VII. Recommendations and Conclusion
U.S. health policy is inconsistent with several provisions of CERD, including virtually all of Articles 2 and 5. Federal agencies have repeatedly found discrimination and bias in health care but have consistently failed to address these problems. Disparities and bias range from treatment and diagnosis to access, funding, training, and representation of racial minorities in the health care system. Millions suffer and thousands lose their lives each year as a result of discrimination in health. Current trends toward managed care only exacerbate disparities. To rectify the situation the CERD Committee should make the following actions:
1. The Committee should clearly define the current situation related to health care for minorities in the United States (the significant disparate impact in the health status of minorities, in access to health care, and in diagnosis and treatment of illness) to be a violation of the International Convention on the Elimination of All Forms of Racial Discrimination, that is, human rights.
2. The Committee should make it clear to the United States that “justifiable” discrimination does not include racial discrimination resulting from policies and practices that limit access and quality of health care received; or racial discrimination resulting from policies and practices that have a disparate impact where there is an alternative that would either not discriminate or have less impact.
3. The Committee should ask the United States to make significant progress, by its next report, in eliminating disparities in health and health care including, but not limited to,
A. increasing the availability of facilities and training of providers in communities of color;
B. adequately funding the Department of Health and Human Services' Office of Civil Rights to enforce civil-rights laws related to non-discrimination in health;
C. designing specific civil right laws, regulations, and policy guidance to address health care discrimination;
D. developing clear standards for culturally competent health care;
E. adequately funding research by minority and women scientists;
F. establishing funding guidelines that promote research on women and minorities;
G. developing policy guidance specifically addressing Title VI compliance in the health care setting (i.e., managed care); and
H. developing specific training related to the use of race and class in research and intervention development.
4. The Committee should ask the United States to develop a unified data-collection system in government programs (medicaid, medicare, and military), which would allow easy determination of facilities, providers, and organizations that discriminate in the diagnosis and treatment of illness.
Medicine has found cures and controls for many afflictions, resulting in the improved health of all Americans — African-Americans, Asian-Americans, Hispanic-Americans, Native-Americans and White Americans. However, the health institutions have failed to extend the same magnitude of improvement in health among White Americans to minority populations. Health institutions have failed to eliminate the inequitable racial distribution of health care. They also perpetuate distinctions among racial groups. The law in the United States has proven ineffective in eliminating racial discrimination in health care. This situation is a violation of basic human rights and is intolerable.