Saturday, September 26, 2009

Race and Healthcare

President Obama resumed his push to overhaul the healthcare system, speaking at the Congressional Black Caucus Foundation’s Annual Phoenix Awards Dinner. He spoke at last year's event as a member and was hailed by caucus chair Rep. Barbara Lee as "our great President" in her introduction to an enthusiastic crowd.

He told the members of the Congressional Black Caucus (CBC) that there comes a time when "the cup of endurance runs over." Obama said the country has been waiting for health reform since the days of President Theodore Roosevelt and Harry Truman. "We must bring about a better healthcare system in this country," he told the audience. "Not in 10 years. Not in five years. Not in one year. This year!"

The President spoke of "affordable choices" to the uninsured but did not mention any plan for a government-run public option. Members of the CBC have said that they will not support a plan that does not include a public option. But the President made a strong case for his plans, borrowing a line from Martin Luther King Jr., saying that health reform called for "the fierce urgency of now."

With 42 members, the CBC counts as its members some of the most powerful leaders on the Hill. Rep. James Clyburn (D-SC) is majority whip, Rep. John Conyers (D-Mich) heads the judiciary panel, and Rep. Charles B. Rangel (D-NY) chairs the House Ways and Means Committee. The President believes that support of the CBC will be crucial to efforts at health reform. And one of the driving factors is the apparent racial inequality of healthcare resources and access.

In a recent Urban Institute study Estimating the Cost of Racial and Ethnic Health Disparities researchers analyze the cost burden associated with excess rates of diseases such as diabetes, hypertension, stroke and renal disease among Hispanics and African Americans relative to non-Hispanic whites. The study predicts that in 2009, "Medicare alone will spend an extra $15.6 billion while private insurers will incur $5.1 billion in additional costs due to elevated rates of chronic illness among African Americans and Hispanics." The researchers also estimate that "over the 10-year period from 2009 through 2018 the total cost of these disparities [will be] approximately $337 billion, including $220 billion for Medicare."

The link between civil rights and health reform is a natural line for many, and the President is showing his usual political acumen in joining the two. However, he is also steering clear of making it a purely racial issue. As a society, many believe that we should be color blind (and judge people based on the content of their character not the color of their skin) so there will be tricky waters to navigate ahead.

The new book Race, Ethnicity, and Language Data: Standardization for Healthcare Quality Improvement (you can read prepublication online here)identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.