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Fmr. AMA President on steps needed for equitable healthcare access in the U.S.

As SCOTUS Senate hearings continue for nominee Amy Coney Barrett, questions surrounding the Affordable Care Act are arising. Former American Medical Association President Dr. Patrice Harris joins 2020: A Time for Change to discuss the healthcare discrepancies in the U.S. and the potential fallout if the ACA is repealed.

Video Transcript


KRISTIN MYERS: Welcome to Yahoo Finance. I'm Kristin Myers and this is "2020-- A Time for Change." Well, Democrats have kept health care in focus this week as the Senate holds hearings for Supreme Court nominee Amy Coney Barrett. A Supreme Court case on the Affordable Care Act, also known as ACA, is upcoming. And many fear that her appointment will put it in jeopardy.

Now experts estimate that repealing Obamacare would cause over 20 million Americans to lose their health care coverage and would only worsen racial disparities. According to the Center on Budget and Policy-- Budget and Policy Priorities, the uninsured rate for Black Americans would nearly double to 20% and increase to 31% for Hispanics.

So we're now joined by Dr. Patrice Harris, the immediate past president of the American Medical Association, the largest association of doctors and medical students in the country. As always, Sibile Marcellus and Jen Rogers are also here for today's conversation.

So Dr. Harris, as I was just mentioning some of those numbers on the impact of repealing Obamacare on Black and Hispanic communities, Republicans are saying right now that they will create something better than the Affordable Care Act. Wondering what your biggest worry here as a health provider, as someone in leadership at the AMA, with an appointment of Amy Coney Barrett on the bench?

PATRICE HARRIS: Well, there is no question that people without health insurance live sicker and die younger. And here in the South where I live, a significant number of folks without health insurance are, of course, from Black and brown communities. Pre-COVID, we had a disproportionate burden of chronic disease and lack of access to health care. And that has just been brought into further stark reality with COVID.

And the AMA supported the Affordable Care Act. And we believe-- we continue to support the Affordable Care Act. And we believe the best path forward is to build on the progress of the Affordable Care Act to make sure that everyone has access to affordable, meaningful health coverage.

KRISTIN MYERS: Now speaking of the coronavirus pandemic, as we've all been talking about, it's only highlighting racial disparities. It did not create them. As we're looking ahead for hopefully an aftermath of this pandemic, what needs to be done to improve, you know, health care and access to health care and also those health outcomes for those minority communities.

Is it increasing Black providers of health care? Or is it increasing hospitals in minority communities? What do we need to be working on now and going forward to really make sure that we have equitable access for everyone when it comes to health care?

PATRICE HARRIS: So you know, the answer is all of the above and more. As I've talked to so many folks over the last couple of months, there is no question that we have to have an all-of-society approach here. Of course, we need everyone to have access to affordable, meaningful health insurance.

We also need to increase the diversity of the physician workforce. As I said in my inauguration, we need to make sure that the faces of physicians match the faces of patients but not just as a checkbox. We know there's some data and some studies to support that Black men, for example, take the recommendations of Black physicians. We know that sometimes Black women feel listened to and really other community members feel listened to by physicians who look like them.

But of course, we also have to look at those upstream determinants of health. We cannot forget, again, as you note, that this is not a new phenomenon. And we need to look at issues such as structural racism, unconscious implicit biases, policies such as past lending practices that were discriminatory. All of these issues-- and transportation and access to healthy food. All of these issues need to be addressed if we really want to move towards health equity.

SIBILE MARCELLUS: The country has been paying close attention to the Supreme Court confirmation hearings. And there's been a lot of talk about possibly Obamacare being taken away from Americans in the middle of a pandemic. As a physician, what have you seen from people? Are they worried that their health care could be taken away as we're dealing with the pandemic?

PATRICE HARRIS: You know, I would say really health care has been on the minds of everyone in this country really over the last couple years. You saw folks really activate when they thought that the Affordable Care Act might be repealed several years ago. You saw folks advocate and activate around the 2018 elections.

And-- and listen. That is-- is what we need to continue to have. I always say, you know, conversations about the best path forward for health care should happen in a democracy. And we should have fair-minded debates about that. I could tell you as a psychiatrist, I know that so many more patients had access to coverage for substance use disorders based on health exchanges and expansion of Medicaid.

So I see a lot of worry about repealing or replacing or declaring the Affordable Care Act unconstitutional. Again, the AMA has been activated as well because we do believe that we should, again, build on the progress made with the Affordable Care Act, as opposed to moving back and taking away health insurance from so many who have gained access to better care.

JEN ROGERS: Dr. Harris, the coronavirus has only brought into stark relief some of the disparities that we have in this country over health care. I want to ask you about breast cancer because it's Breast Cancer Awareness Month. And about one in eight women in the US will develop invasive breast cancer over the course of their lifetimes.

But Black women, although they're less likely to-- to develop it, are 40% more likely to die from it than white women. That's according to the CDC. And I think it points to an issue overall in health care. It's a real-- a 1, 2 punch that Black women face racism and also sexism. So do you see solutions out there for this issue?

PATRICE HARRIS: Well, you know, again, we want to make sure that Black women have access to mammograms so they can be screened early on. Because as you state, it's not so much that the incidence is greater. But we are certainly dying in greater numbers from breast cancer.

And one reason-- it's always complicated. But one reason is the time of diagnosis, getting diagnosed later on in the course of the disease. And so we have to make sure that everyone has access to health care so that they can get in early, have a usual source of care, make sure they're having preventative care.

And by the way, we don't talk about this enough. But prevention and preventative services were covered in the Affordable Care Act. So again, for so many reasons-- and many of those reasons impact Black and brown communities, or many of those reasons are important to Black and brown communities-- we certainly need to make sure everyone has access to this coverage.

KRISTIN MYERS: So picking up on that-- and Dr. Harris, you mentioned some of those things about-- about health outcomes and how they improve when essentially patients have doctors that look like them. And I've been talking to a lot of my friends who are currently in residency just about all of the hurdles that students face but particularly students of color to get into, get through medical school, get through residency.

Wondering from your perspective what needs to happen either at the level of medical school, at the level of residency, or perhaps even sooner to really make sure that we are increasing the number of minority health care providers?

PATRICE HARRIS: Well, you know, I'm a child psychiatrist. And it probably won't surprise you to hear me say that I think that we really need to start early if we want to make sure there are solid foundations for learning, right? Even in early childhood education, we need to have those solid foundations for learning because oftentimes what happens early on in school dictates how far our students will go.

Now we also have to make sure that our schools are adequately funded and adequately resourced. We have to look at issues around school discipline. You know, there had been some studies that show that Black boys in particular are disciplined more, perhaps referred for more punitive measures more often. But again, so we really have to start early on and look at all of these issues in the pipeline.

Of course, as we get further along, I know programs like they have at the Morehouse School of Medicine here in Atlanta where I am, these pipeline programs, again, where we connect with children and young students in junior high and high school, really all along the way undergraduate and even in medical school.

Because you know, just because you may not have done so well on the entrance exam doesn't mean you won't succeed in medical school. And I know that Dr. Valerie Montgomery Rice and all of her colleagues over at Morehouse are demonstrating success in many of these pipeline programs.

So we have to start early. And we have to make sure there is support for student success all along the way because it is a long journey to become a physician, no question. Well worth it, in my opinion, but a very long journey. And we need to make sure we are nurturing students to do that.

You know, just quickly one of the reasons I was just so proud, many reasons, of my accomplishment as the first African-American woman president of AMA is I could be evidence, tangible evidence, that you certainly can aspire to become a physician and even aspire to leadership positions in organized medicine. And it's important because we know that a diverse workforce means better health outcomes.

KRISTIN MYERS: All right. Well, I wish we had so much more time, but we'll have to leave that conversation there. Dr. Patrice Harris, immediate past president and, as she reminded us, the first Black female president of the American Medical Association. Thank you so much for joining us today.

PATRICE HARRIS: Thank you for having me.