Annotations
Racist Health Care:
Reforming an unjust health care system to meet the needs of
African-Americans. 3 HEALTH MATRIX 127 (1993).
In this article, Professor Vernellia Randall points out that
while the present debate on health care reform focuses on the
need to control costs and to improve access, the needs of
minorities, specifically African Americans, are overlooked. Using
statistical evidence, she reveals the disparity in the medical
treatment of European Americans and African Americans. She shows
that despite being in a worse state of health and suffering from
a higher death rate, the African American community receives less
care than the healthier European American community. In
conclusion, Professor Randall proposes several ideas to improve
the present system making it more equitable.
Professor Randall organizes her article into three distinct
parts. Part I reveals and discusses the disparity the health
status of the African American Community and the European
American community. Part II discusses the institutional racism
that exists in the health care system. Part III discusses changes
that will improve the health care system and make it an equal
one.
After reading this article, the reader will be made more aware
of how the element of race affects the access to treatment and
the quality of care received by minorities in general and
specifically the African American community. The article blends a
discussion of the discriminatory issues surrounding health care
and the statistics that prove such practices exist.
Professor Randall gives a convincing presentation about the
presence of racial discrimination in the health care system. She
intertwines strong statistical evidence with her arguments
producing a well-supported position. Then in conclusion, she
proposes suggestion that if applied can solve many of the
problems of today's system. After reading this article, the
reader will have a better understanding of what minorities face,
as well as what it will take to fix the present system.
Addressing Racial Inequalities in
health care: civil rights monitoring and report cards. 23 J.
Health Pol. Pol'y & L. 75 (1998).
In this article, Mr. David Smith describes the discrepancies
that exist between minorities and whites in access to health
care, quality of medical treatment, and insurance coverage.
In addition, Mr. Smith proposes some changes to the proposed
report card approach to monitoring the performance of the
institutions and providers in the system.
First, the article presents a historical account of the Civil
Rights movement in health care. Then, it deals with the current
standing and limitation of the present attempts by Title VI to
control racial discrimination. Finally, it explores ideas that
will strengthen the present system.
Mr. Smith proposes a comparative report card approach that
would compare the treatment of racial categories with each other
to assure they are receiving the same level of treatment. The
implementation of this approach as proposed by Mr. Smith would
improve the health care system in three areas.
Mr. Smith provides an excellent presentation of his ideas and
improvements for the present system. His organization is superb
as he begins with the history to show that progress that has been
made and concluding by showing where progress needs to and must
continue.
Racist Health Care? 48
Fla. L. Rev. 357 (1996).
In this essay, Ms. Barbara Noah presents evidence that the
race of an individual can adversely affect access to health care
and the quality of care that individual may receive. She further
reveals that while this discrimination is not in an overt form,
this discrimination still poses a serious problem.
Ms. Noah breaks her essay into three parts. Part I address the
use of Medicare services and how discrimination continues even
where care is supposed to be provided. Part II addresses the
discriminatory treatment of recipients for transplants. Part III
addressees the lack of minority representation in the area of
medical research.
The essay presents data that suggests that African Americans
receive a lower quality of care. Examples include the study that
show that minorities, especially African Americans, wait longer
to obtain a kidney or some other organ transplant. Other examples
include the statistics that show that new drug trials and other
types of biomedical research frequently fail to include subjects
from minority groups and communities. Ms. Noah maintains that the
health of theses groups cannot be improved if they are not
included in the search for treatment and cures.
This essay provides the reader with insight into the treatment
of minorities at every level in the health care system. Ms. Noah
employs a great degree of skill in making it clear that
minorities are not receiving the same access to health care from
the beginning stages of research to the actual treatment of
illness.
Title VI Challenges by private
parties to the location of health care facilities: towards a just
and effective end. 37 B.C. L. Rev. 517 (1996). Total pages
read:16
In this article, Daniel Hampton insists that health care
facilities in areas inaccessible to minority communities
discriminate against those communities. He suggests that Title VI
can be used an effective challenge to this subtle form of
discrimination.
This article addresses three different points. First, it
presents a general discussion of the background of Title VI.
Second, it presents the history and current state of the law in
Title VI actions as it relates to the specific issue of
the discriminatory location of health care facilities. Finally,
it presents Mr. Hampton's idea that the burden on plaintiffs in
Title VI actions regarding the discriminatory location of health
care facilities should be decreased.
Mr. Hampton employs the use of statistics to show that
minorities have grater health needs than do whites. Yet, the
minority communities are unable to get the necessary treatment
because there are few or no facilities to provide treatment in
their immediate area. Facilities are unwilling to relocate and
providers are unwilling to build in these areas producing a
discriminatory result. Mr. Hampton maintains that present Title
VI actions are not successful. His proposed suggestion is that
the courts need to lower the burden placed on the plaintiffs in
these cases.
This article presents a different approach to the fight
against discrimination in the area of access to health care. it
does an excellent job of revealing the types of discrimination
that exists and how this adversely affects minority communities.
However, this article goes farther as it proposes a possible
legal solution to the present problem. These ideas can be argued
in front of a court in an attempt to protect minority communities
from being denied access to the health acre they so desperately
need. But in the end, the decision rests with the courts that
must recognize the subtle discrimination and end it.
Symposium: Breaking the
barriers of access to health care: A discussion of the role of
civil rights litigation and the relationship between burdens of
proof and the experience of denial. 60 Brook. L. Rev. 517
(1996)
In this article, Ms. Marianne Englmeann Lado shows that the
health acre system in America is multi-tiered. The greatest and
best benefits of medical care are reserved for selected segments
of society. She further states that the courts as well as society
in general are in a state of denial about the discrimination that
exists in the health care system. This denial prevents a solution
or any improvement of the problem. Half the battle of defeating a
problem is admitting you have one.
The article addresses several points. First, it focuses on the
need to ensure that barriers to health care for minorities will
be removed. Then it discusses the role of civil rights litigation
in addressing these barriers to health care for minorities.
Finally, it addresses the denial of discrimination by courts and
society in general as a barrier to the solution of the
problems.
This article presents a unique view of the debate by
presenting that the courts and society are in a state of denial
concerning this issue. The article also points to despite all the
efforts by admirable people things have actually gotten worse.
Ms. Lado is firm in her statement that it is difficult to fight a
problem when people will not admit it exists. This article is a
noble effort to open the reader's eyes to the problems that do
exist. Ms. Lado also includes excellent real life accounts and
examples of discrimination faced by minority individuals in these
situations. The article is a skillful presentation.
Civil Rights in a changing
health care system. 18 Health Affairs 16 (1997).
The authors of this article emphasizes that the adoption and
implementation of a new health care system will not be helpful to
minority communities if the same policies of discrimination based
on race and national origin continue. They show that even managed
care providers may perpetuate past discriminatory
practices in new ways. They voice concern and show how the repeat
of present discrimination can be avoided.
The article is constructed in an organized fashion. Part I
deals with an overview of Title VI of the Civil Rights Act. Part
II and Part II examine past health care institutional practices
that have been identified as discriminatory under fee for service
system and consider the counterparts in managed care.
This article presents a strong warning that a change in the
system is no good if the same attitude and practices are employed
in that new system. This presentation makes it clear that a mere
change in the system is not enough., More safe guards to protect
minorities must be developed. The excellent use of statistics by
the authors of this article present a firm foundation to the
assertion that the present system is bad and the next one will be
too if challenges are not made. The proposal of presented by the
authors should be given consideration as potential improvements.
Health Care in the Inner City:
Asking the right question. 71 N.C. L. Rev.
(1993).
In this article, Professor Sidney Watson reveals the mistakes
made by the health care reformers. Professor Watson maintains
that while the questions being asked are how do we lower costs
and how do we pay for the high costs, the question should be how
do we improve the health of Americans. The article shows that
while African Americans are suffering from poor health the
facilities closed served twice as many African American patients
as this did that stayed open. Professor Watson that while an
increase in health care access will help the African American
community, other socio-economic strategies need to be employed to
be sure that the African American community is improved.
The article addresses four areas. Part I presents the problem
of race and health care. Part II deals with health care
financing. Part III suggest ideas to enable the inner city
community to attract health care providers. Part IV addresses the
enforcement of civil rights to battle lingering
discrimination.
This article does a marvelous job in drawing the attention of
the reader from the misguided questions being asked by many in
the health care debate to the truly important ones that must be
answered. A superb demonstration of how the present
discriminatory practices will be carried over to the next system
whatever it may be is presented. The article does an excellent
job of intertwining statistics with examples of the present
situation to unveil a discriminatory system. In addition, a fine
presentation of alternatives to the system is made.
Race, ethnicity, and Hospital
Care: The need for racial and ethnic data. 30 HOSPLW 125
(1997)
In this article, Professor Sidney Watson shows that while
reported disparities in access and treatment between minorities
and whites are striking, insufficient evidence exists to conclude
the scope and role each factor plays. Professor Watson states
that this problem exists because little is known about what
occurs in individual hospitals. Waston urges that individual
hospitals need to learn more about how they can improve their
treatment of minority patients. He insists they can do this by
collecting and compiling race and ethnicity. While they do not do
it now, it is never too late to start.
The article is divided into three parts. Part I presents an
overview of recent studies that document the fact that racial and
ethnic minorities receive less medical attention than similarly
situated white Americans. Part II explains when racial and ethnic
disparities in hospital access and treatment may be actionable
under Title VI of the 1964 civil Rights Act. Part III defines the
data needed to reveal the present problem.
This article does a noteworthy job of presenting major
mistakes with the way data is collected and used in the present
system. The article present excellent ideas on how to solve the
problem.
Effects of discrimination and racism
on health care. 266 JAMA 2674 (1991).
In this article, Lois Sullivan declares that racism does limit
the access of minorities to health care. Secretary Sullivan
states that because minorities are often eliminated from access
that our country denies access to health care to millions of
Americans. He also maintains that our country can overcome racism
by their formation of a culture with mutual respect and personal
responsibility for each other.
The article address several issues in an organized fashion.
First, it addresses the disparities in the present system. It
discusses the discrimination that occurs in the research lab and
follows that discrimination all the way to the actual health care
setting of treatment. Then, it suggests ideas for overcoming
racism. It maintains that all Americans must have access to
affordable and quality care.
This article presents an excellent array of statistics that
show the troubling state of today's health care system. The
article also contains a noble presentation of how to improve the
system and what steps need to be taken.
How white and African Americans
view their health and social problems: Different experiences
different expectations. 273 JAMA 341 (1995).
This article reveals that despite all the increases in social
programs and expenditures, racial disparities persist in many
aspects of American society. The authors maintain that the health
of our nation's population differs greatly by race. they show
that part of this poor health is directly related to the lack of
access for minority communities. In support, they produce
numerous studies that show that African Americans are more likely
to receive less access to health care. This is also reflected in
the lower assessment given the health care system by the African
American community than that given by the European American
community.
The article addresses health and health care related financial
problems. Included in these are current and future concerns about
paying for the basic necessities of life, the impact of public
safety sector safety net and problems related to employment,
education, discrimination. The article also includes perceptions
of how well US health and social institutions address the problem
minority Americans face. They than address what should be done to
reduce disparities in the future.
This study is an excellent source for the reader who is
interested in obtaining statistics that show the existence of
discrimination ion the health care system. This study highlights
many aspects of tat discrimination. The importance of correct
data is underscored as well it should be. The author gives an
excellent presentation.
Race income factors in access to
health care. 48 AMEDNEWS 10 (1995)
This article presents a study done by whom for what purpose.
This article states that even in Medicare where virtually
everyone is covered race and income are still barriers to care.
The study further points to the finding that there is a lower use
of physician services and emergency department among blacks than
low-income whites. The article and study address the causes of
the differences in the treatment of the different races.
The article relating the findings of the study is divided into
several parts. Part I presents the difficulties present in trying
to measure the access people have to medical treatment. While
most data includes race, it does not include income. This lack of
information makes access difficult to monitor. Part II addresses
the cause of the discrepancies. This article states they are lack
of providers, lack of knowledge, cultural barriers, and provider
bias. These are explained briefly in the article.
This article presents excellent insight into the differing
views of the white and African American on the health care
system. It does an excellent job in unveiling the different
perceptions of Americans and why those different perceptions
exist. It does a noble job in trying to alert physicians to the
actions they commit that can be perceived by the public as
discriminatory.
Black-white disparities in health
care. 263 JAMA 2344 (1996).
This article is based on the council on Ethical and Judicial
Affairs of the American Medical Association. The report reveals
that recent studies have suggested that even when blacks gain
access to the health acre system, they are less likely than
whites to receive certain surgical or other therapies. The
studies have dealt with several areas ranging from kidney
transplants to obstetrics.
The article is divided into three parts. Part I presents
evidence of disparities in medical treatment. Part II discusses
the reasons for racial disparities. Part III addresses the
significance of the disparities and what the response should be
to resolve these discrepancies.
The report emphasizes the need for grater access to necessary
health care for black Americans, greater awareness among
physicians of existing and potential disparities in treatment and
the continued development of practice parameters including
criteria that would preclude or diminish racial disparities in
health care decisions.
This report produces suggestions full of insight that can
resolve the problems in the present system. The report emphasizes
the need of physicians to be aware of their practices. This
emphasis on subconscious racism helps draw attention to the
problem from a totally different angle, an angle that could help
solve the problem. |
