Rogette Harris

Rogette Harris has been following American politics from a young age. As a teenager, she became involved with civil rights issues and became

Oct 16, 2021
Published on: pennlive
1 min read

By Rogette Harris

Many people in the United States do not get the health care services they need and/or deserve, even if they have insurance.

The health care debate in the United States is incomplete. While access to care is essential, the quality of care is just as important. Many Americans have health insurance, but still do not receive the care they deserve. How many people know doctors legally have the right to refuse to treat patients? Only emergency rooms cannot refuse treatment and often, by then, it is too late.

Racial and ethnic disparities in healthcare present considerable moral and ethical dilemmas for the U.S. healthcare system. As a nation, we have an abundance of healthcare facilities, innovative technologies and access to medications. Unfortunately, these are not accessible to everyone. Healthcare can also be connected to social justice issues, opportunity, and quality of life for patients, communities, and the country at large. Inadequate, inaccessible, and/or poor medical care further worsens increasing healthcare costs that have far-reaching consequences for the overall quality of care experienced by all Americans.

Data compiled over the past 40 years undeniably shows the racial disparities of the health care system. The COVID-19 pandemic blew open these gaps for the world to see. For example, infant mortality for Black babies remains nearly 2.5 times higher than for white babies; the life expectancy for Black adults remains approximately one decade fewer years of life compared with whites.

Diabetes rates are more than 30 percent higher among Native Americans and Latinos than among whites. Rates of death attributable to heart disease, stroke, and prostate and breast cancers remain much higher in Black populations, and people of color remain very much under-represented in the health profession’s workforce.

Again, this is a moral and ethical issue. Race must be removed from the equation.

The racial disparities in kidney disease for example are stark and well documented. Black Americans are more than three times as likely as white Americans to experience kidney failure and require dialysis or a kidney transplant but receive subpar care.

Though Black Americans make up around 13 percent of the U.S. population, we represent at least 35 percent of Americans with kidney failure. Almost 100,000 Americans are on a waiting list for a kidney. Out of that number, roughly one-third are Black, about as many as those who are white. That number does not include those who are still trying to make a kidney list.

According to a New York Times article, people of color and low-income Americans are less likely to receive quality care when the warning signs first appear, and chronic kidney disease could be prevented. Black Americans are more likely to progress to kidney failure and to require dialysis, and less likely to be cared for by a kidney specialist before getting to that stage, according to a report by the Centers for Medicare and Medicaid Services. Black Americans also wait longer for an organ and are more likely to be rejected from waiting lists.

Last month, a scientific task force suggested doctors scrap a common measure of kidney function that adjusts results by race, providing different assessments for Black patients than for others. Instead, the task force is advising that doctors should rely on a race-neutral method for diagnosing and managing kidney disease. The task force put this and other recommendations in a report from the National Kidney Foundation and the American Society of Nephrology. The goal of this new report is to exclude racial biases into clinical care, so people are no longer judged based on their race and have their skin color dictate what kidney care they receive.

Regrettably, health care decisions that take race and ethnicity into account is not uncommon or even unique to kidney disease. Algorithms and calculators that doctors rely on to make diagnosis and treatment decisions for many serious and less serious conditions use race as a variable, as outlined in a paper published last year in the New England Journal of Medicine.

Poor quality health services are holding back progress. Although these disparities have always existed, the COVID-19 pandemic has exposed these gaps more openly for all to see. The report, Delivering Quality Health Services – a Global Imperative for Universal Health Coverage -- shows that sickness associated with poor quality health care imposes additional emotional and financial stress on families and health systems.

It is time for truth talk and an honest debate about health care. Regardless of your position on Medicare for All, there cannot be universal health coverage without quality care. Let’s stop rolling the dice with people’s lives. Doctors need to take the Hippocratic oath seriously. Only with improved high-quality and people-centered services to all can we restore trust in health care systems.

Rogette Harris is a Democratic political analyst and a member of PennLive’s Editorial Board.

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