CQ HEALTHBEAT NEWS
June 28, 2007 – 4:50 p.m.
A Breakthrough on Health Disparities Legislation?

The way Virgin Islands Del. Donna M.C. Christensen sees it, lawmakers seeking to end racial and ethnic disparities in health care have just one shot to reach that goal in the 110th Congress — and they’re hoping it isn’t a long shot.

At a press conference to unveil legislation that aims to widen minorities’ access to health care, Christensen said Thursday that, “passing this bill will not be easy and we will have only one bite at the apple.” While advocates of the legislation say they’ve enlisted the support of at least some leading congressional Democrats, much work remains, said Christensen, a Democrat and family physician who heads health policy development at the Congressional Black Caucus.

The House bill would go further than a more modest Senate bill (S 1576), introduced by Massachusetts Democrat Edward M. Kennedy, which would fund grants to increase the number of minority health professionals, conduct research to illuminate disparities, reduce language barriers to appropriate care and fund programs in local communities targeting specific problems, such as high rates of diabetes among Hispanics or high rates of hepatitis B among Asian-Americans.

The House bill includes those provisions, but sponsors say it would go further by ensuring Medicaid coverage for the children of low-income legal immigrants and containing provisions for language services. “This bill is the product of the three minority health caucuses and we’re the ones who really know this issue,” Christensen said. It is “the beginning of real reform that is needed to reduce the 100,000 premature preventable deaths” of African-Americans that occur each year as a result of disparities, she said.

California Democrat Hilda L. Solis, who sponsored the measure, said Thursday that 68 cosponsors have signed on, including House Majority Leader Steny H. Hoyer, D-Md., and House Democratic Whip James E. Clyburn of South Carolina. “This is the first time we’ve seen that kind of support,” she said, adding that she also has a commitment from House Speaker Nancy Pelosi, D-Calif., to move the legislation but not a specific timetable for doing so.

Joining Christensen and Solis at the briefing to urge passage of the House measure instead of the Senate version were the chairmen of the Congressional Hispanic Caucus and the Congressional Asian Pacific American Caucus, Reps. Joe Baca and Michael M. Honda, both California Democrats.

One of the House bill’s major challenges to passage is the cost; sponsors sidestepped that issue saying they haven’t received scoring yet from the Congressional Budget Office. But supporters say Congress can ill afford not to pass the bill. The “investments” must be made “to plan for the changing demographics in this country,” Christensen said.

Solis, a member of the House Energy and Commerce Committee, said she’s trying to get a commitment from panel Chairman John D. Dingell, D-Mich., and the panel’s Health Subcommittee Chairman, Frank Pallone Jr., D-N.J., to hold a September hearing on health care disparities. “We’re going to need everybody to step up to the plate to get our message out,” she exhorted congressional aides and allied health care groups at the press conference.

At the briefing, Honda offered “one stark example” of the stakes involved, in what he called “linguistic isolation.” He recounted a case in which a man who did not speak English went to the hospital to have a leg amputated and was asked by the surgeon whether it was his left or right leg that was to be removed. Not understanding the surgeon’s question, the man just nodded. The surgeon misunderstood the meaning of the nod, Honda said, and removed the wrong leg, which meant, in the end, that both legs were amputated. Honda said that “approximately one-third of Asian-Americans and Pacific Islanders live in linguistic isolation. Funding for language services authorized in this bill would improve equity in our health care system for millions of patients across our nation.” Meanwhile, Baca said 33 percent of Hispanics have trouble understanding and communicating with doctors.

Sponsors said access to care would be improved by training more minority health professionals. “Minority health professionals are more likely to serve minority populations,” Christensen said, and better communication with those patients would lead to more appropriate care and better compliance with health care instructions. She said African-Americans, Hispanic-Americans and American Indians make up about 30 percent of the U.S. population, yet they account for just 9 percent of nurses, 6 percent of doctors, 5 percent of dentists and 2 percent of health care executives.

Source: CQ HealthBeat News
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