The Legal Case for Alleviating Health Care Disparities

By: Bruce L. Adelson, Esq., CEO Federal Compliance Consulting LLC and former U.S. Department of Justice Senior Attorney

Racial and linguistic health care disparities have been part of America for a long time. We debate, study and discuss the basis for such disparities. Such discussions may now benefit from a directional shift.

The Affordable Care Act’s mandates concerning 30-day readmissions, non-discrimination, data collection and patient–centered, outcome based care inform a reoriented focus. Simply put, known and documented health care disparities based on race, color or language that continue unaddressed and unimproved may violate the powerful injunctions of Title VI of the Civil Rights Act of 1964 against race, color or national origin discrimination. As America prepares for the 50th anniversary of this landmark law, which had a pivotal role in ending racial segregation in the United States, we are reminded of health care differences because of race, skin color, and language.

Indeed, many studies and analyses document health care differences because of how a patient looks or speaks. For example, JAMA in 2011 noted, “Our findings that racial disparities in readmissions are related to both patient race and the site where care is provided should spur clinical leaders and policy makers to find new ways to reduce disparities.” A 2010 University of California School of Public Health study revealed in one example, “The record [in a medical malpractice lawsuit] notes that the orthopedist ‘stated that there was a definite language barrier making communications difficult.’” Source: The High Cost of Language Barriers in Medical Malpractice, 2010.

Analyzing such studies from the perspectives of law and federal compliance begs this question: are these encounters different because of the patient’s race, color, or national origin? If the answer is yes, as the studies conclude, the analyzed disparities will inform unpleasant, expensive consequences for the health care providers involved.

Such disparities ineluctably predict negative patient outcomes – 30-day readmissions resulting in multi-million dollar penalties, poor quality of care provided, and cognizable claims for medical malpractice and federal civil rights violations.

The Affordable Care Act is the new catalyst for re-examining the liability consequences of health care disparities. The 50th anniversary of the Civil Rights Act of 1964 is a clarion call for health care to have a different conversation about remedying differences in care because of skin color and language.

 
Bruce L. Adelson, Esq., CEO
Federal Compliance Consulting LLC and former U.S. Department of Justice Senior Attorney, © Bruce L. Adelson 2014, All Rights Reserved

One Comment

  • Caterina says:

    I agree with the gist of the article, and that is that there exist clear differences in the quality of healthcare both in terms of the patients’ability to make informed decisions as well as institutions’ abilities to communicate necessary and urgent information that typically has a heightened time element to it. Without trained interpreters, institutions will consistently fail to deliver services that would otherwise be delivered with culturally tuned messaging and content delivery.

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