As The US emerges from a long recession, managing the growing cost of healthcare remains an ongoing concern. The Affordable Health Act will eventually assure the availability of healthcare insurance coverage to over 30 million more Americans. This landmark legislation will improve access to a previously uninsured or underinsured group of Americans. www.healthozz.com
Health and Healthcare disparities is broadly defined as worse baseline states of health and relatively worse clinical outcomes associated with certain diseases in certain population groups. The affected groups may be distinguished by race, ethnicity, culture, gender, religion and age. The costs to treat the diseases which result from Health and Healthcare disparities represent one of the recognized areas of unnecessary and arguably avoidable healthcare delivery costs. Specifically, in certain instances both prevention and more cost efficient management of chronic disease states can significantly reduce healthcare costs. A chronic disease is defined as a long lasting or recurrent medical condition.
Some common examples include diabetes, hypertension, asthma and cardiovascular disease. Unfortunately, our current healthcare system may be better equipped to manage intermittent and episodic disease occurrences and not the demands of chronic medical conditions In a study published by Weidman et al from The Urban Institute,the authors estimated that in 2009, disparities among African Americans, Hispanics, and non-Hispanic whites will cost the health care system $23.9 billion dollars. Medicare alone will spend an extra $15.6 billion while private insurers will incur $5.1 billion in additional costs due to elevated rates of chronic illness among these groups of Americans. Over the 10-year period from 2009 through 2018, the authors estimated that the total cost of these disparities to be approximately $337 billion, including $220 billion for Medicare.
In the same study, the authors estimated the total healthcare costs secondary to racial and ethnic health disparities in chronic disease treatment (diabetes, hypertension, stroke, renal disease, poor general health) in African Americans and Latino Americans residing in the Commonwealth of Pennsylvania to be $700 million. The Urban Institute. A study entitled The Economic Burden of Health inequalities in the United States by LaVeist et almeasured the economic burden of health disparities in the US using three measures: (1) direct medical costs of health inequalities (2) Indirect costs of health inequalities (3) Costs of premature death Their findings revealed:
The combined costs of health inequalities and premature death in the US among African Americans, Hispanics and Asian Americans were $1.24 trillion
Eliminating health disparities for minorities would have reduced direct medical expenditures by $229.4 billion for the years 2003-2006
Between 2003 and 2006, 30.6% of direct medical expenditures for African Americans, Asians, and Hispanics were excess costs due to health inequalities.
Cultural competence (CC) refers to an ability to interact effectively with people of different cultures. CC comprises four components: (a) Awareness of one’s own cultural worldview, (b) Attitude towards cultural differences, (c) Knowledge of different cultural practices and worldviews, and (d) cross-cultural skills. Developing cultural competence results in an ability to understand, communicate with, and effectively interact with people across cultures. CC has been increasingly recognized as an important, overlooked and underappreciated factor in delivering healthcare to an increasingly diverse America. US census estimations project that by 2050, over 50% of Americans will be non-white. Over 50% of children will be nonwhite by 2025. It seems intuitive to that the interface between patient, healthcare system and healthcare provider is a critical point in the delivery of healthcare. To this end, The Office of Minority Health in the Department of Health and Human Services has issued mandates and recommendations to inform, guide and facilitate the creation of cultural and language appropriate services. (CLAS Culturally and Linguistically Appropriate Services). Implementation of these guidelines within systems and agencies and among individuals can enhance CC and ultimately improve clinical outcomes.. The Center for Health Improvement and Economic Development was one of several parties which advocated for statewide guidelines regarding the cultural competency CME (continuing medical education) requirements for initial licensure and relicensing of physicians in the Commonwealth of Pennsylvania. To accomplish this goal, we set forth to educate and inform the various stakeholders regarding the intrinsic value of CC as a critical determinant of improving healthcare outcomes and a direct result of a utilitarian argument of social justice in the United States. The Center also recognized the importance of making a compelling business case in the current economic climate Partnering with the Gateway Medical Society, the Pennsylvania State Legislative Black Caucus (PSLBC) under the leadership of State Representative Ronald G. Waters and the Center for Health Improvement and Economic Development-a townhall format meeting was organized and planned in Pittsburgh. Local legislators including State Representatives Jake Wheatley, Tom Preston and Daniel Frankel were in attendance.