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Friday, February 24, 2006 

Health Insurance Who Needs It?

In 2002 the Institute of Medicine came out with their finding in their landmark study, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, which documented the disparities in treatment of minorities in the American healthcare system. They found:
Racial and ethnic minorities tend to receive a lower quality of healthcare than non-minorities, even when access-related factors, such as patients' insurance status and income, are controlled.

The report found that one of the major factors for the lack of health insurance is due to racial disparities that occur regarding healthcare. These disparities occur in the societal context of broader social and economic inequality and a history of racial and ethnic discrimination.

The state of healthcare in America, the study found that too many Hispanic Americans do not have access to even basic health insurance coverage. According to the U.S. Census Bureau's Income, Poverty, and Health Insurance Coverage in the United States: 2004 [PDF] report, "[t]he uninsured rate in 2004 was 11.3 percent for non-Hispanic whites and 19.7 percent for blacks" compared to the "uninsured rate for Hispanics ... was 32.7 percent."

Interestingly, a study conducted by the Aetna U.S. Healthcare, over half of Americans (55%) believe people of color receive the same quality of medical care as White Americans do and only a third (28%) do believe African Americans, Hispanics, and other minority groups receive a lower quality of care. In the same study, they found:
A substantial majority of White Americans (63%) see no differences in the quality of healthcare, while an almost equally strong majority of African Americans (59%) see lower quality care for people of color. Hispanics are divided on the issue.

According to Aetna U.S. Healthcare, the highest uninsured rate in the United States is among people of Hispanic origin. Over one-third, or 39 percent, of Hispanics were uninsured compared with only 14 percent for non-Hispanic whites. [Aetna U.S. Healthcare, "Concerning the Uninsured Worker: An Introduction to a Critical Issue for All Americans," May 1999]

Although tens of millions of Americans lack health insurance, the issue is the ability keep health care. In most other economically developed countries, governments guarantee health coverage, or require that citizens have it. However, in the U.S., coverage is not stable. It can come and go. This can have devastating clinical and financial consequences for those who find themselves without health insurance, even for relatively short periods. Recently, September 2005, a study conducted The Commonwealth Fund found that the young adults and Hispanics with Medicaid or private insurance, were relatively likely to lose their coverage. And less than half of people who transitioned into and out of low income and were initially uninsured were able to obtain coverage.

In another report by the Commonwealth Fund, when it comes to the workforce, The Commonwealth Fund found that Hispanics lag far behind non-Hispanics in health insurance coverage.
In the job market, Hispanics are at a double disadvantage: they are more likely to be employed in industries and occupations where employer coverage is less likely to be offered and within these industries, Hispanics are less likely than non-Hispanics to be offered coverage. For example, within the construction industry, 64% of non-Hispanic whites are offered and eligible for coverage, compared to 46% of Hispanics. Yet when they are offered health benefits, Hispanics are just as likely as non-Hispanic whites to accept it.

Lower income accounts for some, but not all of the disparity between Hispanic workers and other workers. Among families with incomes of less than $15,000, 45% of Hispanics are uninsured compared with 29% of whites and blacks. Among full-time Hispanic workers, 58% have coverage through their job, compared with 75% of blacks and 80% of whites.

"Even after years in the workforce, many Hispanics in the U.S. remain shut out of employer-based health insurance, because they are working in lower-wage jobs, often in small firms, within industries that either do not offer health benefits at all or that restrict eligibility to certain groups of workers." said Claudia Schur, deputy director of the Project HOPE Center for Health Affairs and lead author of the report. "Policymakers, employers, and health care leaders need to be aware of the complex nature of the issue in order to craft appropriate solutions."

Even worse, when it comes to undocumented workers, they are "twice as likely as U.S.-born Hispanics to be uninsured (49% v. 24%)."

For obvious reasons, not having health insurance can kill. About 18,000 deaths among those 25-64 in 2002 could have been prevented had they had insurance, according to the Institute of Medicine. Even when being uninsured does not result in death, it can have profoundly serious repercussions:In addition to health consequences suffered by uninsured individuals, there are community-wide clinical consequences as well. In 1997, New York experienced a large rubella outbreak, which started in an Hispanic immigrant community where many people had no insurance, and did not receive rubella vaccinations. Subsequently, surrounding communities also became infected.

In recent news, a recent report by Trust for America's Health (TFAH) cited that the hospital system are not prepared to handle the number of patients if a pandemic, in fact, "most states have few plans in place for coping and the federal government has not taken charge of such preparation."

According to TFAH:
While considerable progress has been achieved in improving America's health emergency preparedness, the nation is still not adequately prepared for the range of serious threats we face.

To achieve an appropriate level of preparedness, efforts must be rapidly enhanced and accelerated, requiring improved policies and funding at all levels of government

This is considerably serious among the Hispanic and non-Hispanic uninsured community because in a very recent study by Institute for Health and Aging, it was found that "not only did uninsured persons with chronic health conditions lack adequate health care, their illnesses were also poorly controlled."
Compared with insured respondents, uninsured respondents were much less effective at managing their illnesses. The uninsured had poorly controlled illnesses, frequent health crises, difficulty procuring medication, used medication incorrectly, demonstrated poor understanding of their illness, and displayed little knowledge of self-care measures or risk awareness. They rarely had a regular physician or attended a specific health clinic.

Since studies show that persons who are uninsured seek a doctor until it is too late, then the chances of a serious avian flu outbreak are considerably high. It is critical that these findings be taken seriously because hospitals and other health care providers simply would not be aware or have any knowledge if the Avian flu outbreak were occurring. Considering Dr. David Nabarro -- U.N. coordinator for avian and human influenza -- predicted that the "range of deaths could be anything between 5 and 150 million."

Therefore, this is not just a "Hispanic thing" this is an American issue that should be taken seriously. If the pandemic predictions are correct, there is enough information that shows that the speed of on outbreak will depend on the adequacy of a person's health care. As long as the Hispanic community continues to be highest among those who are uninsured, those numbers will be a reality and deaths of thousands Americans will be on Congress' and Bushes head.


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  • From Tejas, United States
  • Un Xicano who is tired of the current status quo.
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