Experts hope Obama will address health disparities

Panelists who took part in a December 2008 webcast hosted by the Kaiser Family Foundation voiced optimism that as president, Barack Obama will work to eliminate ethnic and racial disparities in health care.

"We're in a very good position right now," said Rep. Hilda Solis (D, Calif.), who Obama has nominated for secretary of labor. "Obama has been a long-time supporter of some of these reforms & in particular health care disparities."

Joining Solis on the webcast panel were Peter Bach, MD, former senior adviser for the office of the administrator at the Centers for Medicare & Medicaid Services; and Brian Smedley, PhD, vice president of the Joint Center for Political and Economic Studies, and director of the Center's Health Policy Institute.

The panelists agreed that more emphasis needs to be placed on better data-collection methods for race and ethnicity of patients. Recruiting and training a more diverse pool of physicians and other health care workers also is important, Solis said during the webcast (link).

Panelists were split on how best to attack the disparities problem. Solis and Smedley said that investing in preventive measures and patient education would both help eliminate disparities and reduce preventable illnesses.

Dr. Bach disagreed. He said new funding should instead be spent on helping underserved populations manage chronic illnesses.

Dr. Bach and Smedley said Medicare reimbursement rates also need to be increased for doctors who practice in communities where disparities are most acute.

"[This] is one of the key problems with health care disparities," Smedley said. "Separate and unequal care. We need to correct that. It's absolutely unacceptable, or ought to be unacceptable, in this country."

Solis is the sponsor of the Healthy Places Act of 2007, and expects it to be combined with a Senate version, with the revised bill going before Congress this year.

The measure would require federal agencies to pay for health impact assessments and take other actions to improve the health and environmental quality of communities, particularly those deemed to be most disadvantaged. Solis said the bill also may be folded into a larger health system reform measure.

"[This] could easily complement what bigger package Obama would like to see happen," she said. "It fits in very comfortably. I know that he has a very strong standing on this issue."