Lawmakers Address HHS Report's Lack of Evidence
Feature Story by civilrights.org staff - 2/23/2004
After allegations of the "whitewashing" of disparities in the health care system by the Health and Human Services Department, lawmakers came together in February to learn how health care disparities affect minority communities and to support the Healthcare Equality and Accountability Act.The annual briefing, sponsored by the Racial and Ethnic Health Disparities Coalition (REHDC), focused on controversy surrounding an HHS National Healthcare Disparities Report released in December that did not include information about glaring disparities for minorities in the health care system. Congressional staff from minority caucuses attended the discussion in order to address the information left out of the report.
"It appears that HHS is attempting to portray America's healthcare glass as half-full," said Byron Sogie-Thomas from the National Medical Association. "In our view, to even characterize the glass as half-empty would be an overstatement of the facts. In truth, the glass is unwashed and broken."
The original HHS report -- which helps determine HHS funding priorities -- was congressionally mandated as a follow-up to a 2002 study by the Institute of Medicine (IOM). The IOM study, entitled "Unequal Treatment," exposed serious inequities in the handling of health care for minorities in the United States. Underscoring the IOM findings, an early draft of the HHS report described health inequities as "a national, pervasive problem." The controversy began when the final HHS report released to the public and media had included none of the language that highlighted the IOM conclusions.
An investigation by the Committee on Government Reform's minority staff pointed out that the final HHS report reduced the use of the word "disparity," eliminated the conclusion that health care disparities are national problems, and ignored findings on the social cost of disparities. The Committee concluded that the HHS report focused on successes instead.
In a House Ways and Means Committee hearing in early February, HHS Secretary Tommy Thompson admitted that the final draft was a "mistake" and promised to release the report in its original form.
Research by the Government Reform Committee showed that in the final draft of the HHS report, editors had reworded or eliminated portions of the report in order to create a healthier picture of American communities of color. The edited report limits its acknowledgment of disparities saying, "some socioeconomic, racial, and ethnic disparities exist."
The report goes on to suggest that some minorities are better off than their white counterparts. By highlighting positive information and eliminating dramatic disparities, the Government Reform Committee concluded, the HHS report failed to express the dire inequities suffered by minorities.
In its unedited form, the Healthcare Disparities Report paints a much grimmer picture. For example, the original HHS data reports that African American women and Latinas suffer greater rates of diabetes, high blood pressure, and heart disease than do white women. The study also shows that Native Americans have shorter life expectancies and higher infant mortality rates than do whites. Concluding that minority groups are more likely to report unsatisfactory or negative experiences in the health care system, the report shows that African Americans (23 percent) and Latinos (27 percent) are more likely to say they have difficulty communicating with their health care providers, compared to whites (16.3 percent).
At the Racial and Ethnic Health Disparities Coalition briefing, panelists focused on the difficulties their constituents have when interacting with the medical establishment. They also advocated methods of addressing the gaping inequality in medical care.
"As we wait, people get sicker and people die, and costs are incurred by the entire community," said Brian Smedley, senior program officer at the IOM. "We need comprehensive strategies to address these disparities."
One strategy addressed at the briefing was the "Healthcare Equality and Accountability Act," sponsored by Delegate Donna M. Christensen, D-Virgin Islands. The Act aims to improve minority health and eliminate racial and ethnic disparities in health care by supporting medical institutions that serve minority populations and encouraging diversity in the health care field.
