WASHINGTON – The health care needs of Hispanics, blacks and other minorities are not being addressed in the congressional budget debate, a Johns Hopkins University professor said during a recent conference.
Republican-backed proposals to change the Medicare and Medicaid systems could disproportionately hurt poor, old and disabled people, said Marsha Lillie-Blanton, assistant professor for the Department of Health Policy and Management at Hopkins, and coauthor of a 1995 report on minority health care needs.
“The private market doesn’t have the incentives to take care of people who can’t pay,” Lillie-Blanton said Friday at a gathering of black religious and political leaders.
Federal social programs such as Medicare and Medicaid reduce racial differences in health care among poor people, she said.
Medicare is the federal health insurance program for the elderly. Medicaid is a joint federal-state program providing health insurance for poor children, pregnant women, the disabled and the impoverished elderly.
But with Republican-proposed changes to programs such as Medicare, “some of the very basic philosophies that guided the development of social programs in the ’60s are being challenged,” Lillie-Blanton said.
For this reason, health care decisions should not be left up to the states, such as with Republican-backed block grants for Medicaid, Lillie-Blanton said.
In a move to cut the federal deficit, Republicans want to turn the federal portion of Medicaid into block grants, or discreet amounts of money given to the states to distribute as they wish.
House Speaker Newt Gingrich, R-Ga., and other GOP leaders originally endorsed Medicare reforms that would cut $270 billion from projected spending over seven years. This bill passed the House and was incorporated into the pending balanced budget amendment.
But in a more recent plan, crafted in a compromise with Democrats, Medicare would be cut by $168 billion over seven years. Savings would come mostly from limiting payments to doctors and hospitals.
Allison Griffin, spokeswoman for Rep. Henry Bonilla, R- Texas, a member of the House Appropriations Committee, challenged Lillie-Blanton’s assertions. She said the proposed cuts in Medicare spending would help “all Americans, regardless of their race.”
Medicaid block grants would give the states “more flexibility to spend … money on the people it is supposed to help,” she said.
Hispanics and African Americans, regardless of income or age, go to the doctor less often than whites, according to Lillie-Blanton’s report. In 1987, 39 percent of Hispanics and 36 percent of African Americans did not see a doctor at all, as opposed to 28 percent of whites.
“Some people may look at this and say, `Well, we’re talking about a [small] subset of the population.’ But in our community we’re talking about a third” of African Americans without adequate health care, Lillie-Blanton said, speaking at the Seventh National Policy Institute.
Access to health care can be limited by money, geographic location or a lack of physicians willing to serve in certain communities, Lillie-Blanton said. She said regional differences surfaced in the study. Hispanics are more likely to be uninsured than whites in both the South and the West. -30-