Healthcare reform good for Hispanics

Medical association leaders: Reform will be good for Hispanics, El Paso, and the border
Elizabeth Ruiz, Newspaper Tree, September 3, 2009

Health care reform is needed for the whole country, but will pay specific dividends for such communities as El Paso, which have high percentages of minority residents with specific health needs and low percentages of people covered by insurance, heads of the nation's three largest medical associations said Wednesday.

Dr. James Rohack, president of the American Medical Association (AMA), Dr. Willarda Edwards, president of the National Medical Association (NMA), and Dr. Elena Rios, president and CEO of the National Hispanic Medical Association (NHMA), were at the University of Texas at El Paso Wednesday for the first portion of a three-day meeting of the American Medical Association’s Commission to End Health Care Disparities and to tour the university's new biomedical research facilities.

The health care reform topic dominated the conversation, with Rios saying: “We want everyone to call your congressman and say ‘Yes, we want health care reform,’ because Hispanics are the largest group in the country proportionally without insurance and we do need affordable universal health care coverage for our communities.”

All three presidents agreed that reform was crucial. Dr. Rohack, the president of the American Medical Association who earned his undergraduate degree in psychology from UTEP in 1976, spoke about his conversations with President Barack Obama, saying that he agreed on the eight principles of health care reform outlined by the president.

The perspective of the AMA has been watched closely by the national media throughout the course of the debate. In June, the New York Times quoted the AMA as saying: “The A.M.A. does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health insurance coverage and lower costs. The introduction of a new public plan threatens to restrict patient choice by driving out private insurers, which currently provide coverage for nearly 70 percent of Americans.” In late July after the group came out in support of the house bill, Rohack was quoted in the U.S. News and World report as calling the health care bill a “starting point.”

At Wednesday’s meeting at UTEP, Rohack reenforced that by saying: "What the AMA is supportive of is to say: 'We need to change the health system.' ”

Rohack described where the AMA disagrees with the president -- lawsuit reform.

"We also believe that we need to get rid of unnecessary costs, and that’s one area where we disagree with the president," Rohack said. "He doesn’t like caps on non-economic damages, we know in Texas, that is helped by having those caps to provide OB care, to provide neurosurgeons, to provide high-risk specialties to come back to Texas to provide care in needed areas. We still are working with the House and the Senate to come out with something that is going to come out with all Americans.”

At the meeting, the presidents described the health issues facing the Hispanic community and the unique challenges.

Rios said: "In the year 2042, one out of four Americans will be Hispanic. A third of Hispanics don’t have insurance. In another 20 years, half the country is going to be without insurance if we don’t have health care reform now. Health care reform is going to bring affordable insurance to our working communities, many of whom are Hispanic and African American. And the disparities in this country will decrease if we have access to doctors and clinics.”

Rohack said that unnecessary costs, including the paperwork burden and the defensive medicine costs, could add up to $1000 each per year. He said that making the system more efficient would make the health care more affordable, regardless of immigration status.

“If we can get rid of that extra costs and make it affordable, so regardless of what status you have, you’ll be able to have that affordable health care coverage that you individually own and won’t have to be job locked as a result of our current problem,” he said.

Rios also offered input on how the undocumented immigrants would be covered after health care reform.

“NHMA is supporting that we lift the 5-year ban for all immigrants that are here lawfully, the five year ban for Medicaid, and as well as the new low income subsidies that are part of health care reform," she said. "We also see the importance of cultural competence and language services that are going to be in this bill. Also, primary care so that we can have more clinics and more primary care physicians helping the uninsured and the new insured that will happen, so I think there’s a lot of spillover affects that will happen in the bill.”

Edwards, who earned a bachelor’s degree in biology from UTEP in 1972, spoke about what she believes is an inclusivity that the proposed reform would promote, including the need to overcome the language barrier.

“It does also address the issue of having more people included in the pipeline: having more people in primary care, being able to have more people provide for services for the community, as well as just the fact that we want to see some cultural competence for all physicians, all health care professionals, so that they can more appropriately address the community linguistically as well, so that they can provide better care and better services," she said. "We’re highly in support of health care reform, and I think it’s key that we talk about legislation being passed now, and then we can improve upon the services that will be provided, but we have to have health care reform passed."

Rios said El Paso and the border stand to benefit from the proposals.

“The health care reform bill is going to transform the border to have more services, more clinics, more doctors, more primary care providers that would go to places that do not have health care services,” she said.

Though Rios said that the public option would greatly benefit communities that have high numbers of uninsured by having insurance companies decrease their costs to match public costs, she said that the community would benefit even if a bill without the public option is passed.

“I think that the rest of the bill that’s there is going to transform the system. It may not transform it as fast, but it will transform the system for prevention and affordable health insurance and having more Hispanic doctors be recruited from our high schools and colleges,” she said.

Rohack said that populations with high numbers of uninsured residents would benefit from reform, regardless of whether or not it will include the public option, so long as it is more affordable.

“El Paso is a great example where the benefit of having affordable quality health insurance will allow people that are Hispanic, especially that are a higher risk of diabetes, to get the prevention so that they don’t end up getting gangrene and having an amputation or end-stage kidney disease and end up going on dialysis,” he said.

Edwards talked about the nature of El Paso as place with both high rates of uninsured and with a high percentage of minorities.

“I think that health care reform is essential for the El Paso community in particular," she said. "This will create the ability for people to access health care coverage that’s much more affordable, much more portable, and then also accessible because we won’t have the preexisting condition issue, which we know that’s very prominent in El Paso because we have a minority community, and we know that there’s health disparities in diabetes, hypertension, cardiovascular disease, HIV/AIDS, infant mortality rate is higher. Health care reform is essential for El Paso.”