health care problems derive from failures of medical professionals to
communicate effectively or to fully understand the cultural barriers their
patients face. As this section emphasizes, state lawmakers can make significant inroads by requiring cultural competency trainings for providers, reducing language barriers in medical centers, and increasing workforce diversity.
In 2000, the World Health Organization ranked the US health care system 37th in the world despite spending more than any other country. In 2007, according to the US Census Bureau, the US ranked 42nd in life expectancy.
If you are a person of color, a low-wage worker, non-English speaking,
or live in a low-income community, the picture is much worse. For
instance, the life expectancy for African-Americans
is 73.3 years, five years shorter than it is for whites. For
African-American men, it is 69.8 years, just above averages in Iran and
Syria, but below Nicaragua and Morocco.
Incremental steps to improve the health care system can lay the
foundation for comprehensive reform that provides health care for all.
Comprehensive reforms enacted in Massachusetts, Vermont, Maine and San Francisco were, in large part, the result of pragmatic incremental steps those states had already taken. For example, a Families USA report discusses the many reforms Massachusetts put in place over the years that led to its comprehensive 2006 reform. Not every state is as far along in moving comprehensive health care reform, but
each state does have numerous options for increasing access to
coverage, reducing the growth of health care costs, and improving the
quality of care.