Monday, December 21, 2009

Elder Care and the LGBT Community.

I've been saying for a while that the fight for patients' rights would best be served by a coalition of those who already do amazing work on behalf of women's, elder, and gay rights - three groups that are predominately discriminated against by the state, the medical industry, and "pro-life" groups (who work to impose religious doctrine on how medical care is delivered).

In my postings here I've been consistently trying to address health care from such a perspective. While I write primarily about end of life care (elder and terminal care) expect to see more women's and LGBT issues here (although I already do cover a bit of the former).

The Center for American Progress today has an extensive article about the gap of coverage and care for LGBT elders. Here's a clip:

Despite this progress, however, members of the LGBT population continue to experience worse health outcomes than their heterosexual counterparts. Due to factors like low rates of health insurance coverage, high rates of stress due to systematic harassment and discrimination, and a lack of cultural competency in the health care system, LGBT people are at a higher risk for cancer, mental illnesses, and other diseases, and are more likely to smoke, drink alcohol, use drugs, and engage in other risky behaviors.

People who are both LGBT and members of a racial or ethnic minority will often face the highest level of health disparities. For example, as the National Coalition for LGBT Health notes, a black gay man faces disparities common to the African-American community as well as those suffered by the LGBT community, and a transgender Spanish-speaking woman, regardless of her sexual orientation, must navigate multiple instances of discrimination based on language, ethnicity, and gender. A companion CAP brief, “How to Close the LGBT Health Disparities Gap: Disparities by Race and Ethnicity,” explores these in more detail.

Health surveys cannot continue to treat populations in isolation: Members of the LGBT community who are members of other populations that are recognized as suffering from health disparities must be allowed to identify themselves fully on surveys, including their sexual orientation and gender identity.

Access to health care and insurance graphs

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Making The Case That Tort Reform is Good for The Medical Industry.

But not for patients. From Insurance.US, a case study of how the tort reform laws have not helped patients in Texas:

It’s a way of life in much of rural Texas, where a shortage of doctors and obstetricians means that residents must often rely on volunteer paramedics during the sometimes-harrowing drive to the hospital. And it doesn’t appear likely to change anytime soon.

Although Texas is being held up as a national example of success in limiting medical malpractice damages — with a 51 percent increase in new doctors and a 27 percent drop in malpractice insurance rates since a law went into effect in 2003 — the impact on consumers has been far less clear.

The number of new doctors in family practice, the area most in demand, has increased by only about 200, about 16 percent, and more than 130 counties still did not have an obstetrician or gynecologist as of October, according to a Star-Telegram analysis of licensing data from the Texas Medical Board.

At the same time, the number of specialists in Texas has increased sharply, with 425 psychiatrists, more than 900 anesthesiologists and five hair transplant physicians among the more than 13,000 new doctors in Texas in the five years after the Legislature’s approval of the liability caps, the analysis found.

More than half the new doctors settled in the state’s largest urban areas, not in rural areas, where the shortage has been most apparent.

Healthcare costs, meanwhile, have continued to rise in Texas. Proponents of malpractice caps predicted that costs would drop along with lawsuits and malpractice insurance rates.

“Consumers are much worse off today,” said Alex Winslow, executive director of Texas Watch, a consumer advocacy group in Austin. “Not only have they not seen the benefits they were promised in healthcare, but now they’ve lost the ability to hold someone accountable. I think that puts patients at greater risk.”

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