Health Reform: Race And Representation.

My colleague Sonia Sekhar at the Center for American Progress writes on the Wonk Room about an extremely under-discussed tragedy in American health care:

As Congress argues about health care reform, within sight of the Capitol, African American babies are dying at three times the rate of white babies born in the U.S. Nationwide, African-American women are 35% more likely to die of heart disease than white women, and 28 percent of Latinos report having little or no choice in where to seek care. Only 15 percent of whites report this difficulty.

She then highlights a CAP report on how the current bills in Congress will not only cover a vast number of uninsured people of color, but will begin structuring our health-care system to meet the unique needs of minority communities:

• Provisions that attempt to realign payment incentives so that they are tied closely to outcomes rather than the quantity of services rendered. Shifting to a quality-based payment system will help improve the care that people of color experience.
• Demonstration programs to promote access for Medicare beneficiaries with limited English proficiency by providing reimbursement for culturally and linguistically appropriate services.
• Incentives to encourage a range of needed health professionals to work in primary care settings, in public health services, and in areas of workforce shortage.
• Improved data reporting and collection in an effort to better evaluate programs and develop targeted strategies for addressing racial and ethnic health care disparities.

Although we have a good start at addressing America's “medical apartheid," it's troubling that these issues have not been at the forefront of the reform discourse. The first and most glaring reason for why race has not been discussed is the controversy-mongering and policy-apathetic traditional media, with cable news channels especially muddying debate. Maybe the lack of discussion is yet another casualty of the post-racial America myth. If Sen. Ted Kennedy were a part of the debate this year, he would undoubtedly raised concerns about racial inequities in American health care. But instead, we have a different set of senators guiding the deliberations.The "gang of six" who steered the health reform negotiations for a good part of this year hail from Maine, Iowa, North Dakota, Wyoming, New Mexico, and Montana. The only state in that mix with a significant minority population is New Mexico; none of those states has a large metropolitan city. Deciding legislation with a group of all white senators from some of the whitest states in the union has policy implications. For example, as Sen. Ben Nelson of Nebraska (91.4 percent white) continues to suck all the oxygen out of any substantive debate, expect to continue to hear more about the "unborn" rather than the African American children dying within a few Metro stops away from the Capitol. --Lee Fang