Our healthcare system has too many barriers for Black, Indigenous, Latinx, Asian and poor New Yorkers
Health/stethoscope Credit: Image by StockSnap from Pixabay
[Ed. - Dr. Patterson is a member of NYPAN]
I have been a pediatrician for over 50 years, treating mostly working class and working poor Black and Brown families. Starting from my residency at Harlem Hospital in the late 1960s, I realized that the work of a dedicated doctor is more than just treating an earache or diagnosing strep throat. It’s also helping parents navigate our expensive and unnecessarily complicated healthcare system so they can take the best care of their families. It’s helping communities improve their health and the health of future generations. It’s advocating for necessary improvements in the health care facilities that serve them—I worked in one.
A new report released by the Black, Puerto Rican, Hispanic and Asian Legislative Caucus and the Campaign for New York Health, which is fighting for statewide universal health care for all NY residents, reveals how hard that is for communities of color. The report details how Black, Brown, Indigenous and other New Yorkers of color were hit harder by the pandemic due to long-standing inequities in decent health care, housing, food and fulltime jobs, also their lack of employer-paid health insurance resulting in significant medical debt.
Another recent study has reported 8,600 children in New York City lost a parent or caregiver to COVID. One in every 200 children! The brunt of that loss is on the shoulders of Black children who are 3.3 times as likely to have suffered a loss and together with Latinx and Asian children whose loss is almost 3 times greater than that for white children. Do we know what is happening now with those children? Where are they? Who’s providing for them? What’s the quality of their lives?
Quality preventative health care is expensive for families. When kids are sick, seeing the doctor is often a last resort usually because before the age of 10 they are frequently sick and going for care is disruptive to and onerous for the family routine. It wasn’t unusual for families to try home remedies first or ask a neighbor or local healer for advice. It wasn’t unusual for parents to split one prescription for antibiotics between other sick children at home because they couldn’t afford to fill more than one prescription or they’d schedule an appointment for one child but bring in two and ask me to just peek into the other ones’ ears. In our public hospital waiting rooms one could see multiple children waiting with a parent late into the night. They’d be asleep on the cold plastic chairs waiting to be called into an exam room, but perhaps only one of those children was sick and the others had no one to stay with at home when the sick child was brought in for care. Often the emergency room is the ‘go-to’ for minor acute care because it is open after working hours when poor and working class parents can go without losing a day’s pay.
In the early years of my practice, we had more leeway to offer extra care or a ‘free’ consultation to families, but with computerization, the need for underfunded public health facilities to increase revenue added to the overreaching power of insurance companies and their inequitable financial practices that has become impossible.
It’s not computers that are the problem, however, it is the failure of our medical system to put our health and well-being before profits or to ensure all children and adults get the care they need and should have.
If we truly want to build a healthier future for all New Yorkers, we need a healthcare system that puts the humanity of children, families and people first and doesn’t simply reduce them to a billing code. That’s why I am calling on our lawmakers to pass the New York Health Act before the end of the current legislative session in Albany on June 2.
I believe medical care is a human right. A single-payer system that is free at point-of-use will provide medical care to all at a price affordable for all.
It will also be transformative for medical providers and medical institutions that serve working people and the poor.
The New York Health Act would enable healthcare providers to focus more on patient care and education, which is why they became medical workers in the first place, because they won’t have to spend hours each week fighting with insurance companies to cover prescribed care or filling out endless insurance and billing forms.
The New York Health Act would equalize payment for services in all communities. Right now healthcare providers in non-wealthy communities often have to cram 40 or more patient visits in a day because of lower rates of reimbursement for Medicaid, public health insurance, and many HMO option patients. These unsustainable reimbursement rates and workloads lead to provider shortages in many Black, Brown and poor neighborhoods where often, due to this chronic underfunding, the working conditions are difficult and the pay is below par. In recent years, I’ve filled in for an inner-city pediatrician who would see as many as 60 patients in a day in order to meet his office expenses.
Our current system is unjust, unhealthy and unsustainable. Equal access to affordable care is a key part of fighting the racial inequality in our health system. We need our lawmakers in Albany to pass the New York Health Act without delay.
MaryLouise Patterson, MD, MPH lives in Washington Heights. She is a board member of Physicians for a National Health Program, NY Metro Chapter and a recently retired pediatrician.