The Chinese curse “May you live in interesting times,” seems to be active today, activating our anxiety. Globally. The news sounds more and more like the most alarming drum roll. In the past few weeks, the world has been gripped by reports of terrorist plots and attacks in the US, in France, in Bangladesh, in Istanbul, in Baghdad, in Munich. Refugees from Syria are drowning by the hundreds as they desperately seek a safe foothold. Everywhere the number of the dead mounts.
When Dr. Joseph Betancourt spoke on “Solutions for Disparities: Delivering Quality Care to Diverse Populations” in Chattanooga TN, he delivered both unusual expertise and a personal model for future healthcare. Dr. Betancourt’s family came from Puerto Rico to NYC and he talked about his childhood as interpreter for his grandparents to their doctors. Today, Dr. Betancourt is Director of the Disparities Solution Center and Senior Scientist at the Institute for Health Policy at Massachusetts General Hospital. With his medical degree, fellowship in Minority Health Policy and Masters from the Harvard School of Public Health, Dr. Betancourt is now a well-respected expert in cross-cultural medicine.
To achieve organizational cultural competence within the health care leadership and workforce, it is important to maximize diversity. This may be accomplished through:
• Establishing programs for minority health care leadership development and strengthening existing programs. The desired result is a core of professionals who may assume influential positions in academia, government, and private industry.
• Hiring and promoting minorities in the health care workforce.
• Involving community representatives in the health care organization’s planning and quality improvement meetings.
California was the first state to pass a law requiring health, dental and specialty insurance companies to provide translators “at least by phone,” ALTA.com reported in January. The bill gave insurance companies until January 1st to make these adjustments. Although this new policy will provide services to fill the diversity needs of people with Low English Proficiency (LEP), some object that insurance companies have found a new justification for outrageous billing prices. Could these cultural brokers be another example of additional costs in the age of diversity?
Providing patient care without regard to race, ethnicity, gender, or religion is a core value of all medical professionals. However, do they extend the same level of tolerance, stand against prejudice, with other members of their profession?
Beginning in colonial America, the myth of the drunken Indian persisted throughout the 19th and early 20th centuries. The current, more “enlightened,” explanation for the high incidence of alcoholism among Native Americans, concludes that since they were exposed to alcohol for only the past few hundred years, they were genetically unprepared and, therefore, have little genetic “immunity.” American Native people, therefore, have little tolerance for alcohol, become intoxicated on small amounts, and, consequently, experience high rates of alcoholism. This belief, like many others concerning Native American culture, adds to the stereotype of genetic inferiority that continues to influence white American thinking.
The nation is crying out for universal health care reform to provide adequate health insurance for the diverse citizens in the nation. Yet, American diversity includes a group of individuals who remain silent as they continue to face limited access to health care because of their limited English proficiency (LEP). A study released by the Kaiser Family Foundation in April, 2008 indicated that during 2004-2006 almost one third of non-elderly Korean Americans in the US do not have health insurance.