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Schnequa N. Diggs

For complete article see: Schnequa N. Diggs , Health Disparities and Health Care Financing: Restructuring the American Health Care System, 38(4) Journal of Health Care Finance 76 (Summer, 2012) (65 Footnotes)


For more than seven decades there has been a systematic disregard for the health needs of certain groups of individuals. Discrepancies in treatment and privilege based on race/ethnicity, gender, sexual orientation, class, and socio-economic status have been significant players in any portrait of American health care and have helped frame considerations of those who deserve and those undeserving of quality health care. Continuous incidences of inequitable health care practices strongly suggest a need for drastic changes in our current health care system. Although growing interest in social inequalities in health preside, health policy makers struggle to find appropriate intervention strategies to alleviate health disparities. The purpose of this article is to depict a clearer portrait of the American health care system within the context of health disparities and recognize intervention strategies to reduce/eliminate health care disparities. This article concludes with suggestions on how to refinance the American health care system based on equality principles. Key words: health disparities, health care spending, health care financing.

Structural racism and institutionalized discrimination continue to deeply entrench American society. This entrenchment has affected the medical profession, medical education system, our health delivery system, and our health policy system. We can no longer afford to neglect undergirding determinants of health disparities. Although some may refuse to acknowledge that race/ethnicity, gender, sexual orientation, class, and socio-economic status are major determinants of health outcomes, the fact remains that caste, race, and class distorted the nation's hospital system from its beginning. If careful consideration for a major health care reform is ignored, health disparities will continue to worsen and strain our current health care financing system.

The intent of this article is to evaluate the intriguing dimensions of health disparities in order to paint a clearer portrait of the American health care system. Delineating health disparities contributes significantly to health policy formulation and implementation; it also creates initiatives specific to reducing the occurrence of health care disparities/inequalities. In addition, transforming our current health care financing structure would result from those initiatives. The goal of national public health research and practice is to provide equal access to health care to build stronger communities.

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