Improving Hispanic Access to Health Care

By Jordan Harp

Although health care reform is not the main issue on most people’s minds today, it is still one of the most important. This is particularly true for Hispanic Americans, who are disproportionately burdened with higher rates of diabetes, asthma, chronic liver disease and cirrhosis, strokes, and HIV/AIDS, among other illnesses. In order to address these disparities and the health needs of America’s fastest growing population, it is necessary to lower health care costs and increase health knowledge and awareness.

The expenditures in the United States on health care are by far the greatest in the world. In 2007, U.S. health care costs grew 6.1 percent, nearly double the rate of inflation, to $2.1 trillion, or 16.2 percent of the GDP. Health care expenditures averaged about $7,500 per person, almost double per capita health care expenditures of the next highest nation, Switzerland.

However, despite these expenses, an estimated 45 million Americans are without health insurance, the highest rate of industrialized countries. With an economy that shows no sign of improvement in the near future, the Obama administration has said that number could top 50 million. While the validity of those numbers is contested, the point still remains that the United States has an inefficient health care system. For the amount we invest in health care, we are not receiving adequate results with regards to health care coverage and education, which results in relatively poor health care indicators like life expectancy.

For Hispanics, affordable health care coverage is an especially important issue. According to the Center for Disease Control and Prevention, the prevalence of almost every disease is higher among Hispanics, yet Hispanics are less likely to be able to obtain medical care when needed: Hispanics under the age of 65 are 21 percent more likely to be uninsured than non-Hispanic whites.

One potential solution to improve health care access for Hispanics, as well as the general public, includes a renewed focus on primary care. Primary care is the first point of contact most people have with the health care system and plays preventative roles in a patients’ health. The scope of primary care is broad, addressing diverse health conditions like depression, urinary tract infections, and care for an aging population with increased incidences of chronic diseases. In a recent column in the Wall Street Journal, Dr. Benjamin Brewer, who has a family practice in Forrest, Illinois, wrote that “countries with better health care systems are all based on primary care.”

Despite its importance, however, the quality of primary care in the U.S. has deteriorated rapidly during the past decade. A 2006 report by the American College of Physicians says primary care is in danger of collapsing due to its dysfunctional financing and delivery system. Furthermore, the number of U.S. medical school graduates entering primary care has decreased by 50 percent from 1997 and 2005 due to relatively low compensation for primary care physicians and reports of job dissatisfaction.

Recommendations to improve the overall quality of primary care include revising Medicare payments to increase compensation for physicians, as well as encouraging the recruitment of nurse practitioners and physician assistants, who have smaller salaries but are still capable of dealing with many basic health conditions. This would help increase the amount of health care professionals in primary care. Having a physician, or another professional, whom people are familiar with and feel comfortable coming to would improve one's comfort with seeing a doctor. Getting primary care physicians in traditionally underserved Hispanic communities would have a positive effect on the overall health of the community.

While these revisions may help improve primary care in general, there will also be a need for complimentary measures specifically aimed at improving primary care for Hispanics. Improving Hispanic access to medical care includes strengthening that community’s relationship with health professionals. This can be achieved by increasing the number of Hispanic physicians by encouraging more Hispanic students to pursue medicine or other health-related professions.

The best way to increase Hispanic recruitment, however, is not by setting quotas at medical schools but through a comprehensive program that targets Latino students at an earlier age. In a recent interview with The Hispanic Community for Policy, Dr. Elena Rios, president and CEO of the National Hispanic Medical Association, outlined what could be done to help recruit minority students. This includes expanding Title VII, which helped recruit minority students into health professions, as well as health career opportunity programs and centers of excellence. In addition, providing Spanish speakers at health care facilities would benefit first generation Hispanics to better navigate the health care system. This can be done through the recruitment of Hispanic medical students, as mentioned above, as well as by providing Spanish-language training to English-speaking physicians and other health professionals.

Furthermore, there is a need for more health education campaigns aimed at Hispanics. There are already a few that are aimed at promoting health awareness among the Hispanic population through the National Alliance for Hispanic Health, including Proyecto Ciencia, Vive tu Vida! Get Up! Get Moving!, and Para un Corazón Saludable… for a healthy heart. Health education, as well as encouraging Hispanics to see a doctor regularly, and when they feel sick, can help prevent the more serious, acute conditions that drive medical care costs up.

Two other methods that can help reduce costs or increase access to care include greater focus on public health programs as well as implementing cost effective research. Public health, which is not the same as medicine, would function primarily as a safety net for the uninsured, many of which are Hispanics. Cost effective research is another method that would allow the effectiveness of treatments for the same disease to be tested, and would hopefully have the effect of lowering costs and therefore increasing access to health care among those who can’t afford it.

The main thing that should be cast away when dealing with health care is singular devotion to one ideology. The purely free market and the single payer proponents simplify a complex issue. Unlike a computer, car, or house, health care is a right. People need health care, they need medicine, and we need to ensure they can access it without going broke.

America may not have the greatest health care system, but it does have the most vibrant research community in the world. Research into medical technology, whether it’s pharmaceutical drug research or new medical devices, are one of the greatest contributors to improving quality of life. They save lives where previously it had been impossible. Those who are reworking the system must ensure the continued vibrancy of this great industry, as it benefits all.

There is no perfect solution to improve the U.S. health care system, but reform is necessary to close the health gap between Hispanics and America’s general population. General reforms of deteriorating areas, such as primary care, and ensuring the continued strength of medical research should, however, be complimented with targeted policies aimed at improving Hispanic health care access and knowledge of health issues. The question now isn’t what should be done, but rather, will lawmakers address these issues and help create a stable, more inclusive health care system?

Jordan Harp is a regular contributor to IDP. Mr. Harp is a Senior at the University of Illinois at Urbana-Champaign majoring in Molecular Biology with a minor in Spanish. He is a premedical student.