Friday, April 8, 2011

Health, Race & Social Class

Government Plan to Reduce Health Disparities:

From cradle to grave, minority populations tend to suffer poorer health and get poorer health care than white Americans. In a first-of-its-kind report, the government is recommending steps to reduce those disparities.

The plan being released Friday runs the gamut from improving dental care for poor children to tapping “promotoras,” savvy community health workers who can help guide their Spanish-speaking neighbors in seeking treatment.

But it acknowledges that giving everyone an equal shot at living a healthy life depends on far more than what happens inside a doctor’s office — or steps that federal health officials can take.

“It’s also a product of where people live, labor, learn, play and pray,” Dr. Howard Koh, assistant secretary of Health and Human Services, told The Associated Press. “We really need a full commitment from the country to achieve these goals.”

I'm not sure if Dr. Koh has been reading the papers recently, but a sizable fraction of the American electorate today believes the opposite: that government is the problem, not the solution (the lobotomized "Shut 'Er Down!" crowd you see outside the Capitol), and that the poor can basically go away and die in the name of "austerity."

Fiscal conservatives tend to justify these reductions as shared sacrifice. But not all sacrifices are shared equally. Some get a pay freeze. Some get a benefit adjustment. Others get a fever and a small coffin. This is not fiscal prudence. It is the prioritization of the most problematic spending cuts — a disproportionate emphasis on the least justifiable reductions. One can be a budget cutter and still take exception to cuts at the expense of the most vulnerable people on earth.
And that's coming from one of President George W. Bush's former speechwriters.

But despite the Bread and Circuses going on in D.C. today, the HHS plan is really an astonishing acknowledgement on behalf of the federal government concerning the importance of social class, race and health in this country.

Among the HHS plans outlined in Friday’s report:

—Working with states to increase by 10 percent the number of poor children who receive preventive dental care, including cavity-blocking sealants.

—Developing reimbursement incentives to improve the quality of care for minority populations, such as better prevention of heart disease and strokes.

—New studies comparing which treatments work best for diabetes, asthma, arthritis and heart disease in minority populations.

—Creating an online national registry of certified interpreters that doctors or hospitals can use for patients who don’t speak English.

—State grants to measure and improve community asthma care.

And so forth.

Unfortunately, this report is going to gain zero traction since most of the drama in D.C. is on the brain-dead budget standoff. You've got cowering Democrats afraid to propose any sane revenue increases, Republicans wanting to shut down the government over abortion, and Obama standing in the middle saying he's "the mediator" (anyone else suddenly longing for the days of a "decider" as president?).

The faux state and federal "budget crises" are being used as a cudgel against the most vulnerable segments of our society. As I've pointed out repeatedly, there is no "state budget crisis" nor is there an intractable "debt crisis" on the federal level.

These are, instead, fantasies that both the hard left and hard right in this country have cooked up to exact their vision for social engineering, while the great moderate middle stands by with a bemused/shell-shocked look on its face.

And lost in the rhetoric, as usual, are the most vulnerable segments of our society. The HHS plan would lead to increased life chances for the poor which simply don't exist today, but the prevailing mood seems to be "if we wait long enough, maybe all those poor people will just die off and go away."

There's your "austerity" legacy.

1 comment:

Rachel said...

Same for higher ed -- cuts in Pell & HOPE! Ugh!