Last Updated Jun 2008
Addressing Health Disparities One Bill at a Time
Addressing Health Disparities One Bill at a Time
By AdvaMed President and CEO Stephen J. Ubl.
Unfortunately, African Americans are at higher risk for a whole host of diseases and conditions compared to other segments of the U.S. population. In fact, according to a 2007 article in the Journal of the American Medical Association (JAMA), even though the past century has witnessed a steady decline in mortality rates, African Americans still experience a 30 percent higher mortality rate than Caucasians.
The disparities in rates of potentially deadly colorectal cancer, heart disease, HIV and diabetes are no exception. One of the reasons African Americans die more frequently of these types of chronic diseases is that they are less likely to be diagnosed in time.
Fortunately, advances in medical technology diagnostics are now making it possible to predict disease even before symptoms occur, to determine the benefits and risks of certain treatments before a course of action is decided, and ultimately to give patients more control over the chronic diseases that plague people of color and Americans in general.
New genomic-based tests that detect the presence of a protein associated with leukemia enable physicians to choose a drug that binds to that specific protein and inhibits its ability to reproduce. This factor helps improve early intervention, which can lead to higher survival rates. In addition, cardiac tests to diagnose a heart attack help doctors triage patients so that those with a confirmed diagnosis can be treated promptly, while patients in whom heart attack is ruled out thus avoid unnecessary procedures. These advancements hold the potential to positively change the delivery of nearly all health care services, and if widely used, could have a dramatic impact on the rates of disease in African American men, women and children.
The challenge becomes making sure these newer technologies are available to everyone, and it is particularly important to ensure access for people in underserved communities who need them most.
Rep. Bobby Rush of Illinois and Rep. Donna Christensen of the Virgin Islands, members of the Congressional Black Caucus, are to be commended for their ongoing efforts to ensure the availability of new diagnostic tools to all Americans through The Medicare Advanced Laboratory Diagnostics Act. This bill helps lay the groundwork to ensure that Medicare beneficiaries – not simply people with private health insurance or the means to pay – would be able to receive the fastest and most accurate testing available. The end goal of this legislation is a faster and more accurate diagnosis, most appropriate treatment, and better health outcomes for the patient.
The importance of diagnostic tests in improving the quality and efficiency of health care is evident in the numbers: clinical laboratory diagnostics make up less than five percent of hospital expenses and less than two percent of all Medicare costs, but they influence approximately 70 percent of all health care decisions.
Also evident is that many diagnostic tests are underutilized. According to the National Committee for Quality Assurance, 56,200 avoidable adverse health events, nearly 34,000 avoidable deaths, and $899 million in avoidable healthcare costs were linked to under usage of diagnostics-based quality measures for diabetes, cardiovascular disease, colorectal cancer and breast cancer in 2004 – all diseases that disproportionately afflict people of color.
Further, an Institute of Medicine study found that Medicare often pays substantially less for a new test that offers greater benefits to patients and the health care system than an older test, providing little incentive for the development and adoption of new tests. Half of all Medicare recipients are living at or below 200 percent of the poverty line, and the majority are women – who live longer and are more likely to develop chronic diseases such as Alzheimer’s, arthritis, hypertension and osteoporosis over time. These are not people who need additional challenges to their health, particularly when there are tools available that can have specific benefits for them as individuals based on factors like genetics. It simply doesn’t make sense to discourage this progress, particularly when the benefits are so clear.
We’ve all heard about that “ounce of prevention.” The medical technology industry is doing its part to help; it’s time for the U.S. government to do its share. Please join us in thanking Mr. Rush and Ms. Christensen for their leadership. Please contact your representative to show your support for better diagnostics for all Americans. There is so much to lose, but yet even more to gain, if we do this right.
Stephen J. Ubl is President and Chief Executive Officer of AdvaMed, the world’s largest medical technology industry trade association, headquartered in Washington, D.C.