Monday, April 22, 2013

FDA: "Making Health and Health Care Equal for All"

    Liberals have long been accused of wanting to "level the playing field" by dragging everyone down to the same level rather than giving everyone equal opportunity by securing the rights to life, liberty and the pursuit of happiness.  A recent post on the website of the Food and Drug Administration (FDA) is only going to reinforce that notion.  The post is titled "Making Health and Health Care Equal for All" and explains the mission of the Office of Minority Health (OMH), established by the Affordable Care Act:
What exactly are health disparities? And how can they be reduced or eliminated? 
At the Food and Drug Administration (FDA), achieving equality in health and health care is part of the mission of the Office of Minority Health (OMH). The office was established in 2010 by the Affordable Care Act to help the agency address the needs of Americans who may be more vulnerable because of their race, ethnicity or other factors...
There can be many causes of health disparities, says [OMH Director Jonca Bull, M.D.]. They range from underlying genetics to socio-economic status, lack of insurance and lack of access to quality health care, including preventive care and follow-ups when a disease is diagnosed. And this can be complicated by limited English proficiency, which can affect the quality of a patient's interaction with a health care professional.
    The article lists several diseases and conditions that have higher rates of incidence among certain ethnic groups, and notes that "minority populations ... also have higher rates of obesity, asthma, preventable hospitalizations and infant deaths."

    So what is being done?
    FDA works in partnership with its counterparts in [Health and Human Services] but as a regulatory agency, its role is unique in bringing about changes that could help level the playing field when it comes to health and health care. 
Essentially, everything FDA's OMH does is related to fighting racial and ethnic health disparities[.]
    Again, talk of working to "level the playing field" and "fighting... disparities." But what about improving health?  Here are the four bullet points in the article:
  • Enhancing diversity on FDA's scientific advisory committees is one area of focus, involving the recruitment of independent experts who have a scientific background in related health fields and expertise in the areas of minority health and health disparities. These advisory committees provide advice on health and science policy issues.
  • In December 2012, the Summit on the Science of Eliminating Health Disparities attracted more than 4,500 people and featured more than 100 workshops. The summit was led by the National Institute on Minority Health and Health Disparities and co-sponsored by OMH and HHS. Highlights of the conference will be featured in a future publication on best practices for reducing health disparities on a broad scale.
  • OMH works with health care professionals and patient advocates to increase minority representation in clinical trials of medical products.
  • The office partners with universities to advance the study of, and research into, health disparities and the regulatory science that is the foundation of FDA's decisions.

    With the possible exception of the third point, none of these address actually improving the health or healthcare of anyone.  Even the third point ("increase minority representation in clinical trials of medical products") could be counterproductive if increasing minority representation skews the population sample away from one that reflects the population as a whole.

    Not until the very end of the article is there a statement about “ensuring the best health outcomes for all Americans.”  But from the very title of the article, it's a dubious assertion.  The FDA's aim is not equal access to good healthcare, but rather "Making Health and Health Care Equal for All."  If the focus is on increasing diversity and reducing disparities, the outcome is less likely to be the "best health outcomes for all Americans" and more likely to be the lowest common denominator for all.

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