Three experts offered perspectives on the changing but persistent phenomenon of disparities in access to health care at panel discussion on Oct. 22.
The event, which was hosted by the Health Law Society, the National Lawyers Guild and the law school’s Diversity and Inclusion Committee, was moderated by 2L Bryce Kleeman, a member of HLS who received his PharmD from the University of the Sciences.
Race, gender, geography and socioeconomic status can all create barriers to care that undermine health outcomes, said Calvin Johnson, who has served as Pennsylvania’s secretary of health and as the chief medical officer of Temple University Health System.
Robert Okwemba, a community-based pharmacist with CVS Health and former classmate of Kleeman, noted the “asymmetry of information” that puts care providers and insurance companies at an advantage over patients in understanding health care delivery and costs. In this sense, Okwemba said, even attorneys and other highly educated patients can struggle to understand relevant issues in their care.
The problem is that much harder for patients who are illiterate or do not speak English well, said Cynthia Haskin, a supervising attorney with the Philadelphia Medical-Legal Community Partnership through which Philadelphia Legal Assistance and the Philadelphia Department of Public Health serve low-income city residents.
The Affordable Care Act has made significant strides toward reducing disparities by giving the working poor access to health care insurance, though many immigrants have not benefited from the law, Haskin said.
The law also fueled innovation, moving funding toward treatments that provide the greatest impact and streamlining payment systems, Okwemba said.
The controversial law has reformed health insurance, Johnson said, observing that it encountered unrealistic expectations in the public sphere.
“It was never designed to address all issues in the health care system,” Johnson said. “We still need to reform physician payments, cost and quality issues.”
The panelists contrasted policies and attitudes surrounding the opioid crisis with those tied to the use of heroin and other illegal drugs.
Johnson recalled that during his training to become a physician, he was advised to be skeptical of “drug-seeking behaviors” of patients with sickle-cell disease, most of whom are black, despite the acute pain that is a common symptom of the disorder.
In contrast, he said, it’s largely white, working poor people who have been ensnared in opioid addiction.
Opioid abuse is viewed as a disorder, Okwemba said, observing that the antidote Naloxone is readily available without a prescription.
“It’s being managed as an epidemic,” Okwemba said. “We’re looking at it from a different lens.”