What strategies would you suggest?
Dr Daniel Laroche, the President of the Empire State Medical Association shared the following recommendation by e-mail.
Legislation must be enacted to ensure mandatory cultural competency for all physicians and healthcare workers in New York State.
Healthcare workers in New York must be made aware of the terminal effects of prejudice in healthcare on ethnic minority groups in New York State.
David Satcher M.D., the former U.S. Surgeon General, estimates 83,570 annual premature deaths are due to social assumptions, misunderstandings and prejudices in healthcare.
Dr. Nelson Adams, the 111th President of the National Medical Association, states:
"Cultural competency education is urgently needed. Racial inequities in healthcare will never be scientifically justified, politically excusable, or morally acceptable".
The main feature to improving quality would be to ensure financial reimbursement for an effective medical team approach to health care and public health and support for health information technologies (electronic medical records) that make sharing of patient health information more efficient.
Also, quality can be assured when Latinos are provided with appropriate referrals at point of service. Training of direct service providers (medical assistants, case managers, social workers and receptionists) as well as medical providers and allied health professionals on where resources exist for patients inside the health system (translation services, dental, mental health and substance abuse programs) and outside (promotoras, transportation, food stamps, housing, and clothing, domestic violence resources) is essential. Finally, working in private and public partnerships to ensure that care is comprehensive (e.g., cancer control continuum - prevention, detection, diagnosis, treatment and survivorship) and that efforts at improving health behaviors start by supporting community based organization that strive to empower individual's ability to succeed (social determinants of health) - not just trying to change social norms (not cool to smoke).
We presently have a three-tiered system: the poor have Medicaid, some workers have various levels of care and the working poor have nothing. The only way to improve quality for all is to have a single payer similar but an improved form of medicare. Without this, there is no guarantee of quality and those who have access to the best insurance will continue to receive the finest care while all the others will be driven to profit driven HMO's and second class insurance. We must not have an expansion of Medicaid! This is not real quality and most of these patients end up in my ER. Only a single payer with adequate provider compensation and incentives for prevention and quality can improve the quality of care for all. Beware the beast that lurks behind this reform....the insurance companies already have strategies for sucking up more profits from any system that it passed. They have been working on this for a long time. We are kidding ourselves if we truly believe that this process will be truly transparent. There is too much money involved and the vultures have already prepared their plate.
Latinos will be the target population for a second class delivery system. We must speak out now. They can compete for the services but they should not be major players in this reform. I wish that I were wrong on this one but they will make sure that single payer is not an option.
What strategies would you suggest?