Health Disparities, Health Care Reform, Morality, and the Law: 'Keep Your Government Hands Off My Medicare (original) (raw)
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There is an inherent tension between cost containment and expansion of coverage for the uninsured. African Americans disproportionately benefit from expanded health care options but they also bear a disproportionate burden in attempts to control costs. This recognition justifies a race-conscious analysis of health policy changes that appear race-neutral on their face.
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People of color and the poor die younger than the White and prosperous. And when they are alive, they are sicker. Health inequity is morally tragic. But it is also economically inefficient, raising the nation’s healthcare bill and lowering productivity. The COVID pandemic only, albeit dramatically, highlights these pre-existing inequities. COVID sufferers of color die at twice the rate of Whites. The cause, in large part, is structural inequality and racism. Neither the popular nor the scholarly discussion of healthcare inequity, while robust, has translated into palpable and rapid progress. This article describes why health inequity has so far proven intractable. In the healthcare system, no one actor has both adequate incentive and adequate wherewithal to create progress. The healthcare system cannot solve the problem alone. To jumpstart reform, the article suggests a new regulatory approach, grounded in principles of democratic experimentalism and cooperative federalism. It draws...
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