It’s not news that the healthcare situation in the United States has become a huge, seemingly hopeless headache. But Ruben Medina goes so far as to call it a war.
“The healthcare war has four players in it, whose interests aren’t always the same: insurance, hospitals, community providers, and the patient population,” explains Mr. Medina, CEO of Promesa, a New York–based health and human services organization that aids the underserved. In the battle between insurance companies and hospitals, minorities have been caught in the crossfire, he says.
Recent studies confirm Mr. Medina’s assessment. The National Coalition on Health Care predicts that health insurance premiums will increase 20 percent or more for many small businesses in 2002, forcing some to drop coverage altogether. Hispanics own about 1.5 million business in the United States, and most of those fall into the categories most vulnerable to healthcare cost increases – sole proprietorships and firms that employ fewer than five people (see “‘Perfect Storm’ Strikes CEOs,” April 2002).
But the storm will affect more than Hispanic CEOs. A report released in March by the Institute of Medicine, an independent research group that counsels Congress, suggests that minorities receive inferior health care compared to Anglos, even when their insurance coverage and incomes are comparable. Below the coverage line, the uninsured segment of the healthcare market consists predominantly of low-income working families. Eight in ten of the uninsured come from working families but do not obtain coverage in the workplace, according to a Kaiser Family Foundation report.
Without a comprehensive governmental solution to the healthcare crisis, Hispanic hospital administrators have put guerrilla strategies in place to soften its effects and provide basic care. They’re conducting community outreach programs and attempting to engage people in wellness practices rather than treating them only when they get sick. They’re educating CEOs and corporate managers on health insurance alternatives. They’re streamlining their own operations to keep costs low. And they’re recruiting culturally astute colleagues and making sure opportunities exist for Hispanics seeking careers in the health industries.
George Zeppenfeldt-Cestero, president of the Association of Hispanic Healthcare Executives (AHHE), believes a major reason for high healthcare costs is that those who lack both insurance and information on available health resources tend to avoid treatment until health crises demand emergency room treatment. “There are lots of Latinos at a lower level economically who can’t afford health insurance. When their children get sick, they’re going to go to an emergency room because the children don’t have physicians they see on a regular basis,” Mr. Zeppenfeldt-Cestero contends. “That’s one of the contributors to the huge increases in healthcare costs. In this society, we haven’t put much value on the issue of prevention, but we have to make sure that consumers are educated.”
CEOs hold high priority in the AHHE’s education campaign. “The hospital does a lot of work with the chamber of commerce to educate CEOs and business men and women as well as the neighborhood at large,” says Jeannette Marrero, an AHHE member who serves as interim executive director at the University Hospital of Brooklyn. “We talk about healthcare and how they can best access it.”
How can executives fight the healthcare crisis? Industry officials insist that healthcare costs would drop if individuals were encouraged to engage in health-promotion and disease-prevention practices, such as controlling their blood pressure, quitting smoking, losing weight, and exercising. The workplace can play an important role in employees’ adoption of such activities.
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