscle to see that a public option makes it out of Congress.

The TriCaucus is planning on introducing the Health Equity and Accountability Act of 2009 (Equity Act) as part of a comprehensive approach to health reform that includes provisions for addressing health disparities. Designed to address some of the root causes of health problems faced by people of color, the Equity Act includes a proposal for a public health insurance option that includes mental health and dental coverage, training minority health professionals and community-based prevention programs for HIV/AIDS, diabetes, obesity and other health conditions that disproportionately affect people of color.

Keep Reading: Pt. 3 Beyond Access: Medical Coverage is Just Part of the Equation

Beyond Access: Medical Coverage is Just Part of the Equation

As the Equity act suggests, access to care won’t fix everything. The landmark Unequal Treatment report from the Institute of Medicine documented that even with comparable insurance coverage, income and education levels, blacks and other people of color receive lower quality care.

From cardiac care to kidney dialysis, minorities receive unequal treatment. National standards for data collection are needed to track and target programs and resources to address these disparities. Comprehensive health reform has to include mandates for improving quality and data collection and reporting on race, ethnicity and gender in the health care system.

Whether intentional or not, provider bias is real. Physicians and health care providers must be prepared to treat a culturally and economically diverse population.

But we also have to take personal responsibility for our health. Lifestyle choices are a critical part of the health equation. Medical care accounts for only 10 to 15 percent of preventable early deaths. Healthy eating, regular physical activity and stress management are essential. Moving from an approach to health that emphasizes sick-care to one that promotes wellness in schools, workplaces and communities will help kids and families stay healthy.

Policies and programs that address the environmental barriers to health are needed. Black and other underserved neighborhoods are less likely to have sidewalks, recreational facilities and green spaces that facilitate physical activity. Supermarkets and other sources of fresh fruits and vegetables are also noticeably absent in many black communities.

White neighborhoods are four times more likely to have a supermarket than black neighborhoods. Yet, the presence of supermarkets in black communities is associated with increased consumption of fruits and vegetables. Without access to healthy foods or neighborhood conditions that facilitate health, communities of color are at a severe disadvantage. Tax credits and other incentives can be used to stimulate investments in supermarkets, parks and further infrastructure development in underserved communities.

For more information about addressing the social determinants of health, visit www.leadershipforhealthycommunities.org the Joint Center’s Place Matters initiative at http://jointcenter.org/hpi/pages/our-purpose.

Keep Reading: Pt. 4: Call to Action: What You Can Do

Call to Action: What You Can Do

Lawmakers need both the support and pressure from the people to make meaningful reform a reality. If we lose this opportunity for real change, it could be another generation before we come this close to reform that could help close the long-standing gaps in health.

As a society, we can no longer sanction a system that limits the provision of health care only to those who can afford it. The moral and financial imperatives are clear.

While some would like to advance the notion of a post-racial America, our health care system provides a frightening wake-up call that we are far from equal treatment. But a public option is a step in the right direction towards improving the health and quality of life of all Americans, regardless of their race, gender or income.

Here are a few things you can do to voice your support:

1. Call, email or fax a letter to your senators and representatives voicing your support for a public health insurance option. Click here for talking points and information on how to contact your Members of Congress.
2. Spread the message to family, friends, and members of your church, sorority, fraternity, and other organizations. Use social networking sites like Twitter, Facebook and personal blogs to get the word out as well.
3. Plan or attend a rally. On June 25th, the Health Care for America Now! coalition is sponsoring a massive health reform rally in Washington, DC. Visit http://healthcare09.org/ for more information.
4. Follow the debate – here are some of the top blogs and resources on health reform:

• Kaiser Health News
• Health Care for America Now! Blog
• New Health Dialogue Blog
• Ezra Klein Washington Post Blog
• Center for Budget and Policy Priorities

Do you have suggestions on great sites for plain talk about health reform? Leave your tips and recommendations in the comment section below.

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Tags: african americans, blacks, health disparities, health reform, insurance, minorities, obama, people of color

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