by Juliana Birnbaum Fox
According to a report released last Thursday by statewide coalition of more than 30 organizations, a majority of the newly insured under the health reform proposals being debated in Sacramento would be immigrants and people of color. Entitled “Health Care Reform Proposals Hold Promise for Diverse Communities: Getting California Ready,” the report analyzed the impact of proposed health care reform on immigrants, communities of color, and the poor.
“The data clearly show that health care reform proposals being discussed by Governor Schwarzenegger and state legislators will have a very direct effect on communities of color in California,” said Ninez Ponce, PhD, co-author of the report. “Our data indicate that an additional 2.5 million people of color would be insured, which is a positive step forward.”
According to the study, approximately fifty percent of the newly insured would have limited English proficiency.
At a press conference discussing the issue, experts on the proposed reform advised lawmakers to include increased training and resources for healthcare providers to ensure that they were ready to accommodate the diverse languages and cultures of these new patients.
Currently, there are three proposals being discussed by lawmakers, and only one of the proposed bills requires language services.
Dr. Alice Chen, Medical Director of the General Medicine Clinic at San Francisco General Hospital, asserted that language services should be “at the core of new policies,” pointing out that California already has a good foundation for culturally diverse healthcare that can be built upon.
“California has a momentous opportunity to be a national leader by finding solutions that work for all communities in the state,” said Ellen Wu, Director of the California Pan-Ethnic Health Network, “which means we must support linguistically and culturally appropriate services to make reform meaningful.” She stated that the newly insured would reflect the diversity of California, and that reform should create a system that serves everyone.
“I speak English, but my wife and I feel more comfortable with a Spanish-speaking doctor, especially with all of the technical and medical terms,” said Enrique Barrera of Los Angeles, who is employed but recently decided he couldn’t afford the $560 monthly insurance co-payment. “We were looking for a Spanishspeaking doctor, but had to make an appointment so far in advance, and then when we arrived the doctor was on vacation. I prefer going to the community clinic: I feel more comfortable because you don’t need an appointment, and the doctor speaks my fi rst language.”
At the press conference, heathcare reform advocates emphasized that resources for community-based clinics– often the best option for linguistically appropriate care for low-income patients– should be prioritized under the new plan.
“The clinics care more about the community, they’re not always thinking about money,” Barrera added. “But because they’re underfunded, they have problems with adequate supplies.”
The Healthy San Francisco program, launched July 2, reflects a similar need for services geared toward culturally diverse populations. The program is designed to cover as many as 82,000 San Franciscans who don’t have health coverage through work or elsewhere.
“San Francisco can provide a good model for statewide reform,” said Dr. Chen. She highlighted the fact that trust is a key issue between doctors and patients, and that trust is often based on care provided in the patient’s native language.
