Roundtable Discussion: Is Equal Access the Prescription for Equity?

Introduction

Health care reform recently has emerged at the forefront of national debates. Brought to the table by the Clinton administration, the issue of health care is critical to economic and social progress in the country. The United States spends over 14 percent of the Gross Domestic Product (GDP) per year on health care; the average inflation rate for health care spending from 1983 to 1991 was approximately 7 percent. These high numbers reflect the dual standards of American health care: while nearly thirty-nine millionAmericans are currently uninsured, those who do have access to American medical treatment receive what may be the highest quality health care in the world.

Victor W. Sidel, MD., of Montefiore Medical Center in the Bronx, New York, led the panel of experts and moderated the discussion. Participants included Dr. Katy Anastos, primary care physician, Bronx Lebanan Hospital; Jennifer Dohm, Director of Midwifery Services, Morris Heights Health Center; Nitza Milagros Escalera, attorney, Community Service Society of New York; Peter Holland, Consumer Affairs Director, Lambeth Family Health Authority, London, England; Sylvia Kleinman, National Gray Panthers; Professor Sylvia Law, New York University School of Law; Jack O’Sullivan, journalist, The Independent; Robert Padgug, Director of HealthPolicy, Empire Blue Cross Blue Shield; Dennis Rivera, President, Local1199, New York State Health Care Workers Union; Professor Dorothy Roberts, Rutgers Law School; and Professor Beth Weitzman, New York University Wagner School of Public Service. During the first half of the program, experts on the panel elaborated on these problems of cost and access and their effect on the current state of health care delivery. Looking for solutions to existing problems was the focus of the second half of the discussion.