Health Reform – Path to Health Equity
Daniel E. Dawes, J.D. is a health care attorney and consultant in Washington, DC. During health reform negotiations, he worked closely with the White House and Congress, and founded and chaired the National Working Group on Health Disparities and Health Reform – a group comprising over 250 national organizations and coalitions – to ensure that health reform legislation included health equity provisions to reduce disparities in health status and health care among vulnerable populations.
Dr. Martin Luther King, Jr. once observed, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” This statement rings especially true for vulnerable populations in the United States—who, as a group, have long suffered from severe and pervasive disparities in health status and outcomes and faced barriers to quality health care.
For instance, racial and ethnic minorities, people with disabilities, LGBT individuals, women, and older adults suffer disproportionately higher rates of disease, disability and mortality from chronic conditions such as heart disease, stroke, HIV/AIDS, cancer, mental health disorders and substance use, diabetes, respiratory disease and endstage renal disease.
As many of you know, in March 2010, after almost a century of discussions and debate, Congress passed and President Barack Obama signed into law two monumental pieces of legislation – the Patient Protection and Affordable Care Act of 2010 (H.R. 3590) and the Health Care and Education Reconciliation Act of 2010 (H.R. 4872), which collectively make up the health reform law and provide comprehensive reforms to our fragmented healthcare and public health systems. These sweeping changes will over the next several years:
- Expand health insurance coverage for approximately 32 million Americans;
- Transform the focus of care from treating sickness to preventing illness and promoting wellness;
- Strengthen protections for about 57 million people who have a pre-existing condition by prohibiting discrimination based on health status;
- Increase the diversity as well as cultural and linguistic competence of health service providers;
- Improve the quality of care patients receive from health care providers;
- Prioritize the reduction of health disparities in research; and
- Reduce the gap in health status and health care between vulnerable populations and the general population.
For the millions of racial and ethnic minorities, women, children, and people with disabilities who are overly represented among the uninsured and the underinsured, and experiencing the highest unemployment rates in the country – making it harder to obtain employer-sponsored health insurance coverage, health reform should be welcomed news. The fact of the matter is that health reform was an absolute necessity – a national imperative – based on several factors, including the fact that nearly half of the U.S. population lives with at least one chronic condition; disease management accounts for 78% of our national health care spending; and 62% of all personal bankruptcies are related to health care expenses. Fortunately for all of us, a key component of health reform is the goal of achieving health equity, which will increase access, improve health status and quality of care, and help save lives.
Over the next several months, I intend to dispel some of the myths and misconceptions around the health reform law, and inform and empower readers with information about the benefits and opportunities that are available to them. I also intend to address emerging political and policy issues impacting health equity. In my next blog posting, we’ll be going deeper into the health reform law to get a better understanding of how it will be affecting every-day people.