Excerpt: Latinos' Access to Employment-Based Health Insurance

Brown, Richard E., and Hongjian Yu. [2002] 2005. "Latinos' Access to Employment-Based Health Insurance". Pp. 348-353 in Understanding Society, 2nd ed., edited by Margaret L. Andersen, Kim Logio, and Howard Taylor. Belmont, CA: Thomson Learning, Inc.

The problem: 37% of Latinos do not have health insurance (as of this article, published in 2002). The authors note that Latinos are more likely than non-Hispanic whites to report being in "fair" or "poor" health and less likely to visit a doctor. That is to say, Latinos have the same or greater need for health services but are less likely to use them. The authors believe that this disparity is due to the high percentage of those without health insurance, which makes medical fees and prescription costs easier to pay.

"The access barriers created by not having health insurance coverage undoubtedly contribute to the overall disparities in health status between Latinos and non-Latino whites," the authors argue. The most important source of health insurance is employment, as employers often pay a portion of the health insurance premiums (which are often written with the much lower group rates) and both employer and employee receive tax exemptions for their contributions—this means that health insurance is significantly more affordable when it comes through an employer than when it doesn't. And yet, only 69.5% of Latinos are offered health insurance at their place of employment, compared to 86.4% for non-Latino whites.

The solution, according to the authors, is "public policy". Specifically, "a national health care system that covered the entire population, or even a mandate that all employers cover those who work for them and those workers' dependents".

The argument is obvious. Health care is expensive, and insurance helps to alleviate the financial burden. Health insurance is expensive, unless offered through employment. And not all employers offer health insurance. Statistically, Latinos are more likely to take the jobs that don't offer many benefits. This is a consequence of a much larger social issue—that of Latinos' lower positions (on average) in America's class hierarchy.

Relevance: 3/5 (neutral)
Salience: 2/5 (trivial)

References:

• Brown, E.R., V. Ojeda, R. Wyn., and R. Levan. 2000. Racial and Ethnic Disparities in Access to Health Insurance and Health Care. Los Angeles and Menlo Park, CA: UCLA Center for Health Policy Research and Henry J. Kaiser Family Foundation. - factual data.
• Vega, W.A., and H. Amaro. 1994. "Latino Outlook: Good Health. Uncertain Program." Annual Review of Public Health 15:39-67. - cited in agreement.
  
• Fuentes-Afflick, E., and P. Lurie. 1997. "Low Birth Weight and Latino Ethnicity: Examining the Epidemiological Paradox." Archives of Pediatrics and Adolescent Medicine 151(7):665-74. - cited in agreement.
  
• Abraaido-Lanza, A.F., B.P. Dohrenwend, D.S. Ng-Mak, and J.B. Turner. 1989. "The Latino Mortality Paradox: a Test of the 'Salmon Bias' and Healthy Migrant Hypothesis." American Journal of Public Health 89(10):543-48. - cited in agreement.
  
• Freeman, H.E., L.H. Aiken, R.J. Blendon, and C.R. Corey. 1990. "Uninsured Working-Age Adults: Characteristics and Consequences." Health Services Research 24:811-23. - cited in agreement.
  
• Newacheck, P.W., D.C. Hughes, and J.J. Stoddard. 1996. "Children's Access to Primary Care: Differences by Race, Income, and Insurance Status." Pediatrics 7(1): 26-32. - cited in agreement.
  
• Halfon, N., D.L. Wood, R.B. Valdez, M. Pereyra, and N. Duan. 1997. "Medicaid Enrollment and Health Services ccess by Latino Children in Inner-City Los Angeles." Journal of American Medical Association 277:636-41. - cited in agreement.
  
• Brown, E.R., R. Wyn, and S. Teleki. 2000. Disparities in Health Insurance and Access to Care for Residents across American Cities. New York and Los Angeles: The Commonwealth Fund and the UCLA Center for Health Policy Research. - factual data.
  
• Hajat, A., J.B. Lucas, and R. Kington. 2000. Health Outcomes among Histpanic Subgroups: Data from the National Health Interview Survey, 199-95. Advance Data from Vital and Health Statistics, no. 310. Hyattsville, MD: National Center for Health Statistics. - cited in agreement.
  
• U.S. Bureau of the Census. 2000. Projections of the Resident Population by Race, Hispanic Origin, and Nation, Middle Series, 1999 to 2100. Washington, DC: U.S. Census Bureau. - factual data.
  
• U.S. Congressional Budget Office. 1997. Trends in Health Care Spending by the Private Sector. Washington, DC: U.S. Congressional Budget Office. - factual data.