Can healthcare be cured of racial bias?

by Rob Cullen on September 1, 2015 - 1:36 PM

Maria Smolnitcaia, 52, is a singer living on a TB ward in Balti, Moldova. Smolnitcaia says "When we take the pills, we feel worse. I'm losing my hearing a little. I feel pain in my bones, in my whole body."

Last month marked the anniversary of the shooting of Michael Brown by a police officer in Ferguson, Missouri, and with it, the birth of the Black Lives Matter movement. Since then, we’ve seen time and again how the conscious and unconscious biases of police officers mean that black Americans are disproportionately targeted and much more likely to be killed or injured by the police.

But interactions with law enforcement aren’t the only time racial stereotyping can lead to injuries or even death for people of color. As this excellent article by April Dembowsky of KQED (in partnership with Kaiser Health News and NPR) illustrates, in medicine too, the unconscious biases of doctors are a major factor in the disparity in treatments and outcomes between white patients and black and Latino patients– a gap that new training programs hope to address.   [click to continue reading…]


first Republican debate 2016

For the most part, in last week’s GOP primary debates there wasn’t much we haven’t already heard about healthcare. Candidates promised to repeal Obamacare, none offered a plan to replace it. They said they would defund Planned Parenthood (and of course none pointed out that the organization isn’t actually selling baby parts). Former Arkansas governor and Fox News host Mike Huckabee repeated Mitt Romney’s wildly misleading claim from the 2012 election that Obamacare robs $700 billion from Medicare. In the undercard debate, Louisiana governor Bobby Jindal cited the same flawed Oregon Medicaid study we’ve covered before.

There were, however, three interesting moments.   [click to continue reading…]


In response to a series of undercover videos taken by anti-abortion activists posing as medical researchers, Republicans in Congress quickly pushed for a vote to strip Planned Parenthood of federal funding. The vote failed in the Senate, but as the Washington Post reports, the fight is far from over:

Defunding Planned Parenthood is now a centerpiece of the Republican agenda going into the summer congressional recess, and some hard-liners have said they are willing to force a government shutdown in October if federal support for the group is not curtailed.

Since clearly the issue isn’t going away anytime soon, here’s a serious question for Congressional Republicans and other anti-abortion activists: what is it from the videos that disturbs you about Planned Parenthood?

Is it the fact that Planned Parenthood is making aborted fetal tissue available to researchers? That’s perfectly legal, thanks to legislation that members of both parties– including some who are now spearheading the movement to defund Planned Parenthood– have supported; and most religious leaders, ethicists, and most of the American public consider it moral, regardless of their stance on abortion. Is it that the organization seems to be selling fetal body parts for a profit? The unedited videos actually show the opposite.

Or is it simply that Planned Parenthood provides abortions? Because, even if you’re opposed to that aspect of their work, the majority of the services they provide– and the only family planning services for which they receive federal funding– are meant to reduce unintended pregnancies that end in abortion.   [click to continue reading…]

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On Obamacare’s fifth anniversary a few months ago, we noted that so far it’s doing exactly what supporters claimed: between 16 and 17 million more Americans now have coverage, spending on healthcare has slowed dramatically, and the quality of care we get seems to be improving.

That said, the Affordable Care Act was never going to solve every problem with our healthcare system. Now that we know the law is here to stay (thanks Supreme Court), it’s past time we look at some of the biggest gaps in our health system post-Obamacare, and how we might fix them.   [click to continue reading…]


trans health now sign

Since the transition of celebrity Caitlyn Jenner, and the popularity of shows like Orange is the New Black and Transparent, transgender people have been much more visible lately. With this new spotlight, we realized that while we’ve covered how the Affordable Care Act affects many other groups who have traditionally had trouble accessing care (for example, women, immigrants, and gay couples before the Supreme Court decision), we’ve never looked at how it affects transgender Americans.

Partly that’s because under the Affordable Care Act, things should be pretty straightforward. Insurers can no longer deny coverage based on gender or pre-existing conditions, and back in May the White House released further guidance clarifying that insurers cannot deny coverage of sex-specific preventive services to transgender people. Yet as a report from the nonprofit news service Kaiser Health News shows, insurance company rules are still preventing some from accessing those services. [click to continue reading…]


cigna gavel

Well this report from The New York Times about a recent wave of mergers among giant insurance insurance companies sure sounds ominous:

The nation’s five largest health insurance companies are circling one another like hungry lions closing in on prey.

On Friday, Aetna said it would acquire its smaller rival Humana to create a company with combined revenues of $115 billion this year. Anthem is stalking Cigna. UnitedHealth Group, now the largest of the five, is looking at its options. At the end of the maneuverings, three national behemoths are likely to emerge.

Senate majority leader Mitch McConnell (who represents Kentucky where Humana is headquartered) was, of course, quick to blame Obamacare, saying, “The many layers of regulation spawned by the law mandate less choice and reward bigger scale over more competition.” McConnell is mostly wrong– new regulations aren’t the thing motivating insurers to consolidate. Insurers, like companies in any industry, have always eyed mergers as a way to increase market share and profits. The timing of the current deals is related to Obamacare though. The law’s coverage expansion has poured a lot of money into the insurance industry, meaning big insurers have a lot of cash available to acquire other companies.

What’s more interesting though, is the underlying assumption that these mergers are bad news everywhere. If health insurance worked like most other industries, that might be true. However– and this is pretty much our mantra on this site– healthcare is weirdly complicated. In certain places, less competition between insurers could actually be good for consumers.   [click to continue reading…]


In a 6-3 decision, the Supreme Court ruled in favor of the government in King v. Burwell, a lawsuit that had threatened to take the Affordable Care Act’s subsidies away from more than 6 million people. Our prediction from yesterday was correct— the court upheld the subsidies, but in a way that limited the power of the executive branch. Here’s a quick breakdown of key points of the decision and what it means going forward.   [click to continue reading…]


[UPDATE 6/25/14: In a 6-3 decision, the Supreme Court has ruled to uphold the subsidies. They went with the second option below.]

With the Supreme Court set to issue a decision tomorrow or Monday in the latest Obamacare case– this one over federal subsidies that help 6.4 million Americans afford coverage— we figured it’s a good time to take another look at what the case is about and all the different ways the court could rule.   [click to continue reading…]

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grocery shopping

If you follow health and wellness news on TV or other websites, this has likely happened to you: you come across a story saying that you should eat more of some food, say chocolate, because a new study shows it may help lower your risk of cancer or heart disease… but you swear that just a few months ago you read another article on a study saying you should avoid that food because it causes those diseases. This new article doesn’t mention that last study, so then you think maybe you’re just misremembering– after all it was a while ago, and there are so many studies about so many ingredients that it can be hard to keep track.

Turns out you probably weren’t wrong after all. Some recent meta studies (studies of studies) show that there’s conflicting research behind most foods we eat, and the media is terrible at helping us make sense of it all.   [click to continue reading…]

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aca application form

This week, the Kaiser Family Foundation answered addressed a grab bag of questions related to insurance coverage of hearing aids, doctors who drop out of a plan mid-year, and what happens if you receive subsidies for exchange coverage but learn later on you were eligible for Medicaid all along. It’s all useful stuff to know, so we thought we’d share it here.   [click to continue reading…]