Inequality

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Family Well-Being, Public Policy, and Economic Growth: Lessons from History and Insights for the Future

September 19, 2006 ~ A Policy Education Seminar

Views about social welfare policy are shaped by assumptions about what works, what we as a nation can afford, and how the economy responds to policy. Given rapid changes in the U.S. economy and the growing national debt, how should we think about raising and spending taxpayers' dollars for the social safety net? What does history tell us about tradeoffs between universal and targeted, or mean-tested, benefit programs for families? And equally important, what are the implications for economic growth of different choices about the shape and size of the tax system that supports the safety net? Is there a common base of facts upon which our nation's leaders can develop an enduring vision to guide social welfare policy?

November 9th, 2006|

Strengthening Medicare’s Role in Reducing Racial and Ethnic Health Disparities: Summary

Medicare Brief No. 16 ~ October 2006

This brief provides a handy, four-page summary of the report of NASI's Study Panel on Medicare and Disparities.

Disparities in health care for racial and ethnic minorities and low-income persons pose a pressing national problem. The study panel concludes that Medicare is obligated to take the lead in reducing disparities—both for its beneficiaries and throughout the health system—and makes 17 recommendations to those who set policy for and administer the Medicare program.

October 5th, 2006|

Strengthening Medicare’s Role in Reducing Racial and Ethnic Health Disparities

October 2006

Disparities in health care for racial and ethnic minorities and low-income persons pose a pressing national problem. This report of a study panel convened by the National Academy of Social Insurance examines Medicare's role in moving towards a solution.

Disparities in access to health care and medical treatment have been documented again and again. Even among Medicare beneficiaries, marked disparities persist in health care, although disparities in the use of health care services by race and income have diminished since Medicare's implementation. Minorities also fall short of whites on many measures of health status.

October 5th, 2006|

Medicare, the National Quality Infrastructure, and Health Disparities

Medicare Brief No. 14 ~ October 2006

Summary: What can Medicare do to improve quality and reduce disparities in clinical care? Increasing the cultural competence of individual physicians and their use of evidence-based guidelines will be useful—but insufficient. What is needed are organized care management processes that will support physicians and medical teams in their clinical decisionmaking, assist patients in managing their own illnesses, and provide clinicians with feedback on their performance.

October 5th, 2006|

Improving Medicare’s Data on Race and Ethnicity

Medicare Brief No. 15 ~ October 2006

Summary: Medicare's databases provide a rich source of information about the program's 43 million beneficiaries. These data have played an important role in documenting racial, ethnic, and socioeconomic disparities in health and health care. Because they derive largely from administrative records that have been collected over many years using varying standards, however, they are not fully adequate for monitoring and reducing disparities.

October 5th, 2006|

A New Strategy to Combat Racial Inequality in American Health Care Delivery

Title VI of the Civil Rights Act prohibits discrimination on the basis of race, color, and national origin in programs and activities receiving federal financial assistance. Title VI applies both to intentional discrimination and to the unintentional, disparate impact of superficially neutral policies and practices. Since a 2001 Supreme Court decision, however, charges of disparate impact can be brought only by federal agencies.

This article provides an overview of Title VI and its application to the health care industry. The author advances a new strategy that would reestablish a private individual's right to bring a claim of disparate impact by alleging that civil rights violators have defrauded the U.S. government in violation of the Civil False Claims Act.

August 1st, 2006|

Racial and Ethnic Disparities in Medicare: What the Department of Health and Human Services and the Centers for Medicare and Medicaid Services Can, and Should, Do

This paper discusses concrete steps that the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) could take today within the scope of their current legislative authority to address racial and ethnic disparities in Medicare. The first and most important of these steps is for HHS and CMS to make the elimination of racial and ethnic disparities from the Medicare program a top priority. If the disparity problem were to become a priority for Medicare—as important, for example, as the promotion of the Medicare Advantage or the new prescription drug program is currently to CMS–much could be accomplished. Once CMS and HHS decide that addressing racial and ethnic disparities is an issue worthy of greater attention, there are many steps that they can potentially take to deal with disparities.

May 27th, 2005|
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