Race and ethnicity in healthcare disparities: reducing gaps and reform impacts

¶ … Race and Ethnicity

Over the last several years, racial and ethnic disparities have been increasingly brought to the forefront when it comes to the delivery of health care services. This is because there are gaps that exist among different segments of the population. A good example of this can be seen with 2005 report by the New England Journal of Medicine. They conducted two different surveys to see if there were differences in coverage and how they were occurring. In the first study, actuaries analyzed data from 1994 to 2002, in relation to patients receiving treatment for heart conditions. What they determined, is that whites were more than likely to be referred to a specialist and will often have access to advanced procedures in comparison with African-Americans. ("Racial and Ethnic Disparities," 2006)

In the second survey, actuaries looked for disparities in Medicare programs. This was accomplished by examining the data from 1992 and 2001. The focus during this part was on the different procedures that were covered. The results were disparities in 5 out of every 9 programs between the different racial groups. These elements are important, because they are highlighting how minorities are receiving worse health care services and coverage in comparison with the general public. To address these issues requires looking at: how these disparities can be reduced, recent efforts that are being implemented to deal with the challenges and how President Obama's health care reform regulations can address these issues. Together, these elements will offer the specific insights about the best ways for tackling these problems. ("Racial and Ethnic Disparities," 2006)

How these Disparities can be reduced?

To deal with the challenges affecting health care services a number of tools must be utilized that will: increase accountability, improve transparency and identify / correct any problems. This means that an all-encompassing approach must be taken that will be focused on several different areas to include: improved partnerships between health plans / employers and greater collaboration with government / nonprofit entities. As far as improved partnerships between health plans and employers is concerned, there is a lack of awareness of the problem. Moreover, these two entities can often be at odds over costs and the kinds of coverage that is available. This will have an adverse impact on employees who will receive less coverage for health care services. In the case of minorities, they could see similar reductions based on sudden changes in their policies. When this happens, it means that the individual will be forced to shoulder more of the responsibility associated with the costs. If there are greater amounts of collaboration, this could let everyone know about the problem and what steps to take in preventing sudden changes in coverage. This will ensure that minorities receive the same kind of services in comparison with other groups of employees. (Higgins, 2009)

Greater cooperation on the governmental and nonprofit levels will help to directly address these issues by creating a workable policy of enforcement. The way that this could occur are the nonprofits can place pressure on the industry by showing how there is a problem that must be addressed. At the same time, they can have discussions with regulators about possible steps to deal with these issues over the long-term. This will create a workable standard that can be used to monitor and enforce issues of equal access to different services. (Higgins, 2009)

The way these strategies will be able to deal with these challenges is by changing the culture inside the industry. This is because nobody is aware of the problem and they are unwilling to discuss what is happening with anyone. Over the course of time, this can make the underlying situation even worse. Once this happens, is when the disparities between the different demographics in the population will become more severe. (Higgins, 2009)

Recent efforts to deal with these Challenges

There have been efforts on the federal and state levels to deal with these challenges. What is happening is the federal government has been leading the way by forcing insurance companies to begin offering coverage to everyone through their employer. In the Patient Care Act, there are different provisions that are specifically designed to address these issues to include: the elimination of select copays / deductibles, the expansion of Medicare, increased coverage for the uninsured, greater choices in selecting providers and minimum standards for all health insurance policies to be established. The combination of these elements is important, because they are showing how the federal government is seeking to address this problem by phasing in various provisions between 2012 and 2014. ("Affordable Care Act," 2010) (Russell, 2009)

On the state level, these issues are being dealt with by taking the federal standards and then customizing them to their own programs. This means that there will be greater flexibility in determining how various services will be provided to residents. In some cases, there will be an expansion of certain programs to help provide better coverage for minorities such as: Medicare. While at other times, this could lead to the establishment of private health exchanges to give consumers greater choices. This is important, in showing how the basic approach that is being utilized is attempting to address disparities in health care services. The problem with this approach is that many provisions are being phased in over the course of time. In the short-term, this is doing very little to address the challenges that are effecting the system. However, in the longer time frames, this could help to deal with these issues by directly going after the costs of coverage. In many ways, one could argue that this is one of the different reasons why minorities do not receive the same kind of treatment in comparison with other segments of the population. ("Affordable Care Act," 2010) (Russell, 2009)

How President Obama's health care reform regulations can address these issues?

President Obama's health care reform plan can be able to address these issues by focusing on the root causes of the problem. What is happening is the current system is splintered between: a combination of private, government and nonprofit programs. The problem is that there is segregation at every level.

For example, if someone is using private insurance, they will more than likely have to pay higher costs in comparison with Medicare or Medicaid. The reason why, is because the government has a lower negotiated rate that they are paying for these services in comparison with private insurance carriers. This is troubling, because it is making the underlying situation worse by having a splintered pricing structure. Moreover, insurance companies will often try to pass on these higher costs to policyholders in the form of: higher premiums, copays and deductibles. (Smith, 2008) ("Affordable Care Act," 2010)

For minorities, this makes their underlying situation worse by having to be selective about what health care services they can use. The reason why is because most individuals will have to go through: a system of referrals to see specialists and have access to the latest treatment options. Given the fact that this group is the least likely to be referred to these kinds of doctors, means that they are effectively being priced out of the health care system. The President's plan is imposing caps on how much of these costs can be passed onto consumers. At the same time, it is making it harder to apply large deductibles / copays. Furthermore, the federal government will be able to control costs through the health exchanges that are being created. The combination of these factors will implement a new system that is integrating all of the different programs together. This will reduce the chances of minorities being priced out of health care services and it will improve their access to the best treatment options. Over the course of time, this will offer a first step in addressing these challenges. (Smith, 2008) ("Affordable Care Act," 2010)