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Black Patients Still Denied Medical Equality

Posted on: Wednesday, 24 August 2005, 15:00 CDT

HOW MANY disparities can be counted in the U.S. health care system?

There are marked differences in medical care between the insured and the uninsured, between the rich and the poor and between whites and blacks.

Efforts have been made in recent years to eliminate racial gaps in medical treatment.

But new research - showing that blacks are much less likely to undergo common surgical procedures such as appendectomies and heart bypass operations - is yet another indicator that our health care system is failing many Americans.

Despite its reputation, the system is world-class only for certain people - whose comprehensive insurance plan, pocketbook or skin color may open the door to quality care.

Small steps - such as New Jersey's new requirement that all doctors become "culturally competent," meaning sensitive to minority health concerns - will result in some improvement.

New Jersey is the first state in the nation to require such training. Doctors will learn that blacks, for example, have high incidences of asthma and high blood pressure. AIDS and some cancers also affect minorities at greater rates.

But nothing drastic will change until the system itself is overhauled. That means finding a way to guarantee that every American has access to quality medical care - either through a single-payer system, greatly expanded Medicaid coverage or some combination of government and business initiatives that extends good benefits to part-time and low-wage workers.

That's not politically palatable now, with the nation at war and the mushrooming federal deficit. But millions of Americans know from personal experience there's a crisis in access to affordable health care.

In the meantime, we live with a patchwork system that can be incredibly unfair.

In three studies published last week in The New England Journal of Medicine, black patients were found to get fewer treatments for heart disease and diabetes than white patients. This disparity can be a matter of life or death.

The more invasive and expensive the procedure, the greater the unequal treatment. Blacks patients narrowed the gap in treatment with white patients when the solution was a simple prescription or a cheap and easy test.

Emory University researchers, for example, found blacks much less likely than whites to receive invasive treatments for heart disease, such as angioplasties.

The reasons for these racial disparities may include poverty, racism, cultural or biological differences, the refusal of some doctors to accept Medicaid patients, the inadequate rate of Medicaid reimbursement, the high cost of medical care and prescription drugs and a lack of insurance for the working poor.

In general, black Americans do not have the same access as well- off whites to top doctors, hospitals and gold-standard insurance plans. Many white patients don't have that access, either. But even when blacks have the same economic and educational background, they are sometimes treated differently.

That's another reason to keep pressing our representatives in Washington, D.C., to make reforming the nation's health care system a top priority.

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Source: Record, The; Bergen County, N.J.

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