Summary: The Commonwealth Fund just released an important national and state-by-state review of inequities in health care. The findings are unsurprising and distressing – higher rates of access barriers and mortality from treatable conditions among people of color, and marked variation by state. If only there were a way to pay for health care to efficiently eliminate these inequities…
Achieving Racial and Ethnic Equity in U.S. Health Care: A Scorecard of State Performance, The Commonwealth Fund, November 18, 2021, by David C. Radley, et al
Black and American Indian/Alaska Native (AIAN) people live fewer years, on average, than white people. They are also more likely to die from treatable conditions; more likely to die during or after pregnancy and to suffer serious pregnancy-related complications; and more likely to lose children in infancy.
People’s health also varies markedly across and within states, as does access to health services and overall quality of care. Large racial and ethnic health inequities, driven by factors both inside and outside the health care delivery system, are common.
Issues around cost, affordability, and access to care also contribute to inequities. Black, Latinx/Hispanic, and AIAN populations are less likely to have health insurance, more likely to face cost-related barriers to getting care, and more likely to incur medical debt.
Decades of policy choices made by federal, state, and local leaders have led to structural economic suppression, unequal educational access, and residential segregation, all of which have contributed in their own ways to worse health outcomes for many people of color. The failure to ensure all Americans have reliable health coverage has paved the way to inequitable access to health care.
From Conclusion: Too often in the U.S., race and ethnicity are correlated with access to health care, quality of care, health outcomes, and overall well-being. This is a legacy of structural, institutional, and individual racism that predated the country’s founding and that has persisted to the present day, in large part through federal and state policy. By pursuing new policies that center racial and ethnic equity, expand access to high-quality, affordable care, and bolster the primary care workforce, we as a nation can ensure that the health care system fulfills its mission to serve all Americans.
By Don McCanne, M.D.
Achieving racial and ethnic equity has been a goal for as long as I can remember, and after 80 plus years of my life, one devoted to health care, it still hasn’t been achieved, as this Commonwealth Fund report reveals.
Just think about what one public policy could accomplish: establishing an equitable, single payer, improved Medicare for All program. Yes, there would still be perpetual details to attend to, but just think of the gains we would make by taking that first step, making the rest of the gains semi-automatic once the principle of equity is established. Isn’t now the time to finally make that move?