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Bush Administration: Persistent Racial Health Disparities are Just Fine
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The Department of Health and Human Services, under the increasingly wretched Tommy Thompson, has now agreed to release an unedited version of its recent report on disparities in health status and access to health care between ethnic groups. The original report - required by law - included statistics demonstrating such differences; the final report removed some statistics and text noting their existence or importance.

The theme of the original report was that members of minorities “tend to be in poorer health than other Americans” and that “disparities are pervasive in our health care system,” contributing to higher rates of disease and disability.

By contrast, the final report has an upbeat tone, beginning, “The overall health of Americans has improved dramatically over the last century.” . . .

The original version of the report included these statements, which were dropped from the final version:

“We aspire to equality of opportunities for all our citizens. Persistent disparities in health care are inconsistent with our core values.”

“Disparities come at a personal and societal price.”

“Compared with whites, blacks experience longer waits in emergency departments and are more likely to leave without being seen.”

When hospitalized for heart attacks, “Hispanics are less likely to receive optimal care.”

The original report included a stark, prominent statement that “black children have much higher hospitalization rates for asthma than white children.” The final version included the data, without comment.

The report also downplays the differences it does acknowledge:

The final report acknowledges that “some socioeconomic, racial, ethnic and geographic differences exist.” It says, “There is no implication that these differences result in adverse health outcomes or imply moral error or prejudice in any way.”

(Apparently, racial disparities in death and disease rates are not an “adverse health outcome”, and are the result of consistent coincidences involving millions of people generation after generation. Luckily, also, they have no moral significance.)

“African-Americans and Native Americans die younger than any other racial or ethnic group,” [Republican Senate Majority Leader and former surgeon] Dr. [Bill] Frist said. “African-Americans, Native Americans and Hispanic Americans are at least twice as likely to suffer from diabetes and experience serious complications. These gaps are unacceptable.”

He should check with the White House. They’re perfectly acceptable to Bush and Thompson.

Predictably, some conservatives were concerned that actually acknowledging problems was itself a problem.

Dr. Sally L. Satel, a psychiatrist and scholar at the American Enterprise Institute, said that [in] agreeing to issue the original report, “Secretary Thompson succumbed to political pressure that was applied by members of Congress who are identified with ethnic causes.” Critics, she said, have grossly exaggerated the significance of changes in the report.

Among those who wanted to rewrite the report was Arthur J. Lawrence, a deputy assistant secretary of health and human services.

“The present draft remains highly focused on the health care system’s supposed failings and flaws,” Mr. Lawrence said in a memorandum to Mr. Thompson last fall. “In short, the report lacks balance.”

Mr. Lawrence said that geography, income and other factors could be more important than race. For example, he said, whites in rural northern Maine may have worse heart problems than blacks in big cities. In addition, he said, the report should place more emphasis on “personal responsibility for one’s own health status” and on “problems with the medical malpractice system.”

How does a report on racial disparities in the system “lack balance” by focusing on the sytem’s “failings and flaws”? When it fails to blame the victims of the disparities, and to sufficiently limit their opportunity for redress! The report was flawed by not being ideological enough, and not pushing a “tort reform” political agenda! Merely seeing the racial disparities in the system as appropriate content for a report on racial disparities in the system was proof of its bias.

February 22nd, 2004 Health | 3 comments