HEALTH CARE REFORM
OF HEALTH CARE
FOR ETHNIC AMERICANS
AND THE POOR? Vernellia
60 Brooklyn Law Review 167-235 ( 1994).
The current health care system is flawed in a number of ways.
There are significant economic barriers, including no insurance,
no money, co-payments and deductibles. People do not have
universal portable health care coverage. Moreover, even the
massive financing reforms of the Health Security Act that are
aimed at increasing coverage do not automatically translate into
broadened access and improved services. After some years, when
government and private institutions encounter budgetary
stringency, it is likely that they will economize by decertifying
persons and placing limits on benefits(287)
Furthermore, the reformed system lacks adequate infrastructure to
provide culturally competent care. Instead, it perpetuates a
middle-class European American focus for the delivery of health
care. Where services do exist, there is significant fragmentation
with ill-defined or inadequately defined community health or
public health programs. Furthermore, the Act permits different
population groups to receive different health care treatment.
This is due in part to the institutional racism in the system but
also to the insufficient or nonexistent health research data that
is race or culture-specific (including quality assurance or
utilization review data). Given the focus of cost containment on
middle-class health care needs, there exists the potential for
significant health care discrimination. The existing
anti-discrimination laws will not effectively combat this
discrimination. For these reasons, the Health Care Security Act
is only a partial answer and, in many ways, an inadequate answer
to the need for health care reform.
287. FN287. Ginzberg & Ostow, supra
note 158, at 2561. For instance, during shortfalls of Medicaid,
states arbitrarily limited the number of physician visits, days
of hospitalization, and number of prescriptions for which they
provided reimbursement.' Id.