Every Thursday, my daily live radio show (The Harry Jackson Show) focuses on health. During the past year, discussions with health and fitness experts have revealed that there is no easy fix to being healthy. The government can’t legislate it and so it is amazing how much weight has been put into Obamacare as the one-stop-shop for health and wholeness. And the cookie cutter formula is to be inclusive of all people, no matter their health history or ethnic origin. It is no wonder that the initial sign up for Obamacare has been underwhelming.
In particular, few Latinos signed up for health insurance through the Affordable Care Act. Many analysts are asking why this group did not participate in the open enrollment. According to the White House, at least 10.2 million Hispanics in America are currently uninsured, and over 80 percent of these would likely qualify for coverage subsidies. Originally, the White House had hoped six million members of America’s largest ethnic minority would have enrolled by now, but early reports suggest the actual numbers will be much lower.
"The enrollment rate for Hispanic-Americans seems to be very low, and I would be really concerned about that," lamented health policy specialist Mark McClellan of the Brookings Institution. There is has been much speculation about why those numbers are so low. At least one probable factor is the tremendous amount of personal information individuals are required to disclose when they sign up. In addition to worrying about hackers, many Hispanics were also concerned that the information gathered about them might be used to deport relatives who are in the United States illegally.
It is an interesting moment for the President’s appeal among Latinos. Over 70 percent supported him in his reelection bid, and Gallup polls showed 61 percent of Hispanics approved of the ACA as recently as last September. However, support began to drop steadily after the problematic rollout last October. A more recent poll shows the Hispanic community evenly split, with 47 percent approving and 47 percent disapproving.
Many experts also point to multiple problems with the Spanish-language ACA website and the weak outreach efforts to the Latino community. As early as January, the Associated Press reported that CuidadoDeSalud.gov—in addition to launching over two months late—was full of grammatical errors that made the site frustrating and confusing to users. (This led to speculation that the content had been translated by machine.) Furthermore, many of the links directed users to fill out English versions of the enrollment forms, a daunting task for a non-English speaker.
But there may be yet another reason Latinos are not signing up for Obamacare in droves. Study after study confirms what researchers have now dubbed the “Hispanic Paradox.” In short, Hispanic Americans—despite (on average) earning less than whites and being less likely to have health insurance—consistently show better outcomes in various measures of health.
“The Hispanic paradox refers to the surprising finding that despite having a worse risk factor profile, Hispanics and Latinos tend to have better health than non-Hispanic Whites,” explained Dr. John Ruiz, professor at North Texas University. Latinos live longer and are significantly more likely to survive a variety of diseases including cancer, heart disease, HIV infection and diabetes.
No one is quite sure why Latinos have historically enjoyed better health than whites while getting less medical care. Dr. Ruiz speculates that their tendency to have stronger social support networks and closer family relationships helps patients resist disease and lowers mortality risk. Whatever the cause of the Hispanic Paradox, it is not terribly surprising that they were not too eager to sign up for a health insurance program plagued by various problems.
The failure of the ACA to meet the needs of one of the key demographic groups it was created to serve raises questions about the law’s overall purpose. According to the White House website, the ACA is intended to “improve access to affordable health coverage for everyone and protect consumers from abusive insurance company practices.” In the grand scheme of things, however, I think we would all agree that the general idea was to improve Americans’ overall health outcomes.
But the irony of trying get everyone healthcare coverage by law is that the correlation between obtaining healthcare coverage and becoming healthier isn’t as clear cut as we might hope. In 2008, Oregon held a lottery to add 10,000 new people to the Medicaid rolls. This provided a unique opportunity to study the difference in health outcomes for people who weren’t able to obtain Medicaid coverage and those who were.
After two years, the results were disappointing. Ezra Klein of the Washington Post admitted, “The study didn’t see much improvement in the health indicators it was tracking. Blood pressure and cholesterol readings were mostly unchanged. Diagnosis of diabetes went way up, and the use of medicine to control diabetes also went up, but, again, there wasn’t much difference on the relevant blood tests.”
In short, obtaining healthcare coverage, while desirable, doesn’t necessarily have a dramatic impact on health outcomes. Lifestyle choices and family support may be far more important to living longer and healthier lives. Of course we want all Americans to obtain affordable healthcare coverage and have access to quality medical care. But as the weeks and months wear on, it is clear that the ACA is failing to provide either. Join me in letting our government representatives know how we feel. Out voice and vote count!
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