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Mrs. Clinton focuses on minority health issues


WASHINGTON -- Reaching out to minorities, Hillary Rodham Clinton assured black and Hispanic lawmakers yesterday that the president's task force on health care reform is attuned to the special health needs of their constituents.

Some lawmakers have worried that the task force lacks minority representation and sensitivity to their unique health issues.

Studies show that compared to non-Hispanic whites, blacks and Hispanics receive less medical care and are more likely to be uninsured. And minorities are less likely to get sophisticated treatments, such as bypass surgery, when they do have insurance.

Meeting separately on Capitol Hill with the congressional black and Hispanic caucuses, Mrs. Clinton, head of the task force, listened to their concerns and promised a closer working relationship with them. But she gave no indication of what policies the task force will espouse when it makes a final report by May 1.

"We're looking at all the options," she told reporters between meetings of the caucuses, which were private.

Several members of the black caucus -- including its chairman, Maryland Rep. Kweisi Mfume, a Baltimore Democrat -- are co-sponsoring a health reform bill being introduced today in Congress. It is modeled on the Canadian system, which has the government pay all medical bills and people pay for health care with taxes rather than insurance premiums.

The administration has ruled out such a financing system, although other aspects of the Canadian system, such as universal coverage, are among President Clinton's goals.

Several black lawmakers, including Mr. Mfume, who escorted Mrs. Clinton into the meeting, praised her after their hour-long discussion with the first lady.

Yet it remained unclear how many minorities are among the 300-member task force staff. The administration has refused to identify the staff or to open meetings to the public.

Although Mrs. Clinton read off several names of minority staff yesterday, some black lawmakers said they hadn't heard of the individuals.

White House spokesman Bob Boorstin said minorities are "represented on a number of the working groups" that make up the task force, but he could not say specifically how many.

Mrs. Clinton impressed lawmakers with her familiarity with minority health needs and told reporters that in the Hispanic and black communities there is a "disproportionate" number of people who "are underserved." She said the nation is "not doing as good a job as we should be doing in providing access to quality, affordable health care right now."

Health experts say that lack of access to medical care and the high cost of health services and insurance are the key issues bedeviling minorities. Because of poverty, discrimination, ignorance of the medical system, a shortage of minority health professionals and other factors, blacks and Hispanics are less likely to receive health care than whites.

Blacks are nearly 1 1/2 times as likely as whites to die of heart disease, the leading cause of death in the population as a whole, according to the National Center for Health Statistics.

They are also at greater risk to die of cancer, strokes, diabetes, liver disease and AIDS.

For Hispanics, lack of insurance is a critical problem: One study found that 39 percent were uninsured in 1989, a rate three times higher than that for non-Hispanic whites, and twice that of blacks.

But having the ability to pay for care does not necessarily mean that minorities will receive it. There are insufficient medical services available in inner cities and rural areas. A lot of minorities wind up going to hospital emergency rooms for expensive treatment, often long after their condition has worsened.

"There's a shortage of primary care," said Suezanne Orr, an associate professor at the Johns Hopkins School of Public Health.

"We cut back in recent years in [funding for] community health centers and the National Health Service Corps, that were putting physicians in areas where there were shortages of primary care physicians."

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