Moments after House passage of the landmark health care reform bill, Republican National Committee Chair Michael Steele and House Republican Minority Leader John Boehner loudly sounded the war drums. Both pointed out three obvious and ominous facts, the bill passed by the narrowest of narrow margins, and that Americans are as deeply divided as ever on health care reform, or even whether there should be health care reform. The third point both made is the most ominous. They vowed to fight hard to repeal the law. They bank on a swell of public anger to punish the Democrats by plunging their numbers in the House and Senate in the November midterm elections. This political Armageddon scenario would be a disaster for the Democrats. It would be a catastrophe for blacks and Latinos.
Under the reform law, the promise is that more than 30 million uninsured will get coverage. The Commonwealth Fund estimates that blacks and Hispanics make up nearly half of the uninsured. But widely expanded coverage is as yet the promise, and that promise is still, even if the GOP saber rattle against the law turns out to be just so much hot air, years down the line. There's much fine devil in the language of the law that needs to be worked through before that promise is totally fulfilled.
In the meantime, millions of middle-class, and especially poor, minorities, still must watch and wait for coverage to begin. There's no wait on the crisis that many blacks and Latino uninsured face. They are far more likely than the one in four whites, who are uninsured to experience problems getting treatment at a hospital or clinic. This has devastating health and public policy consequences. According to the Joint Center for Political and Economic Studies minority uninsured are far more likely than whites to suffer higher rates of catastrophic illness and disease, and are much less likely to obtain basic drugs, tests, preventive screenings and surgeries. They are more likely to recover slower from illness, and they die much younger.
Studies have found that when blacks and Hispanics do receive treatment, the care they receive is more likely to be substandard than that of whites. Reports indicate that even when blacks and Hispanics are enrolled in high quality health plans, the racial gap in the care and quality of medical treatment still remains low. Private insurers routinely cherry pick the healthiest and most financially secure patients in order to bloat profits and hold down costs. American medical providers spend twice as much per patient than providers in countries with universal health care, and they provide lower quality for the grossly inflated dollars. Patients pay more in higher insurance premiums, co-payments, fees and other hidden health costs. At the same time, government medical insurance programs shell out more than public insurers in other countries with universal health care.
Blacks and Hispanics have far greater incidences of all major medical ailments than whites. Even when they can pay for medical coverage, they can be excluded from coverage if afflicted with these medical maladies. The health care reform law addresses this frontally and forbids private insurers from barring anyone with preexisting conditions. The problem with this is that while the language of the law clearly spells out the prohibition, much depends on how aggressively government agencies monitor and enforce penalties on private insurers who refuse to cover, or find endless dodges and subterfuges to weasel out of covering, those with major illnesses.
The "public option" was, of course, excised from the law. But that was really the only near fail safe government check and balance that might have guaranteed coverage and treatment for the uninsured and those labeled as high risk. The compromise alternative "is that the uninsured can turn to a vague and unproven system of loosely regulated, nonprofit health care co-operatives, and state run exchanges to find the best deal on coverage.
In decades past, the health care industry successfully gutted every proposal for expanded health care. It couched its attack by posing as the noble public-spirited guardian of the nation's health and pocketbook and argued that government intervention in health care was too costly, inefficient and entailed too much heavy-handed government control and interference. That argument didn't totally fly this time around. And we now have the long needed health care reform law. But there's still much to do to put the law fully into play, not to mention overcoming the still formidable political opposition to it. In other words, blacks and Latinos who suffered the greatest and longest from access to affordable quality health care are still not out of the woods yet.
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