Program October 2009 – Disparities in Health Care

October 8, 2009

Disparities in Health Care and the Challenge of Covering Everyone

Speaker: Dr. Will Ross

Health care reform proposals provide the opportunity to address disparities in health care in the United States. This was the message of Will Ross, MD, associate dean for diversity, Washington University School of Medicine, and Amy Smoucha, community organizer, Jobs with Justice, at an informative, well-attended Women’s Voices monthly meeting on October 8. They defined “disparities” as unequal health problems among various populations. For example, Dr. Ross said the infant mortality rate in Clayton is 5.4 per 1,000 live births, while in an area in North St. Louis it is 20 per 1,000.

Some reform proposals would reduce disparities through “medical homes”– centers where people receive coordinated care and holistic treatment that emphasizes prevention, he said. The medical home concept embodies the elements required in a health system that reduces disparities: patient-centered care that is affordable, accessible, culturally sensitive, and contains costs by using treatments proven to be effective.

Because health disparities are caused by many factors (e.g., inadequate housing, poor nutrition), the medical home provides support services such as transportation, Ross explained. The Cleveland and Mayo clinics use the medical home model and have lower costs and improved outcomes, he said.

Amy Smoucha encouraged the audience to continue to contact all of their elected officials to voice support for health care reform–“even those we think support it, because they need reinforcement.” In advocating health reform with officials or others, she advised us to stress that current proposals:

• Continue employer-based coverage.
• Strengthen Medicare and Medicaid.
• Guarantee access to coverage and affordable choices through health insurance exchanges that allow small businesses and individuals not covered by Medicare, Medicaid, the Veterans Administration, or their employer to purchase coverage under fair, consistent rules.

It is not clear whether proposals will include a public insurance option in health exchanges, but, she pointed out, Medicare is a good example of such an option. The Medicare program covers everyone over age 65 and offers all beneficiaries the same benefits, cost controls, and access to providers. The public option would affect only 5 percent of the U.S. population, she noted.