We all have read that Hillary Clinton has proposed her health plan. Rave reviews are pouring in. For instance, Time Magazine has observed that Hillary’s health plan is the sort of bill with "a chance to work" and observed that the plan’s elements are "quite astute."
The Clinton campaign is endeavoring to explain to different demographic groups in the United States what precisely they can expect to get out of the plan. This diary represents one in a series of diaries by various Kossacks who support Hillary, such as Alegre, masslib, and campskunk, to explain the implications of the plan for different groups of Americans. The Clinton campaign issued a press release entitled, "Clinton Health Plan Will Provide Quality Health Care and Coverage for Millions of Hispanics." Because of my background in preventive health and in various activities among Latin populations, I thought I might take a crack at this topic.
Sort of simply put, I have a small company that conducts research in health education. We do this research with grants from various institutes within the National Institutes of Health. Though I am of German and Irish ancestry, I have a long history of interaction with Latino populations. I lived and worked in a Mexican orphanage in Tecate when I was young. I also worked with Latino gang youth in east Los Angeles and Latino children in central Los Angeles. I have done training and research for interventions with injected drug users in Puerto Rico, Texas, and California. And I have traveled extensively in Central and South America.
I think it’s important to note several things about Latinos in the United States. The Latino population, at more than 31 million persons, is now the largest minority group in the United States. According to the U.S. Census Bureau, their numbers are expected to reach more than 96 million in the next 50 years. It cannot be said too emphatically that there is immense variability within the Latino population; this variability reflects both country of origin and acculturation status. Some Latino Americans have families that have been here since before the American revolution. Some are arriving only just today. In the United States, two of five Latinos are foreign-born, and many born in the United States still adhere to customs from their ancestral country. But despite their immense diversity, Latinos often encounter similar challenges when they negotiate the dominant culture in the United States and the nation’s health care system. This is why it's important to talk about how Hillary's health care plan might affect this population.
The Clinton campaign observes that among all racial and ethnic groups in the United States, Latinos have the highest rates of the uninsured:
- At least 15.3 million uninsured Latinos lived in the United States.
- About half of foreign-born Latino persons are uninsured.
- Latinos are the least likely demographic population to have employer-sponsored coverage.
- Regular sources of health care have diminished among Latin persons even as they have increased among every other ethnic and racial group.
This injustice, both immense and unfathomable in a country as wealthy as ours, has led to decreased quality of care for Latinos across many areas of health, increased incidence of diabetes, heightened risk for infection with HIV, substantial rates of obesity, low rates of immunization, low rates of doctor visits and prescription-taking, inadequate dental care, and other serious problems. This situation is a moral outrage.
Hillary’s plan will begin to address the situation. It will serve three groups of Latino persons:
- For the millions of Latinos without health insurance, it will provide high quality health care coverage at a cost they can afford.
- For the 17.9 million Latinos with employer-sponsored coverage, the plan will provide increased security, allowing them to pay less and receive higher quality coverage.
- For the 9.6 million Latinos who participate in Medicaid, the plan will fill the gaps that mar the safety net to ensure they receive affordable, quality care.
Hillary’s plan will:
- Make coverage affordable for Latino persons by providing a tax credit. This is notable because Latino household median income at $37,700 is almost 30 percent less than the household medium income of $52,423 for non-Hispanic whites.
- Increase cultural and linguistic competence in the health care system with Federal funding for training of healthcare providers and the development of greater diversity in the workforce "through recruitment initiatives, scholarships and loan-forgiveness programs."
- Support small business through tax credits that expand access to employer health coverage. As Hillary’s campaign observes, 1.6 Latino persons in the United States own small business, and this number between 1997 and 2002 increased by 31 percent, so the proposal has significant import for this demographic group.
- Provide better care for chronically ill persons. As I observed above, the population of Latinos in the United States disproportionately suffer from chronic conditions such as diabetes and HIV disease. Hillary’s plan will fund case coordination and promote research into alternative treatments.
- Expand coverage for dental and mental health care.
And in a proposal near and dear to my heart because of my own interest in issues related to preventive health:
Focus on Prevention – Only half of recommended clinical preventive services are provided to adults and less than half of adults had their doctors provide them advice on weight, nutrition, or exercise. Hispanics are particularly at risk for missing vital preventive care because in general they have less access to insurance and doctors visits.
Hillary’s campaign notes that 31 percent of Latino persons report they do not enjoy routine health care. To describe the import of this finding, the campaign observes, "Hypertension contributes to 35 percent of all heart disease and dramatically increases the risk of stroke, yet only one in three people with this condition know it, despite the availability of simple, proven screening tests. Along with guaranteeing access to insurance throughout the system, the American Health Choices Plan ensures coverage of preventive care services that are proven and effective."
The American Health Choices Plan addresses not just the needs of the broad American populace but also the needs of the many disparate demographic groups that make up this wonderful mosaic that is our country. If you are ready for change in America, Hillary Clinton has the experience to make it so.
Now, just to change the topic a touch, let me invite you all to come over once and a while for discussions about Hillary and her plans for America at Hillary’s Bloggers.