As thousands of people gathered in Washington this past weekend to dedicate the Martin Luther King, Jr. National Memorial, I found myself reflecting once again on a statement Dr. King uttered two years before his assassination: "Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
These 16 powerful words have motivated much of my career. As a physician, I have worked to reduce the health care disparities that exist in our society -- that deny many Americans the access and quality of care that would help them lead healthy lives. No question, we have made progress during the past half-century. But I remain extremely troubled by how much distance we have not covered.
Equity in health and health care are singular human rights. The code word for the lack thereof is disparities. We seldom say out loud that it really means what happens when you're not white. And disparities remain because the majority of America too often fails, even today, to regard the vast numbers of our poorest, oldest, sickest non-white people as equal members of our society.
For African Americans, the ramifications are seen in statistic after statistic. They extend from the moment of birth all the way through old age.
Since then, little has changed. This past spring, the federal Department of Health and Human Services announced a plan to reduce health disparities. It acknowledged that African Americans and other racial and ethnic groups still face more barriers in getting preventive care to stay healthy or acute treatment when they fall ill. They also get poorer care in managing chronic disease.
Communities of color continue to be hit harder than their white counterparts in almost every category that contributes to health security -- not only health care but education, employment, income and housing. The impact is persistent and pernicious, and it spans generations.
This is not a natural disparity. This is a national disgrace. And unless we truly narrow the gap, this will become a national disaster. The Census Bureau reports that more than half the nation's working age population will be people of color by 2039. We must make significant strides forward, or the future U.S. workforce will be less healthy and less productive as a consequence.
So how do we turn the tide of health care inequality?
America cannot reconcile the differences that divide us without reconciling the issues embedded so deeply in the health and health care of our people. As Dr. King taught us, "Whatever affects one directly, affects all indirectly."
This, then, is the task before us. Let us draw inspiration from the man we honored this past weekend, who also said, in a speech several months before he was killed, "The arc of the moral universe is long, but it bends toward justice."
Let us transform disparities into equity -- and bend the arc of America's good health toward justice.
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You clearly don't understand what a human-right is.
Because you believe something should be, does not make it a right. Because you believe it's a good idea does not make it a right. Because the world would be a better place were it a reality, does not make it a right.
"Our scientific power has outrun our spiritual power. We have guided missiles and misguided men."
Martin Luther King Jr., Strength to Love, 1963
Though - in this case one misguided woman.
"African Americans are twice as likely to be diagnosed with diabetes compared to whites " Even when you control for income and accesss to insurance this is still the case. Why? Many of us are still eating like our grandparents or great grandparents who often worked very physically depanding jobs (e.,g working the fields). Many of us still eat the same, but sit on our butts much of the day which leads to obesity. Again, this is really our problem.
People are people. They all deserve health care. This is not a racial problem. So, let's omit the irrelevant detail from your most interesting discourse.
If their being "people of color" is not cuasing them to be poor, it's errelivant to the conversation: move on.
protected by Laws and Governments who want to limit Competition.
Break Up the Legal MONOPOLY by limiting liability and providing PA's and RN's to write Prescrip-
tions and do most routine medical examinations. STOP the DUPLICATION of medical Resources
at the City, STATE and FEDERAL levels !
Return the economics of medicine back to the individual, Medicare fails in 2015 without a major
restructuring of Benefits and Cost Reductions !
Risa lives in Dreamland ! Hospitals are closing daily because nobody can pay for them.
Unfortunately, you did not elucidate a real solution to address these issues. I understand why, as it is very difficult to address the root cause in this politically charged climate. Lack of insurance and access to a medical home fosters dependence on ER care. A great short term fix for some, but completely inadequate to address chronic illness.
If the politicians, who have the best health insurance of anyone in the country, could be forced to give up their Cadillac health plan in favor of Medicaid coverage, change would happen a lot faster.
Yes, lifestyle often contributes to poor health. But if you think your suggestions, excellent as they are, are a magical amulet that will give you 100% or even 30% protection against disease, you're as misguided as medievel physicians who breathed through sachets of rosemary for protection from small pox.
Good living improves your chances of avoiding disease by about 20%, more or less, depending on the disease and particular lifestyle choices, and improves your immune system. It isn't a silver bullet.
Many people who exercise regularly, eat well, don't smoke, drink, drug or do anything unhealthy die of cancer, heart disease, and diabetes every day? A 117 pound relative who exercised, complied with a strict and good diet, and never smoked a cigarette had 3 cancers, including lung cancer, and 2 heart attacks. A marathoner dropped dead at 36.
What lifestyle choices cause Alzheimers, birth defects, congenital diseases, glaucoma, schizophrenia, the devasting injuries of automobile and other accidents, MRSA, juvenile leukemia? What will protect you from someone else's tuberculosis or hepatitis?
What lifestyle choices enable you to avoid the hormones and chemicals that permeate our food and environment?
You'd think someone smart enough to enumerate the good lifestyle choices you did would also be smart enough, and decent enough, not to blame the victim or be so judgmental as to suggest that everyone with a disease caused it by his behavior. Patently ridiculous.
We also need to be allowed to BULK BUY medicines within this single payer system. And...we don't need a middle-man insurance system whose only reason to be there is to increase the cost of our care by filling out unnecessary paperwork (ever hear of computer input?) and give the CEO's multi-million dollar bonuses with our money.
With a "cost plus" type of health care system, perhaps the system will also resort to more natural cures and cures emphasizing good diet plans, which will keep the cost of our care down as much as possible.
And yes...the system would be accessible to all of our citizens, because we are all in this together whether we realize it or not.
The next challenge is to bringing healthcare costs down and improving quality. This is not rocket science. Here are some proven methods:
Eliminate obvious waste, including majority from the multitude layers of middle level healthcare management (in hospitals and insurance carriers), consultant s and experts who are not involved in direct patient care.
Implement proven cost-saving techniques like pre-authorizations for outliers, use of second opinions and audits targeted to those who over-utilize healthcare resources.
Disincentives for over-utilization by the patient (paying increasing cost for treatments which provide no or marginal benefit); and reduced or no payment to providers (physicians and hospitals) for unnecessary care.
Revamp accrediting organizations to encourage aggressive evaluation of healthcare providers for quality of care and utilization of resources using proven benchmark standards.
A new direction in medical research and to editors of medical journals to explore de-intensification of treatments and provide Comparative Effectiveness Data. The "more is better" has often been a myth encouraged by increased payment for unnecessary use of marginally beneficial healthcare resources. Intensification of treatment may provide marginal benefit but carries significantly increased side-effects and complications from treatment including treatment-related death; all of which adds to the cost of care.
Incentives to public (NOT providers be they doctors, hospitals, ACOs or insurance carriers like Medicare Advantage) to be savvy consumers of healthcare . This would involve every six month a tax-free refund of their healthcare premiums (up to 30%); based on a point system and certified by their physician (PCP).
a) Non-smoker; having active exercise program; undergoes annual physical examination, screening and vaccination; and BMI index within normal range.
b) Patient will provide and develop their own family and support network for non-medical care.
c) If a chronic illness is present, proper management at the advice of the patient's doctors.
d) If admitted to the hospital, their stay is within the appropriate length of stay for the diagnostic related group of their illness, unless their illness demands their stay in the hospital.
Sad information, but very true.
I don't disagree with you on any of your points. I just think our focus has got to be more overall, less about one segment of the population more than another. I may be living in a fantasy, but I really feel that if we can do this, we can overcome a lot of the roadblocks we constantly witness in all areas of discrimination.