On April 3, Sara Rosenbaum (’76) delivered the 12th annual Haddad Lecture at Massachusetts General Hospital (MGH). Named in honor Ernest M. Haddad, who served for 21 years as general counsel for MGH and Partners HealthCare, the lecture features speakers who are experts on topics related to ethics and conduct in the health care environment.
Rosenbaum, the Harold and Jane Hirsch Professor of Health Law and Policy and Founding Chair of the Department of Health Policy at George Washington University School of Public Health and Health Services, has devoted her professional career to issues of health justice for populations who are medically underserved as a result of race, poverty, disability, or cultural exclusion.
More than one hundred MGH staff members attended the lecture, entitled “Early News from the Front Lines on the Road to Health Equity.” In her remarks, Rosenbaum highlighted some of the challenges faced by regions of the country in which large portions of the population are uninsured. She emphasized the strong links between geography, poverty, and health disparities, and drew direct connections to political decisions about implementation of the Affordable Care Act (ACA) and the consequences for population health equity.
There is no easy answer to the health care crisis and ongoing legal battles in the Supreme Court over the ACA, Rosenbaum noted. “The answer doesn’t lie in what we can do to improve health care. It’s one thing in 1965 to sit around and let states decide who should have health care and quite another in 2014 to offer health care and wait for states to come on board.”
Rosenbaum demonstrated that Americans in the Southern and Mid-western regions of the US are disproportionately affected by poverty. She pointed out that while most Americans born into poverty have approximately a 10% chance to break into the top earning bracket, in these states that average is less than 4%. In addition life expectancy rates across those states are significantly lower for both men and women compared to the rest of Americans.
“Given this health inequity,” said Rosenbaum, “it is discouraging that Southern and Mid-western states have refused to expand Medicaid under provisions of the ACA. Opting out of Medicaid expansions flies in the face of overwhelming evidence that their poor residents—those who would qualify for the new coverage—critically need health services.”
The struggle for equitable health care in these states continues in the court room. “A lawyer’s skills are not unlike a physician’s,” said Rosenbaum, “You’ve got to diagnose a problem and treat it.” She concluded her remarks by pointing out that many of the states enacting restrictive voting laws are among those in this high poverty, poor health region.
According to Haddad, “much has been written and spoken about the regions in the United States where folks experience high levels of poverty or poor health, or opposition to government support of health care or voter suppression. Sara presented powerful hard data in great graphics that demonstrate how closely these geographies overlap.”
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Reported by Sara Womble
Last edited August 8, 2014