Most people today are focused on health insurance reform. I’m concerned about ensuring that the Latino community’s needs are fully met by such a reform.
There are approximately 46 million uninsured Americans. About 1/3rd of those are Latinos. And according to the White House, 34% of Latinos lack health insurance.
“Latinos are by far the largest group of uninsured,” President Obama said. “Passing reform that addresses the vulnerability of this community is a critical pillar for a new economy.”
So how do we ensure reform meets not only the exigencies of reluctant Republicans and balking Blue Dogs but also the urgencies of the Latino uninsured?
Digging into the numbers and my experiences as a public policy communicator, I believe the Public Option is crucial to meet the needs of underserved communities.
Our privately-run health care system has failed minority groups dismally for generations, contributing to deadly health disparities among Latinos and Blacks. I’m not convinced regulating the same old health insurance providers while squeezing their budgets will create the paradigm shift required to radically alter this industry’s approach to the unique challenges Latinos face. According to the Office of Minority Health, “Hispanic health is often shaped by factors such as language/cultural barriers, lack of access to preventive care, and the lack of health insurance.” Making matters worse, Corporate America faces cultural obstacles of its own in tackling minority health needs.
My skepticism is informed by my experiences at Interlex, the advocacy marketing agency I co-founded in 1995, through which I’ve worked with the American Cancer Society, American Diabetes Association, numerous State health departments, and over a dozen hospitals.
At one point, Interlex was engaged by an insurance company specializing in illnesses that severely impact Latinos. The company – devoid of Latino executives – required assistance connecting with our community. We flew into action. The first obstacle was that they had not allocated time for developing culturally relevant materials, forcing us to merely translate their CMS-approved copy to hit their launch date. Accustomed to creating in-culture communications, we were chagrinned but determined to introduce Latinos to this important resource for their prevalent conditions. We overcame the content challenge via imagery and a grassroots team penetrating barrios and churches with the potent air cover of a multimedia campaign. Response exceeded the client’s goals. Then the second obstacle emerged. Insufficient leads were converting into customers. Among those enrolled, retention suffered. What was wrong? We discovered the answer speaking with patients. The health insurance company with the plan designed and marketed for Latinos had failed to hire bilingual salespeople, customer service representatives and clinicians to sell the plan and deliver the care. How did they correct this? Did they hire and train new personnel? Did they regroup and reengineer their approach to be more culturally relevant? No. Instead they pulled the plug on their Latino effort altogether. Servicing Latino customers – given their special needs – was more costly than projected and the returns less lucrative than anticipated. Latino patients were simply not “good business.” So, adios, amigos.
Welcome to traditionally underserved communities. If they were easier to serve and if corporations better understood how to profit doing so, they wouldn’t be neglected. Health disparities might become a distant memory of vanquished social injustice.
That’s why the Public Option is vital. It will provide a recourse for those not adequately – or equitably – served by private insurers. Through my work with government health agencies, I’ve found they’re largely comprised of fair-minded civil servants with a genuine concern for traditionally underserved audiences. They draw on extensive experience conducting outreach and purveying assistance to low-income Latinos. In Texas, when Interlex served the Department of Health, 66% of WIC’s client base was Latino. You better believe we were developing in-culture, in-language materials and they were providing service in Spanish. Public health professionals with this base of experience can build on the effectiveness of programs like Medicaid and WIC to cover and serve the 15 million uninsured Latinos. And they don’t operate under the pressure of hitting profit goals to earn bonuses at the expense of patients.
The President – buoyed by Latino leaders – should champion a Public Option within health care reform.
According to the National Hispanic Medical Association’s president, Elena Rios: “Hispanics have the worst record in terms of [health disparities.] We have the most to gain in terms of health reform.”
I couldn’t agree more. While I’m fortunate enough to be covered, I’d welcome a little insurance that health reform will truly help all people in need, including Latinos.
The opinions expressed in this commentary are solely those of Rudy Ruiz.
Rudy Ruiz has been hailed as a cultural visionary. A published author and multicultural advocate, Ruiz is an acclaimed multicultural communications entrepreneur. He founded Red, Brown and Blue as well as Interlex, one of the nation’s leading advocacy marketing agencies ranked by Ad Age as one of the Top US Agencies across all disciplines. Prior to that, Ruiz earned his BA in Government at Harvard College and his Masters in Public Policy at the Harvard Kennedy School.
La mayoría de la gente está actualmente enfocada a la reforma al sistema de salud. Y yo quiero estar seguro de que dicha reforma pueda realmente satisfacer las necesidades de la comunidad Latina.
Aproximadamente 46 millones de americanos no cuentan con seguro médico. Aproximadamente un tercio de esos 46 millones son Latinos. Y de acuerdo a la Casa Blanca, el 34% de los Latinos carecen de seguro médico.
“Los Latinos son por mucho el mayor grupo carente de seguro,” dijo el Presidente Obama. “Aprobar la reforma que responda a la vulnerabilidad de esta comunidad es un pilar crítico para una nueva economía.”
Así pues, cómo podemos garantizar que la reforma cumpla no solamente con las exigencias de los Republicanos renuentes y los obstaculizadores “Blue Dogs” * sino también las urgentes necesidades de los Latinos que carecen de seguro?
En base a las cifras y mis experiencias como comunicador de política pública, yo creo que la Opción Pública es crucial para satisfacer las necesidades de las comunidades que carecen de servicios.
Nuestro sistema de salud administrado por empresas privadas, durante generaciones les ha fallado a los grupos minoritarios contribuyendo a las fatales disparidades entre Latinos y Negros. Yo no estoy convencido que con reglamentar a los mismos proveedores de servicios médicos al tiempo que se comprimen sus presupuestos creará el cambio de paradigma que se requiere para alterar el enfoque de esta industria a los singulares retos que enfrentan los Latinos. De acuerdo a la Oficina de Salud de Minorías, “La salud Hispana es a menudo formada por factores como barreras de lenguaje y cultura, falta de acceso a la atención preventiva, y la falta de seguro médico.” Para empeorar las cosas, las corporaciones del país enfrentan sus propios obstáculos culturales para atacar las necesidades de salud de las minorías.
Mi escepticismo se forma de mis experiencias en Interlex, la agencia de mercadotecnia de promoción que en sociedad fundé en 1995, y a través de la cual he trabajado con la Sociedad Americana del Cáncer, la Asociación Americana de Diabetes, numerosos departamentos estatales de Salubridad y más de una docena de hospitales.
En una ocasión Interlex fue contratada por una compañía de seguros especializada en enfermedades que impactan seriamente a los Latinos. La compañía – carente de ejecutivos Latinos – requería de ayuda para comunicarse con nuestra comunidad. Inmediatamente pusimos manos a la obra. El primer obstáculo fue que no habían destinado tiempo para desarrollar material relevante a la cultura, forzándonos a simplemente traducir los textos que ya les habían sido aprobados para poder cumplir con la fecha de entrega. Acostumbrados a crear comunicación relevante a la cultura, estábamos disgustados pero resueltos a presentar a los Latinos este recurso tan importante para su condición predominante. Superamos el reto del contenido utilizando imágenes y un equipo base que penetraba los barrios e iglesias bajo la cobertura potente de una campaña multimedia. La respuesta superó las metas del cliente. Pero entonces surgió el segundo obstáculo. A pesar de haber muchas personas interesadas, la mayoría no se convertían en clientes. Y entre los que se inscribían, muchos no se quedaban. Qué ocurría? Descubrimos la respuesta entrevistando pacientes. La compañía de seguro médico con el plan diseñado y dirigido a los Latinos no había contratado vendedores bilingües para vender el plan, ni personal bilingüe de atención al cliente, ni personal médico bilingüe para brindar la atención. Cómo corrigieron el problema? Contrataron y entrenaron personal nuevo? Se reorganizaron y rediseñaron su enfoque para lograr mayor relevancia cultural? No, en vez de ello desistieron totalmente del proyecto. Servir a los clientes Latinos – dadas sus necesidades especiales – resultaba más costoso de lo proyectado y el retorno a la inversión menos lucrativo que lo anticipado. Los pacientes Latinos simplemente no eran un “buen negocio”. Así que . .adiós, amigos.
Bienvenidos a las comunidades tradicionalmente carentes de servicios. Si no fuera tan difícil atenderlos, y si las corporaciones pudiesen entender cómo atenderlos de forma redituable, no estarían tan abandonados. Las disparidades en salud podrían convertirse en un recuerdo lejano de injusticia social conquistada.
Es por esto que la Opción Pública es esencial. Brindará un recurso a aquellos que no son atendidos en forma adecuada o equitativa por las aseguradoras privadas. A través de mi trabajo con las agencias gubernamentales de salubridad, yo he podido comprobar que en gran parte están compuestas por funcionarios civiles que tienen una preocupación genuina por el público carente de atención. Ellos se sirven de su amplia experiencia para llegar a los Latinos de escasos recursos y prestarles ayuda. En Texas, cuando Interlex brindaba servicio al Departamento de Salubridad, el 66% de los clientes del programa WIC eran Latinos. Y por supuesto que desarrollábamos material cultural en español y atendíamos a los clientes en español. Los profesionales de Salubridad que cuentan con esta experiencia pueden elaborar en la efectividad de los programas como Medicaid y WIC para dar cobertura y servicio a los 15 millones de Latinos que carecen de seguro. Y no estarán laborando bajo la presión de cumplir con metas de utilidades para obtener bonos a expensas de los pacientes.
El presidente – impulsado por los líderes Latinos – debería abogar por la Opción Pública dentro de la reforma al sistema de salud.
De acuerdo a Elena Ríos, presidente de la Asociación Médica Nacional Hispana: “Los hispanos tienen el peor historial en cuando a disparidades de salud. Somos los que más tenemos que ganar en cuanto a la reforma a la salud.”
Estoy totalmente de acuerdo. Yo tengo la suerte de contar con seguro médico, pero estaría feliz de contar con la seguridad de que la reforma a la salud ayudará realmente a toda la gente que lo necesita, incluyendo a los Latinos.
* Nota del Traductor: Término que se refiere a aquellos Demócratas moderados y conservadores que se sienten excluidos por un Partido que creen ha virado a la izquierda.
Rudy Ruiz es conocido como un visionario cultural. Autor y campeón de los derechos de comunidades multiculturales, Ruiz es un destacado empresario de comunicaciones. Fundó Red, Brown and Blue e Interlex, una de las agencias de mercadeo social más reconocidas en la nación, proclamada por Ad Age como una de las agencias de publicidad más importantes en el pais. Anteriormente, Ruiz se graduó de Harvard College y obtuvo su maestría en Administración Pública en el Harvard Kennedy School.
August 27th, 2009 at 10:17 am
Great point Mr. Ruiz. I agree that reforming the current system alone is not the best way to increase the accessibility and affordability of health care for all communities. A strong public option will increase competition, lower costs, and enable more Americans to secure the coverage they need.
August 28th, 2009 at 5:11 pm
Mr. Ruiz, well written article, however, I think you are missing the point. You are not distinguishing between legal and illegal Hispanics. Americans do not want to spend tax dollars providing special sevices for people who are not US citizens. You can argue this point right or wrong, but it’s a fact. And, the more the economy takes a down turn, more Americans will feel this way. Also, I worked with a health disparities program for CDC, and Elena Rios is misinformed, Blacks have the worst record with health disparities. As a matter of fact, in some areas, like diabetes, Hispanics rank close to whites. You need to start taking responsibility for your actions. Lack of health insurance for Hispanics is due largely to the illegal population…sorry
August 29th, 2009 at 6:37 pm
What Mr Ruiz and other agents of the Mexican oligarchy want si to allow an influx of labor
mostly uneducated mostly pariah for the elites to the US.
These advocates of illegal immigrants do not have a fundamental understanding of the law and what it represent.
Their logic is so distorted that using the same we should release to all the bank robbers since I am sure they stole the money because they wanted to feed to their kids.
Not only their logic is distorted but the moral compass they use is not working either.
Why don’t they show that compassion with the central American workers entering illegally to Mexico?
Mexico enforce very well their southern border, they just open the doors to the northern one.
If Mr Ruiz wants to give medical attention for free to the illegal workers, fine, provide the assistance and pass the bill to the corrupt government of Felipe Calderon in Mexico.
This is an orchestrated offort from the Mexican government and the elites, in this cartel are the Ruiz, Univision, the sweat shop
owner, the Democrats looking for ignorant voters, the Republicans looking for cheap labor.
September 1st, 2009 at 5:16 pm
Good Heavens. Why is it the reflexive position of wealthy, Harvard-educated “liberals” that all of society’s ills must be cured with bigger, more intrusive government? You speak very eloquently, in English, of your experience, accomplishments, and private health insurance yet disconnect when imagining that anyone else in the Latino community might wish to follow your path to security and independence. Why must all of your fellow Latinos (and all other Americans) do as you SAY, not as you do? Must minority communities be forever coddled and patronized by the government establishment and intelligencia? Must we ALL pay for your heart-warming vision of “social justice”?
Mr. Ruiz, you are obviously an intelligent and sympathetic man. You care a great deal about the Latino community and wish to ease their sufferings with regards to lack of health insurance coverage. But can you not think of even ONE alternative, to the expansion of government, as a balm? Cross-state insurance competition and availability? REAL cafe-styled choice coverage? Eliminating the AMA monopoly on doctors? ANYTHING besides just throwing all your trust yet again in the government?
PS: I am a Latino raised on West 34th street in San Antonio… and I do NOT have health insurance.
September 2nd, 2009 at 10:32 am
Thank you all for your articulate and thoughtful arguments. This is the kind of respectful, well-thought-out dialogue and debate that I seek to inspire and facilitate via RedBrownandBlue.com. I will be giving much thought to your comments as I continue to research and write about these issues. In responding to your comments today, my goal is not to argue the merits of your positions but rather to clarify a couple of important points for the sake of accuracy. Sometimes it’s tempting to tune out a person’s viewpoint by dismissing that person’s credibility. This is what I wish to avoid by making sure that you and other readers have a clear understanding of my background. In particular, I’d like to explain that by no means am I a member of Mexico’s elite oligarchy nor am I thinking or working in conjunction with any orchestrated effort of any kind. I am, and have always been, an independent thinker. I was born in the United States and am an American citizen. I grew up in my birthplace – Brownsville, Texas – back when it was still a sleepy border town. My mom was an immigrant that didn’t bring much to America except wonderful values and a commitment to nurturing in her children strong ideals, faith and an appreciation for reading and education. My father was the son of two orphaned immigrants. He grew up on the wrong side of the tracks in Brownsville and worked his way through both high school and college. He was the first to attend college from either side of my family. And he is still working hard at 69 as a self-employed, registered pharmacist. Neither of my parents ever felt they could afford health insurance, but they never qualified for government assistance until they turned 65. As for me, I was the first of my family to attend Harvard, my lifelong dream. I worked as a bartender to help pay my way through school while my parents sacrificed to help me. The rest of the costs were paid for via scholarships and students loans that I repaid in full over nearly 10 years. When my wife and I started our business, we did so without any financial contributions or investments by anyone. That’s how it’s always been for me and I feel my experience is very American rather than that of a Latin American elite.
I would ask you to please read a column I wrote where I actually call on Mexico’s elite to work towards fundamental socioeconomic change in Mexico; I think you’ll see that not only am I not allied with an ulterior agenda, but rather advocate for change on both sides of the border. That column can be found at this link:
http://www.cnn.com/2009/WORLD/americas/08/13/ruiz.drug.war/index.html
In closing, while I love my heritage and draw much inspiration from it, growing up on the border gave me a very strong sense of the deep flaws in the Mexican system. As a result, I embraced the ideals and promise of the American Dream. I do tend to be generous in my desire to “do good,” but I attribute this to two core values instilled in me since my childhood: my Catholic/Christian upbringing which taught me that it’s intrinsically good to help others, especially the less fortunate, and my belief in the American ideals of freedom, equality, compassion and democracy. Sometimes these values may lead me to put forth a very heartwarming vision for our society. This is because I truly believe we can live up to America’s best ideals if we never give up trying. Alexis de Toqueville once said that “America is great because she is good. If America ceases to be good, America will cease to be great.” I’m devoted to the continuous improvement of America by adhering to the principles upon which the nation was founded. And I’m willing to help pay for it with my hard earned money. I don’t expect everyone to feel the same way, but I will do my best to encourage them to consider the possibilities. Thanks again. Let’s keep the conversation going. And thanks for visiting RedBrownandBlue.
September 3rd, 2009 at 7:19 am
No American should be left without healthcare, regardless of ethnic heritage or income!
Although, I believe there are multiple Americas, we need to stop distinguishing ourselves as something other than American, because it further divides us. I value my Italian heritage, but I would never define myself as Italian. I am simply American. My birth certificate says it, my passport says it and my state health care says it.
It would be great, if the only box we needed to check on health care forms is American.
September 3rd, 2009 at 1:40 pm
Mr. Ruiz, sorry if I come off insensitive but as an alternative consider this. When my German grandparents came to this country they were not provided “culturally sensitive” information about healthcare or anything. They were forced to learn English. Why don’t the latinos do the same. Adapt our culture as our grandfathers did rather than demand that we accept yours.
Dan Callen
September 3rd, 2009 at 2:09 pm
Sorry but I disagree, I feel they are many that chose not to pay for health insure for they know the can use the ER and not pay for the service. I’m for health care reform but feel private insurance is the way to go. mandate that everyone buy insurance and if they truly can’t afforded it subsidized it.
September 3rd, 2009 at 2:36 pm
Healthcare is a privilege not a right, however, healthcare should be more affordable and attainable. Will handing out free healthcare motivate people to become self sufficent or more dependent on gov programs? This is a crisis with no easy solution but free healthcare is not the American way.