Systemic inequalities in health care burden minorities | Opinion


Kenneth Oja

Experiencing a global pandemic has exposed the huge cracks in our country’s broken health-care system. As a nurse and health-care researcher, I’ve seen the effects of the pandemic firsthand. The hospital where I work, and hospitals throughout our country, are overloaded with patients. While nurses and other health-care providers continue to do their best, they have reached the breaking point. Unfortunately, those suffering the most are our patients — especially our patients of color.

It’s unfortunate that it took a global pandemic to highlight the longstanding and systemic inequality that plagues our health-care system such as: fewer health-care facilities in Black communities; higher rates of conditions like diabetes, asthma and Alzheimer’s among people of color; longer waiting times in health-care facilities; more rejections for hospital admissions; and increases in the denial of health-care services. Even worse, the pandemic has exacerbated these issues. For example, Black Americans are five times more likely to contract COVID-19 than their white counterparts and health-care workers of color are two times more likely.

Systemic inequality in health care doesn’t stop once patients leave the hospital. Health-care debt among communities of color in Colorado is soaring. Coloradans of color have twice the medical debt-in-collection as White Coloradans and one in three Black Americans have difficulty paying medical debt compared with the 16% of their White counterparts.

This leaves Coloradans facing dire financial situations. In relation to health-care debt, 46% of Coloradans reported the need to use a credit card to pay for health-care services. Another 37% of Coloradans reported that they were unable to pay for basic necessities like food and shelter. An additional 16% reported taking out a loan to pay for health care. Five percent of Coloradans destroyed their credit and declared bankruptcy due to the cost of health-care.

Instead of working with people to help pay health-care debts in a compassionate way, hospitals, including UC Health, have taken to outsourcing debt collection to third-party sources like Credit Services Company. This company was recently the target of a class-action lawsuit due to their predatory debt collection practices.

Our health-care system must change. As a nurse, I’ve seen the effects that discrimination and predatory billing practices have had on my patients of color. Our representatives at the state and federal level need to work together to pass bipartisan legislation that addresses the systemic inequalities we face in our current health-care system. The health-care system is at its breaking point. The time to act is now. 

Kenneth Oja is an assistant professor of nursing and a nurse research scientist in Colorado who assists nurses in conducting research to improve nursing practice and patient outcomes.

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