On April 3, 2014, the 12th Annual Haddad Lecture featured Professor Sara Rosenbaum, JD, from George Washington University, presenting “Early News from the Front Lines on the Road to Health Equity.” In her lecture, Professor Rosenbaum discussed the strong links among geography, poverty, and health disparities, and then drew direct connections to political decisions about implementation of the Affordable Care Act (ACA) and the consequences for population health equity. With maps and compelling data, Professor Rosenbaum showed that, Americans in the Southern and Mid-western “spine” of the U.S. are disproportionately affected by poverty, both the extent of poverty and its entrenchment over time. She showed that while most Americans born into poverty have approximately a 10% chance to break into the top earning bracket, these states average less than 4%. Furthermore, poverty closely tracks unambiguous health disparities. Across these states, life expectancy rates are significantly lower for both men and women compared to the rest of Americans. The people in these states also experience higher rates of diabetes and obesity, with obesity rates exceeding 30% in some states.
Given this health inequity, it is discouraging that Southern and Mid-western states have refused to expand Medicaid under provisions of the ACA. Opting out of Medicaid expansions flies in the face of overwhelming evidence that their poor residents – those who would qualify for the new coverage – critically need health services. Professor Rosenbaum stated that “this is a case of geographic ethics,” and it cannot be ignored that 85% of underinsured African Americans live in these states. It was “very powerful to see the data [and] the strong correlation of illness to poverty and political decisions,” commented Mr. Ernest Haddad.
The struggle for equitable care in these states continues in the court room. As Professor Rosenbaum said, “a lawyer’s skills are not unlike a physician’s – you’ve got to diagnose a problem and treat it.” She also discussed continuing legal challenges to the ACA. Professor Rosenbaum concluded by noting that many of the states enacting restrictive voting laws are among those in this high poverty, poor health region.
Sara Rosenbaum, JD, is the Harold and Jane Hirsh Professor of Health Law and Policy and Founding Chair of the Department of Health Policy at George Washington University School of Public Health and Health Services. She also holds professorships in the Schools of Law and Medicine and Health Sciences.
The annual Haddad Lecture was created in 2003 by the Massachusetts General Hospital Office of the President to honor Ernest M. Haddad, who served as the general counsel at the MGH and Partners HealthCare for 21 years. While at the MGH, Haddad created a full-service legal office, which continues to provide legal support to the MGH and Partners. Haddad was especially known for setting the highest standard of ethics and conduct, and he played a leading role in developing a comprehensive code of conduct and conflict of interest policy for both the MGH and Partners. Haddad is now at Boston University School of Law, where he served as a faculty member and dean from 1966 to 1971. Continuing his tradition, the Mongan Institute for Health Policy sponsors an annual lecture to emphasize the importance of maintaining the highest standard of ethics and conduct in health policy <more...>