Obamacare seeks to segregate patients, doctors by race

Katie McHugh Associate Editor
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If you like your doctor, you can keep your doctor under Obamacare — if you both belong to the same race.

Obamacare’s spectacular flop of a rollout distracts from its crude calculus that encourages the allocation of healthcare resources along racial lines and a doctor-patient system splintered into ethnicities.

While the 2010 Patient Protecion and Affordable Care Act’s language on diversity sounds innocuous, a review of the frankly separatist thinking of the law’s ardent supporters indicates Obamacare is aiming for a health care system that puts political correctness above the struggle against illness and death.

A 2009 report by the Center for American Progress (CAP) examining the House and Senate bill eventually signed by President Barack Obama advocates pairing patients and doctors of the same race, a goal toward which the law channels taxpayer dollars.

“Research suggests that health care providers’ diagnostic and treatment decisions, as well as their feelings about patients, are influenced by patients’ race or ethnicity,” the CAP report reads. “Several studies have shown that racial concordance is substantially and positively related to patient satisfaction.”

The key phrase is “race concordance” — a word which means “a state in which things agree and do not conflict with one another.”

“There is… evidence that race concordance — defined as shared racial or ethnic identities between clinicians and patients — is related to patient reports of satisfaction, participatory decision making, timeliness of treatment, and trust in the health system,” the report reads. In other words, fixing the broken U.S. healthcare system means assigning Hispanic doctors to Hispanic patients, African American doctors to African American patients, Creole doctors to Creole patients, and so on.

To accomplish this, the CAP report explains, Obamacare pours taxpayer dollars into affirmative-action candidates whose judgment will lead them to make life-or-death decisions. Ultimately, these taxpayer-funded grants would provide scholarships and loan forgiveness for minorities so they could provide healthcare services exclusively to their own race or ethnicity.

Obamacare, the report reads, “provides scholarships and loan repayment support for individuals from disadvantaged backgrounds serving in the health professions, and it grants funding for the Health Careers Opportunities Program, which supports schools that recruit and train individuals from disadvantaged backgrounds to work in the health professions. The bill also establishes a grant program at HRSA to promote health care professionals’ cultural and linguistic competence.”

A 2010 report [pdf] from Families USA’s Minority Health Initiatives offers similar language. The report applauds the Affordable Care Act for providing health care materials that are “culturally and linguistically appropriate.” Families USA adds, “The legislation also provides grants for training health care providers in culturally appropriate care and services.”

Grants are indeed handed out on a racial or ethnic basis. For example, Subtitle D, Sec. 756 of the Affordable Care Act lists eligibility requirements for mental health grants that demand universities and colleges recruit and “understand the concerns” of minority students, that programs offered to those students must emphasize “cultural or linguistic competency” — and the institutions must provide the HHS Secretary racial data on its student body, under threat of not only losing its grants, but being forced to repay them to the government.

Obamacare also re-authorizes The Office of Minority Health, whose secretary will hand out grants, government contracts and other taxpayer-funded favors to “eliminate racial and ethnic disparities.”

Other sections of the Affordable Care Act also go beyond standard diversity boilerplate to describe a more prescriptive approach to ethnicity in health care. In one section, Obamacare outlines the relationship between HHS and the CDC, awarding grants to healthcare agencies to “promote positive health behaviors and outcomes for populations in medically underserved communities through the use of community health workers.”

The law also includes this line:

“The Secretary shall encourage community health worker programs receiving funding under this section to implement a process or outcome-based payment system that rewards community health center workers for connecting underserved populations with the most appropriate services at the most appropriate time.”

That same section of the law also provide grants to “identify, educate, refer, and enroll underserved populations to appropriate healthcare agencies.”

Despite their invocations of “diversity,” progressives pushing healthcare reform are quick to sow self-enriching discord and allege racism lurking in the hearts of nurses changing bedpans for critically ill patients.

The CAP report blames racism for U.S. healthcare woes — “biases and stereotypes inherent in the healthcare system and in individuals” — and for disparities in healthcare coverage. Only 11 percent of whites are uninsured, while 31 percent of Hispanics, 32 percent of American Indians and 19 of African Americans have no health coverage, which CAP, incredibly, deplores as an active effort meant to harm minorities.

Catchphrases such as “culturally competent care” appear several times in the study and its authors advocate for a means to “tackle bias and stereotyping … in the health professional-patient encounter.” In other words, CAP insinuates that coldhearted doctors deliberately withhold treatment from some patients in a conspiracy that leaves millions suffering.

CAP provides no evidence for its extraordinary presumptions, but proceeds apace with wild conclusions drawn from healthcare data. Again and again, the Center presents a specter of racism haunting the U.S. healthcare system, a “root cause” with deadly results.

“A second analysis… concluded that over 880,000 deaths would have been averted if African American mortality rates been equivalent to that of white Americans during this time period,” reads one typical line of breathless inquiry, turning data on its head and implying America willingly lets its own citizens die.

“Addressing these disparities is also an issue of social justice that can be regarded as a moral imperative,” the report declares. According to CAP and Obamacare, segregation of health services is a step forward, “the right thing to do.”

Throughout the Obamacare process, administration officials have put a strange emphasis on racial and ethnic factors of dubious relation to health care outcomes. On the day the exchanges opened, Secretary of Health and Human Services Kathleen Sebelius boasted the national call center employed translators ready to interpret 150 different languages. Her comment was one of many that seemed aimed at separating Americans into units labeled by skin color, ethnicity and other areas that are unrelated to the goal of helping sick people get better.

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Katie McHugh