Jennifer Haberkorn, Washington Times, August 11, 2009
The U.S. Commission on Civil Rights says some little-noticed provisions in the House health care bill are racially discriminatory, and it intends to ask President Obama and Congress to rewrite sections that factor in race when awarding billions in contracts, scholarships and grants.
In a draft of a letter the commission approved Friday, the group raises constitutional questions about giving preferential treatment to minority students for scholarships, and about favoring medical schools and organizations that have a record of sending graduates to areas with inadequate health care services.
“These programs are unlikely to reduce health care disparities among racial and ethic groups,” according to the draft letter obtained by The Washington Times. “A growing body of evidence indicates that increasing access to high-quality physicians–whatever their racial or ethnic ancestry–is the best way to mitigate such disparities.”
The draft letter also cites testimony from Dr. Amitabh Chandra of Harvard University who said the idea that expanding the number of minority physicians and providing “cultural competence training” will bridge the health status gap is “grounded in hope more than science,” according to the draft language.
It cites research from Dr. Chandra that found that improving the quality of health care in the 500 largest minority serving areas would improve minority health care more than the elimination of racial disparities within every provider in the U.S.
The commission, which has four Republican members appointed by President George W. Bush, as well as two independents and two Democrats appointed by Congress, has come under scrutiny in recent months by liberals who say the group hasn’t done enough for minorities.
The Leadership Council on Civil Rights, a civil rights coalition of nearly 200 national groups, said the commission has become too political and, in this case, is attempting to squash equal-opportunity programs.
The federal government already has policies in place that target physicians to underserved areas, such as the National Health Corps, which forgives medical school debt in exchange for working in those underserved areas.
There are many types of underserved areas, said James D. Reschovsky, a senior researcher at the nonpartisan Center for Studying Health System Change. The definition is largely based on the number of primary care physicians per capita, and includes rural and urban regions.
“If you subsidize peoples’ medical education on the condition that they serve in underserved areas, that should have a beneficial effect,” he said. “I’m assuming that the physicians will still have to get through their medical exams and so on, so it has nothing to do with compromising the quality of care, per se.”
Grants and scholarships would be available from the Department of Health and Human Services to educate minority and underserved populations in public health, dentistry and health specialties, as well as to students who agree to serve in those areas of the country after graduation.