Last week in this column we discussed how community programs, physicians and medical schools, and pharmaceutical companies can help reduce healthcare disparities. This week we look at three other players who can contribute to the effort.
Conclusion of a three-part column
Insurance plans
The Affordable Care Act is adding millions of new healthcare consumers to the market but adds no new doctors to serve them. This limitation is compounded by insurance plans now restricting which doctors can see the patients the insurance plans cover by either refusing to add the doctors to their coverage or dropping doctors they were already covering.
By limiting their patients’ access to physicians, the health plans contend they save money, but in doing so, they restrict everyone from choosing their own doctor and ultimately perpetuate the health disparities.
And this is having an effect already. I can’t tell you how many times a patient has told me, “I really loved my doctor, but my insurance changed and I can no longer see her.” Losing this relationship is not good for healthcare outcomes: When people have a good relationship with a doctor, health improves and disparities decrease.
Elected officials
This is compounded when the physicians being excluded from coverage are those who treat patients based on the patient’s need rather than the insurance company’s cost. Referring to a specialist or prescribing the most effective medications 
when a patient truly needs it should not cause an insurance company to sever the physician-patient relationship, and our elected officials should not allow that to happen.
As most states do, our government must require health plans to cover the services of all doctors in good standing, giving patients the right to choose their own doctor, the doctor for their children, and doctors for their aging parents. This will increase access, reduce disparities, and improve overall health.
On a personal note, we may be reaching the breaking point for doctors to focus on good care for their patients. Did you know that most doctors spend from two to three hours every day typing information into mandated electronic health records?
While we need meaningful information about healthcare outcomes, how many more patients could be served during that time? We must develop and implement a better systems with governmental and physician input.
The media
Finally, the media can help in the effort to reduce healthcare disparities by running regular stories on the importance of a Personal Health Plan (PHP) and sticking to it. Celebrities and community leaders could take this on and make an incredible contribution to the well-being of individuals and the community.
They can focus on the need for better eating habits — why is it there is a special value menu with fried foods and 1/2 gallon soda for 99 cents, but bottled water costs $2 and a healthy salad is $4.99? — and providing low-income consumers healthy, affordable choices.
If we start with our children by teaching the extreme importance of eating healthy and staying physically fit, by the time they are adults they will be committed to their health unlike any previous generation. By then, a PHP will be an accepted part of life, as will making sure everyone in the family has a PHP.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.
