October 15, 2009
The Honorable Harry Reid
Majority Leader
The Honorable Max Baucus
Chair, Finance
The Honorable Tom Harkin
Chair, Health, Education, Labor & Pensions
The Honorable Christopher Dodd
Chair, Banking, Housing & Urban Affairs
U.S. Senate
Washington, DC 20510
Dear Senators Reid, Baucus, Harkin, and Dodd:
As you and your colleagues continue to work on health reform legislation, the over 250 undersigned coalitions and organizations urge you to ensure that the final legislation includes provisions to address health inequities and to reduce and eliminate health and health care disparities.
A recent report from the Joint Center for Political and Economic Studies found that from 2003 to 2006 the combined cost of health disparities totaled $1.24 trillion in our country. This report also found that in the same time period, eliminating certain health disparities would have reduced direct health care expenditures by $229.4 billion. These potential savings would be realized not only by improving the health of populations and communities that suffer from health disparities and barriers to health care and public health services, but by reducing the costs resulting from the disproportionate burden of disease faced by these populations. As a result, the final health reform legislation must, at a minimum, include:
- Data Collection, Analyses, and Quality to ensure collection and reporting of data on race, ethnicity, gender, disability status, geographic location, socioeconomic status, primary language, sexual orientation, gender identity, and, especially for subpopulation groups, as well as the development of standards for measuring these factors to improve health status and quality in health care.
- Health Care Quality Improvements, including the National Strategy for Quality Improvements in Health Care, Quality Measure Development, Community Health Needs Assessment, and Cultural and Linguistic Competence in health care and public health services by providing grants and demonstration projects to support research and community-based programs designed to reduce health disparities and barriers to health services through education and outreach, health promotion and disease prevention activities, and health literacy and services.
- Health Workforce and Infrastructure Investment to strengthen the recruitment, retention, training, and continuing education of health professionals, and increase their diversity, distribution, cultural competence, and knowledge of treating the unique needs of populations impacted by health disparities.
- Access to Language Services for Limited English Proficient Patients, including funding for these services under federal programs and new coverage programs, training of interpreters, and evaluation of and accountability for provision of these services.
- Prevention and Wellness provisions, including the National Prevention and Health Promotion Strategy and Prevention and Public Health Fund.
We want to underscore that our support for these crucial health equity provisions in no way signals an endorsement for reducing affordability protections in order to reach a specific spending threshold. Nor should providing affordable coverage prevent us from making progress on reducing health disparities. These provisions are critical to efforts to help us succeed in closing the gaps in health status and health care.
Thank you for your ongoing leadership and support of issues impacting populations and communities that continue to suffer grave health and health care disparities. We would also like to thank you for your thoughtful consideration of this request and offer our assistance in addressing this critical issue. Please contact Daniel E. Dawes, J.D., at (202-682-5110 or ddawes@apa.org, if you would like any additional information.
Sincerely,