Hispanics get overlooked in health care debate
September 15, 2009

The American Medical Association, insurance companies, businesses and even labor have taken turns at opposing "socialized medicine" over the past six decades.

Written by Ronald and Jacqueline Angel, LBJ School of Public Affairs , Austin-American Statesman

The American Medical Association, insurance companies, businesses and even labor have taken turns at opposing "socialized medicine" over the past six decades.

As the debate over President Barack Obama's health care reform initiatives shows, the public is often confused by the complexity of the financing of heath care. Workers with employer-based coverage and older citizens on Medicare fear that their care or their choice of providers may be restricted. Yet this time the debate is a bit different because many of the old adversaries, including big insurance and business, recognize the need to get some control over the spiraling cost of coverage.

Those with good insurance probably have little to gain personally from reforms designed to cover the 47 million uninsured Americans. Yet those uninsured individuals and families represent a serious drain on the health care system and the economy at large.

Of particular relevance to Texas is the serious lack of coverage among the Mexican-origin population. In 2007, while 16 percent of non-Hispanic whites were without coverage for all or part of the year, approximately 40 percent of Latinos in the state were uninsured. Inadequate health insurance and the serious lack of retirement coverage among Latinos Americans are documented in our new book, "Hispanic Families at Risk: The New Economy, Work, and the Welfare State"

We found that although many factors contribute to the growing number of uninsured Latinos, the serious lack of health insurance among Mexican-origin families is largely explained by the same factors that account for this group's relatively low incomes and few opportunities for upward mobility.

Educational levels in the Mexican-origin population are far lower than among other groups. High school dropout rates among Mexican-origin adolescents are shockingly high; barely half of Latino students 25 and older are high school graduates. This translates directly into lower rates of college admission, and without a college education, even fewer make it into graduate and professional schools .

Unlike other developed nations that have universal health care, in the United States health care coverage is, for the most part, an employment benefit. The labor force disadvantages that Mexican-origin people face largely explains their inadequate work-based coverage and overdependence on public funding. For the poor, the public option is the only option.

This has important long-term implications. Nearly half of the population under age 5 in Texas is of Mexican-origin; only 17 percent of those over 65 are of Mexican origin.

This means that in the future a largely Latino labor force will be called upon to support a non-Latino population and to pay the taxes to support schools, replace decaying infrastructure, and pay for the rest of what the state and the country need.

If this labor force lacks the education necessary to get productive, high-paying jobs and if they suffer the diminished vitality that inadequate health care in childhood and adolescence assures, they will be in no position to bear such an imposing economic burden.

Your political predisposition will lead you to see health care as either a commodity to be bought and sold on the open market or as a citizenship right. If you think of individual's health as a collective good that guarantees the optimal productivity of our economy, you'll come to a different justification.

As a society, we accept the fact that education is vital for a productive labor force and have made education a citizenship right, at least through high school.

We have not come to the same conclusion concerning health. Yet health is wealth in the most basic sense of the term, and our collective wealth depends heavily on the health of the Mexican-origin population.

The celebration this month of Hispanic Heritage begins today and brings a unique opportunity to address the future health security of the Hispanic population and the nation's future. Next week, the International Conference Series on Aging in the Americas at the University of Texas will focus particularly on the critical issues related to Latino health and will seize the opportunity to highlight the urgency and importance of this topic.

Hopefully, lawmakers will use this forum as an avenue for stimulating new solutions as they confront the challenge.

Ronald and Jacqueline Angel teach at the LBJ School of Public Affairs. A copy of the program is available at the conference Web site:

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